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The history of the development of ideas about the causes, methods of diagnosis and treatment of ischemic stroke from the ancient world to modern times

https://doi.org/10.20340/vmi-rvz.2025.2.OZOZ.2

Abstract

Relevance. The ideas about the mechanisms of stroke development have changed over the centuries, being influenced not only by the level of technology, but also by the scientific and philosophical thought of the corresponding era.

Objective of the study: to analyze the evolution of ideas about the causes, methods of diagnosis and treatment of ischemic stroke from the Ancient World to the present day.

Materials and Methods. A historical analysis of medical literature, scientific works and clinical practice of different eras associated with the study and treatment of stroke was carried out.

Results. The transformation of the concept of ischemic stroke from the ancient Greek "apoplexy" to the modern understanding of the pathophysiology of cerebral ischemia is traced. Two main historical periods in the study of stroke are distinguished, separated by the discoveries of European scientists of the 19th century. The evolution of diagnostic methods from clinical observation to modern neuroimaging technologies, as well as the development of therapeutic approaches from symptomatic treatment to reperfusion therapy and the organization of specialized care are described.

Conclusions. Knowledge of the historical path of development of ideas about ischemic stroke allows us to understand modern approaches to its diagnosis and treatment, to evaluate the contribution of outstanding researchers and the role of scientific and technological progress in improving care for patients with cerebrovascular pathology.

About the Authors

E. V. Shevchenko
N.V. Sklifosovsky Research Institute of Emergency Medicine
Russian Federation

Evgeniy V. Shevchenko, Cand. Sci. (Med.), Head of the Neurological Department for Patients with Acute Cerebrovascular Accidents, Junior Researcher of the Scientific Department of Emergency Neurology and Rehabilitation Treatment

3, Bolshaya Sukharevskaya Square, Moscow, 129090



E. A. Kovaleva
N.V. Sklifosovsky Research Institute of Emergency Medicine
Russian Federation

Ella A. Kovaleva, Cand. Sci. (Med.), Senior Researcher of the Scientific Department of Emergency Neurology and Rehabilitation Treatment, senior lecturer of the educational Department, neurologist of the neurological department for patients with acute disorders of cerebral circulation

3, Bolshaya Sukharevskaya Square, Moscow, 129090



Kh. V. Korigova
N.V. Sklifosovsky Research Institute of Emergency Medicine
Russian Federation

Khedi V. Korigova, Junior Researcher of the Scientific Department of Emergency Neurology and Rehabilitation Treatment, neurologist of the Neurological Department for patients with acute disorders of cerebral circulation

3, Bolshaya Sukharevskaya Square, Moscow, 129090



I. S. Aliev
N.V. Sklifosovsky Research Institute of Emergency Medicine
Russian Federation

Ilgar S. Aliev, Cand. Sci. (Med.), leading researcher of the Scientific Department of Emergency Neurology and Rehabilitation Treatment, head of the Intensive Care Unit and Intensive Care unit for patients with acute disorders of cerebral circulation

3, Bolshaya Sukharevskaya Square, Moscow, 129090



G. R. Ramazanov
N.V. Sklifosovsky Research Institute of Emergency Medicine
Russian Federation

Ganipa R. Ramazanov, Cand. Sci. (Med.), Deputy Director – Head of the RSC, Head of the Scientific Department of Emergency Neurology and Rehabilitation Treatment

3, Bolshaya Sukharevskaya Square, Moscow, 129090



References

1. 1 Muresanu D, Dobran SA, Cretoiu D. The birth of neurotrauma: a historical perspective from the Academy of Multidisciplinary Neurotraumatology (AMN). J Med Life. 2021;14(6):737-739. PMID: 35126741 https://doi.org/10.25122/jml-2021-1006

2. 2 Matyushchenko VS. Naturalist period in the development of greek philosophy of medicine. Amurskiy meditsinskiy zhurnal. 2018;(3(23)):6668. https://doi.org/10.22448/AMJ.2018.3.66-68

3. 3 Tsoucalas G, Papaioannou TG, Karamanou M. The Hippocratic Doctrine of "the Acute Brain Suffering" as the Brain Stroke. J Stroke Cerebrovasc Dis. 2019;28(2):412-417. PMID: 30420317 https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.10.017

4. 4 Langhorne P. The Stroke Unit Story: Where Have We Been and Where Are We Going? Cerebrovasc Dis. 2021;50(6):636-643. PMID: 34547746 https://doi.org/10.1159/000518934

5. 5 Pyatnitskiy NYu. The Evolution of the theory of disease and mental disorders in antiquity: from croton school to alexandrian school. Psikhiatriya i psikhofarmakoterapiya. 2022;24(3):58-65. (In Russ.)

