VASCULAR lesions of the central nervous system (CNS) are recognized as a major cause of disability and death, outranked only by diseases of the heart and malignant neoplasms. The scope of medical research into cerebral vascular disease, however, is not proportional to the extent of the human problem which it fosters. Wylie1 suggested that his relative neglect had its origins in several misconceptions about CNS vascular disease, ie, "cerebrovascular accidents attack old people only; that the prognosis is invariably poor; that they affect brains already addled and senile with atherosclerosis"; and, finally, that they "are merely nature's method for disposing of the elderly."
In the past decade, epidemiological surveys of cerebral vascular disease have employed, for the most part, age-adjusted mortality rates gathered from death certificate reports and Board of Health statistics. Such analyses have suffered from inaccuracy and inadequacy of the source material.2,3 Statistical analyses of
Kane WC, Aronson SM. Cerebrovascular Disease in an Autopsy Population: I. Influence of Age, Ethnic Background, Sex, and Cardiomegaly Upon Frequency of Cerebral Hemorrhage. Arch Neurol. 1969;20(5):514–526. doi:10.1001/archneur.1969.00480110078007
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: