The role of the neurologist in the decline of stroke.

Mortality from stroke in the United States has been declining since 1900. In the population of Rochester, Minnesota the primary cause of the decline was shown to be the decrease in the incidence of new cases of stroke from 1945 through 1979. The neurologist's primary contribution to stroke prevention is the identification and management of patients who have had transient focal cerebral ischemic attacks. Although the presence of these attacks is a powerful risk for stroke occurrence, their low prevalence and the lack of clearly effective medical or surgical treatment make it unlikely that management of transient focal cerebral ischemic attacks accounts for much of the decline in the incidence or mortality of stroke.