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(Stroke. 2000;31:1451.)
© 2000 American Heart Association, Inc.

Special Report

CVA: Reducing the Risk of a Confused Vascular Analysis

The Feinberg Lecture

Presented as the Feinberg Lecture at the 25th International Stroke Conference, New Orleans, La, February 10, 2000.

Anthony J. Furlan, MD

Correspondence to Anthony J. Furlan, MD, Head Section of Stroke and Neurological Intensive Care, Department of Neurology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195. E-mail furlana@ccf.org

Key Words: American Heart Association • cerebrovascular disorders • clinical trials • stroke classification

	Introduction

 
Iwant to thank the Stroke Council, my friends, and colleagues for giving me the privilege of delivering the 2000 William Feinberg lecture. I am particularly honored to follow Lou Caplan. Lou is near the top of the list of individuals who have had the most influence on my career. The subtitle of his classic paper, "What is Wrong with Mr. Jones,"¹ has become the mantra for those of us who believe it is essential to know what we are treating before we know how to treat it; otherwise we run the risk of a "confused vascular analysis." I therefore honor Lou by declaring this the millennium of the stroke splitters; I confidently predict that the stroke lumpers will finally be vanquished sometime in the next 1000 years!

The first time I specifically recall being told I was professionally confused was in 1976. I was finishing the third year of my neurology residency at the Cleveland Clinic. My chairman, Jack Conomy, called me into his office to tell me I was confused. He said I really did not want to take an EMG fellowship and that I should go into something "more challenging," like stroke. I always took Jack’s advice, and to this day I cannot interpret an EMG.

Shortly after starting my stroke fellowship at the Mayo Clinic in 1977, I noticed that many patients in Rochester, Minnesota, seemed to be on coumadin. I therefore asked Burt Sandok what the rationale was for using coumadin to prevent CVAs. Burt said, . . . [Full Text of this Article]

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