6. 6 Piradov M.A., Chernikova L.A., Suponeva N.A. Plastichnost' mozga i sovremennye tekhnologii neyroreabilitatsii. Vestnik Rossiyskoy akademii nauk. 2018; 88(4):299-312. (In Russ.) https://doi.org/10.7868/S0869587318040023

7. 7 Adams GF. History and the half-dead disease. Campbell oration 1972. Ulster Med J. 1972;41(2):89-107. PMID: 4563630

8. 8 Lippert-Grüner M. Paresis, historical therapy in the perspective of Caelius Aurelianus, with special reference to the use of hydrotherapy in antiquity. J Hist Neurosci. 2002;11(2):105-109. PMID: 12122803 https://doi.org/10.1076/jhin.11.2.105.15192

9. 9 Karenberg A. Historic review: select chapters of a history of stroke. Neurol Res Pract. 2020;2:34. Published 2020 Dec 1. PMID: 33324934 https://doi.org/10.1186/s42466-020-00082-0eCollection2020

10. 10 Schutta HS. Morgagni on apoplexy in De Sedibus: a historical perspective. J Hist Neurosci. 2009;18(1):1-24. PMID: 19160111 https://doi.org/10.1080/09647040701578219

11. 11 Walusinski O. Jean-André Rochoux (1787-1852), a physician philosopher at the dawn of vascular neurology. Rev Neurol (Paris). 2017;173(9):532-541. PMID: 28434506 https://doi.org/10.1016/j.neurol.2017.03.026

12. 12 Poirier J, Chretien F. Léon Rostan (1790-1866). J Neurol. 2000;247(8):659-660. PMID: 11041341 https://doi.org/10.1007/s004150070142

13. 13 Leicester J. Rudolf Virchow and the Discovery of Cerebral Embolism. Stroke. 2021;52(6):e266-e268. PMID: 34029152 https://doi.org/10.1161/STROKEAHA.121.034443

14. 14 Korostovtseva LS. Rol' R. Virkhova v izuchenii ateroskleroza i ego oslozhneniy. Arterial'naya gipertenziya. 2009;15(3):400-404. (In Russ.)

15. 15 Paciaroni M, Bogousslavsky J. How did stroke become of interest to neurologists?: a slow 19th century saga. Neurology. 2009;73(9):724-728. PMID: 19720980 https://doi.org/10.1212/WNL.0b013e3181b59c1a

16. 16 Schiller F. Concepts of stroke before and after Virchow. Med Hist. 1970;14(2):115-131. PMID: 4914683 https://doi.org/10.1017/s0025727300015325

17. 17 Artico M, Spoletini M, Fumagalli L, Biagioni F, Ryskalin L, Fornai F, et al. Egas Moniz: 90 Years (1927–2017) from Cerebral Angiography. Front Neuroanat. 2017;11:81. PMID: 28974927 https://doi.org/10.3389/fnana.2017.00081eCollection2017.

18. 18 Welch K. Excision of occlusive lesions of the middle cerebral artery. J Neurosurg. 1956;13(1):73–80. PMID: 13286728 https://doi.org/10.3171/jns.1956.13.1.0073

19. 19 Meyer FB, Piepgras DG, Sundt TM Jr, Yanagihara T. Emergency embolectomy for acute occlusion of the middle cerebral artery. J Neurosurg. 1985;62(5):639-647. PMID: 3989586 https://doi.org/10.3171/jns.1985.62.5.0639

20. 20 Sittig DF, Ash JS, Ledley RS. The story behind the development of the first whole-body computerized tomography scanner as told by Robert S. Ledley. J Am Med Inform Assoc. 2006;13(5):465–469. PMID: 16799115 https://doi.org/10.1197/jamia.M2127

21. 21 Kelly MA. Stroke: a modern history. Am J Ther. 2011;18(1):51-56. PMID: 20634683 https://doi.org/10.1097/MJT.0b013e3181e13a0b

22. 22 Kashaev R.C. Otkrytie v Kazani E. K. Zavoyskim yavleniya magnitnogo rezonansa. Georesursy. 2003;2(14): 26-27. (In Russ.)

23. 23 Vander Eecken HM, Adams RD. The anatomy and functional significance of the meningeal arterial anastomoses of the human brain. J Neuropathol Exp Neurol. 1953;12(2):132-157. PMID: 13053234 https://doi.org/10.1097/00005072-195304000-00002

24. 24 Astrup J, Symon L, Branston NM, Lassen NA. Cortical evoked potential and extracellular K+ and H+ at critical levels of brain ischemia. Stroke. 1977;8(1):51–57. PMID: 13521 https://doi.org/10.1161/01.str.8.1.51

25. 25 Ermine CM, Bivard A, Parsons MW, Baron JC. The ischemic penumbra: From concept to reality. Int J Stroke. 2021;16(5):497-509. PMID: 33818215 https://doi.org/10.1177/1747493020975229

