Editorial: Prologue to guidelines for stroke care.

Prologue to Guidelines for Stroke Care • This prologue makes clear the factors that provided incentive for creating the Joint Committee for Stroke Facilities to prepare and publish the series of articles appearing regularly in Stroke (beginning with the May-June, 1972, issue), best described by the general title of Guidelines for Stroke Care. It points out in admirable fashion the many facets of the disease and will serve to acquaint the reader with the comprehensive nature of the subjects discussed in the "Guidelines." D One of those fragmentary recollections I carry in my mind is of my Great Uncle Bob, whom I saw only once when I was three or four years old. I was told he had had a stroke years before, and could not speak or use his arm. I recall wondering what he would look like, since I could not conceive of anyone not using his arm or being unable to talk. He was a rugged Scotsman, with a lean face and a surprising twist to the mouth that disappeared when he smiled; his right arm was held tightly against his chest and his fist was closed and positioned strangely. I was misinformed — he could talk, but all he said was "Yes, yes, yes," over and over again. In spite of his smile I was frightened by his appearance, and it shames me to remember that I would not sit on his lap. Around that vivid and unhappy childish bit of memory the years have gathered much additional information — so much that the problem can no longer be disregarded, like Uncle Bob in his attic room. The blunt fact is that each of us has a high probability of dying of a stroke. The meaning of that term, and the identification of the individual who suffers from it, are distorted in the public mind by association with an extreme example of the stroke patient — an elderly individual already doomed by the devastating effects of vascular disease on the brain and other vital organs. This stereotype does a repeated disservice to the general understanding of the stroke problem by distracting attention from an impressive catalogue of underlying and treatable diseases that may produce this brain disease in anyone, from the newborn, the infant, the youth, and the young adult to even you and me in the years of our greatest usefulness to family and society. …