Medical management of stroke.

Management of stroke has been revolutionised over the past decade, and therapeutic nihilism is no longer justified. The advent of acute treatments, especially thrombolysis, where the window of opportunity for intervention is very short and the treatment carries risk, emphasises the paramount importance of correct clinical diagnosis. Neurologists will need to adopt a front line role that is unfamiliar in the UK if therapeutic advances are to be implemented safely. Closer involvement in stroke care also necessitates that neurologists keep abreast of developments in cardiovascular medicine: vascular neurologists require to be both electrician and plumber.