26. 26 d'Esterre CD, Boesen ME, Ahn SH, Pordeli P, Najm M, Minhas P, et al. Time-dependent computed tomographic perfusion thresholds for patients with acute ischemic stroke. Stroke. 2015;46(12):3390–3397. PMID: 26514186 https://doi.org/10.1161/STROKEAHA.115.009250

27. 27 Astrup J, Siesjö BK, Symon L. Thresholds in cerebral ischemia — the ischemic penumbra. Stroke. 1981;12(6):723–725. PMID: 6272455 https://doi.org/10.1161/01.str.12.6.723

28. 28 Marchal G, Beaudouin V, Rioux P, de la Sayette V, Le Doze F, Viader F, et al. Prolonged persistence of substantial volumes of potentially viable brain tissue after stroke. Stroke. 1996;27(4):599–606. PMID: 8614914 https://doi.org/10.1161/01.str.27.4.599

29. 29 Cornu C, Boutitie F, Candelise L, Boissel JP, Donnan GA, Hommel M, et al. Streptokinase in acute ischemic stroke: an individual patient data meta-analysis: The Thrombolysis in Acute Stroke Pooling Project. Stroke. 2000;31(7):1555-1560. PMID: 10884453 https://doi.org/10.1161/01.str.31.7.1555

30. 30 Wardlaw JM, Murray V, Berge E, Del Zoppo GJ. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst Rev. 2009;(4):CD000213. PMID: 19821269 https://doi.org/10.1002/14651858.CD000213.pub2

31. 31 del Zoppo GJ, Higashida RT, Furlan AJ, Pessin MS, Rowley HA, Gent M. PROACT: a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. PROACT Investigators. Prolyse in Acute Cerebral Thromboembolism. Stroke. 1998;29(1):4-11. PMID: 9445320 https://doi.org/10.1161/01.str.29.1.4

32. 32 Furlan A, Higashida R, Wechsler L, Gent M, Rowley H, Kase C, et al. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. JAMA. 1999;282(21):2003-2011. PMID: 10591382 https://doi.org/10.1001/jama.282.21.2003

33. 33 Loscalzo J, Braunwald E. Tissue plasminogen activator [published correction appears in N Engl J Med 1988 Nov 24;319(21):1428]. N Engl J Med. 1988;319(14):925-931. PMID: 3138537 https://doi.org/10.1056/NEJM198810063191407

34. 34 Skvortsova BI, Shamalov IA, Ramazanov GR, Sidorov AM, Kirillov MG, Luk'yanov AL, et al. Thrombolytic therapy of ischemic stroke. Skoraya meditsinskaya pomoshch'. 2008;9(4):8-12. (In Russ.)

35. 35 Suslina Z.A., Domashenko M.A. Insul't: otsenka problemy (15 let spustya). Zhurnal nevrologii i psikhiatrii im. C.C. Korsakova. 2014;114(11):513.

36. 36 Chant H, Ashleigh R, McCollum C. Thrombectomy for acute internal carotid thrombosis: five thrombectomy devices compared. Eur J Vasc Endovasc Surg. 2004;27(4):403-408. PMID: 15015191 https://doi.org/10.1016/j.ejvs.2003.12.014

37. 37 Gobin YP, Starkman S, Duckwiler GR, Grobelny T, Kidwell CS, Jahan R, et al. MERCI 1: a phase 1 study of mechanical embolus removal in cerebral ischemia. Stroke. 2004;35(12):2848-2854. PMID: 15514171 https://doi.org/10.1161/01.STR.0000147718.12954.60

38. 38 Smith WS, Sung G, Saver J, Budzik R, Duckwiler G, Liebeskind DS, et al. Mechanical thrombectomy for acute ischemic stroke: final results of the Multi MERCI trial. Stroke. 2008;39(4):1205–1212. PMID: 18309168 https://doi.org/10.1161/STROKEAHA.107.497115

39. 39 Nogueira RG, Smith WS; MERCI and Multi MERCI Writing Committee. Safety and efficacy of endovascular thrombectomy in patients with abnormal hemostasis: pooled analysis of the MERCI and multi MERCI trials. Stroke. 2009;40(2):516–522. PMID: 19095994 https://doi.org/10.1161/STROKEAHA.108.525089

40. 40 Penumbra Pivotal Stroke Trial Investigators. The penumbra pivotal stroke trial: safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease. Stroke. 2009;40(8):2761-2768. PMID: 19590057 https://doi.org/10.1161/STROKEAHA.108.544957

41. 41 Malaev DU, Grachev NI, Redkin DA. Endovascular treatments for ischemic stroke. Complex Issues of Cardiovascular Diseases. 2022;11(3):188-198. (In Russ.) https://doi.org/10.17802/2306-1278-2022-11-3-188-198

42. 42 Berkhemer OA, Fransen PS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, et al.; MR CLEAN Investigators. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372(1):11-20. PMID: 25517348 https://doi.org/10.1056/NEJMoa1411587

43. 43 Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, et al.; ESCAPE Trial Investigators. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015;372(11):1019-1030. PMID: 25671798 https://doi.org/10.1056/NEJMoa1414905

44. 44 Saver JL, Goyal M, Bonafe A, Diener HC, Levy EI, Pereira VM, et al.; SWIFT PRIME Investigators. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015;372(24):2285-2295. PMID: 25882376 https://doi.org/10.1056/NEJMoa1415061

45. 45 Campbell BC, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Yassi N, et al.; EXTEND-IA Investigators. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015;372(11):1009-1018. PMID: 25671797 https://doi.org/10.1056/NEJMoa1414792

46. 46 Jovin TG, Chamorro A, Cobo E, de Miquel MA, Molina CA, Rovira A, et al.; REVASCAT Trial Investigators. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015;372(24):2296-2306. PMID: 25882510 https://doi.org/10.1056/NEJMoa1503780

47. 47 Goyal M, Menon BK, van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, et al.; HERMES collaborators. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomized trials. Lancet. 2016;387(10029):1723-1731. PMID: 26898852 https://doi.org/10.1016/S0140-6736(16)00163-X

48. 48 Tserebral'nye krizy i insul't. Moskva: Meditsina;1971. (In Russ.)

49. 49 Gusev EI, Skvortsova VI, Martynov MYu, Kamchatnov PR, Chugunov AV. Etapnaya pomoshch' bol'nym s tserebral'nym insul'tom. Lechebnoe delo. 2004;(3):62-68. (In Russ.)

50. 50 Gusev EI, Martynov MU, Bogolepova AN. The 120th birthday anniversary of N.K. Bogolepov. S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(11):87-89. (In Russ.) https://doi.org/10.17116/jnevro202012011187

51. 51 Gusev E.I., Badalyan O.L. Levon Badalyan — uchenyy, operedivshiy vremya. Nevrologicheskiy zhurnal imeni L.O. Badalyana. 2021;2(3):113-118. (In Russ.) https://doi.org/10.46563/2686-8997-2021-2-3-113-118

52. 52 E.I. Gusev (to the 80th anniversary of birth). S.S. Korsakov Journal of Neurology and Psychiatry. 2019;119(6):7-8. (In Russ.) https://doi.org/10.17116/jnevro20191190617

53. 53 M.A. Piradov (the 60th anniversary of birth). S.S. Korsakov Journal of Neurology and Psychiatry. 2016;116(4):121-122. (In Russ.) https://doi.org/10.17116/jnevro201611641121-122

54. 54 Vladimir Viktorovich Krylov (k 60-letiyu so dnya rozhdeniya). Neyrokhirurgiya. 2017;(1):3-7. (In Russ.)

55. 55 Petrikov S.S. Otkrytie regional'nogo sosudistogo tsentra na baze NII SP im. N.V. Sklifosovskogo. Neotlozhnaya meditsinskaya pomoshch'. Zhurnal im. N.V. Sklifosovskogo. 2014;1: 5-6. (In Russ.)

56. 56 Stakhovskaya L.V., Klochikhina O.A., Bogatyreva M.D., Koshel' V.I., Mozheyko R.A., Strakhov O.A. Sravnenie zabolevaemosti insul'tom v otdel'nykh regionakh Rossiyskoy Federatsii (po dannym territorial'nopopulyatsionnogo registra insul'ta, 2009-2014 gg.). Meditsinskiy vestnik Severnogo Kavkaza. 2019; 14(1-1):64-67. (In Russ). https://doi.org/10.14300/mnnc.2019.14051

57. 57 Skvortsova VI, Volynskiy YuD, Kirillov MG, Gubskiy LV, Shamalov NA, Ramazanov GR, et al. Pervyy opyt primeneniya selektivnogo vnutriarterial'nogo trombolizisa pri lechenii insul'ta. Diagnosticheskaya i interventsionnaya radiologiya. 2007;1(1):47-58. (In Russ.)

58. 58 Skvortsova V.I., Shetova I.M., Kakorina E.P., Kamkin E.G., Boyko E.L., Dash'yan V.G., et al. Healthcare system for patients with stroke in Russia results of 10years implementation of the measures aimed at improvement of medical care for patients with acute cerebrovascular events. Annaly klinicheskoy i eksperimental'noy nevrologii. 2018;12(3):5-12. (In Russ.)


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Shevchenko E.V., Kovaleva E.A., Korigova Kh.V., Aliev I.S., Ramazanov G.R. The history of the development of ideas about the causes, methods of diagnosis and treatment of ischemic stroke from the ancient world to modern times. Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH). 2025;15(2):211-221. (In Russ.) https://doi.org/10.20340/vmi-rvz.2025.2.OZOZ.2

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