This book will contain ten sections, each of which will include a variable number of chapters describing the scientific and medical basis underlying the acute intervention of ischemic stroke. Each section will be introduced by a 1-2 page summary prepared by a clinican who will discuss the relevance of the section for a clinical audience. This summary will be composed in the form of an editorial in the New England Journal of Medicine. Each sections will deal with the fundamental science of ischemic injury, while subsequent sections will discuss the medical science of ischemic injury, followed by the medical practice. Although several excellent resources exist on this topic, none provide the relevance of this topic in every day use. Now that the field is more stable, direction of clinical practice can easily be provided. Because there are few competing projects at this time, and as the most senior figures in the field will be contributing to this text, it will become the leading text of clinical management of ischemic stroke.

Table of Contents:
SECTION PREFACE 1 BASIC PRINCIPLES: PATHOPHYSIOLOGY OF FOCAL CEREBRAL ISCHEMIA. . Part 1 Focal Cerebral Ischemia. Chapter 1 Fundamental Principles of Ischemic Injury in the Central Nervous System. Chapter 2 Neuron Receptor Biology: Responses to Ischemia. Chapter 3 Neuron/Astroglial Responses to Ischemia: I Human, ii animal models. Chapter 4 Microvascular Responses to Ischemic Injury: I Adhesion receptor biology, ii Cellular Interactions. Part 2 Inflammatory Processes During Focal Cerebral Ischemia. Chapter 5 Inflammatory Cellular Processes During Focal Ischemia. Chapter 6 Cytokines in Focal Cerebral Ischemia. Part 3 Biochemistry of Vascular Thrombosis and Recanalization . Chapter 7 Processes of Thrombosis and Thromboembolism in Arterial Disease. Chapter 8 Plasminogen Activators. Chapter 9 Coagulation and Platelet Activation During Cerebral Ischemia. Part 4 Neuron Responses to Focal Cerebral Ischemia. Chapter 10 Nitric Oxide Responses. Chapter 11 Neurotransmitter Release. Chapter 12 Secondary Injury Cascade. SECTION PREFACE 2 BASIC PRINCIPLES: CLINICAL ATTRIBUTES OF FOCAL CEREBRAL ISCHEMIA. Part 1 Thrombosis and Thromboembolism in Focal Cerebral Ischemia. Chapter 13 Carotid Territory Arterial Occlusion. Chapter 14 Vertebrobasilar Territory Occulsion. Chapter 15 Lacunar Disease. Part 2 Collateral Anastamoses. Chapter 16 The Cerebrovascular Arterial Tree and the Relevance of Collaterals: I Human, ii Animal Models. SECTION PREFACE 3 WINDOWS FOR INTERVENTION. Chapter 17 Experimental Attributes of the Window(s), including species difference. Chapter 18 Clinical Attributes Supporting the Nature of Therapeutic Windows and Their Characteristics (PET). Chapter 19 Anatomic Contributions to the Clinical Window. Chapter 20 Windows Characteristic of Therapeutic Interventions (based upon pharmacological characteristics of agents, e.g. antithrombotics, mNMDA receptor antagonists). SECTION PREFACE 4 MEASURES OF CLINICAL RESPONSE. Part 1 Imagine Approaches. Chapter 21 Relevance of the CT Scan to Patient Selection and Follow-up (ECASS/NINDS). Chapter 22 CT Scan-based Assessments. Chapter 23 Carotid Angiography: i Normal, ii Cerebral Ischemia. Chapter 24 Magnetic Resonance Imaging and Angiography: I normal, ii Cerebral Ischemia. Chapter 25 SPECT: i Normal, ii Cerebral Ischemia. Chapter 26 Transcranial Doppler. Part 2 Clinical Outcome Measures in Clinical Stroke. Chapter 27 Validation of Scales. Chapter 28 Neurological Scale Scores and Their Utility. Chapter 29 Disability Outcomes and Mortality. SECTION PREFACE 5 TECHNIQUES FOR DELIVERY. Chapter 30 Intravenous Delivery (pharmacological characteristics of individual agents). Chapter 31 Intra-arterial Delivery Systems. SECTION PREFACE 6 RISKS. Part 1 Hemorrhagic Transformation. Chapter 32 Hemorrhagic Transformation (Experimental). Chapter 33 Hemorrhagic Transformation (Clinical). Part 2 Early Mortality. Chapter 34 Causes of Early Mortality in Ischemic Stroke. SECTION PREFACE 7 THROMBOLYSIS ACUTE FOCAL CEREBRAL ISCHEMIA EXPERIMENTAL. Chapter 35 Perspectives on Experimental Background to Clinical Thrombolysis. SECTION PREFACE 8 THROMBOLYSIS IN ACUTE FOCAL CEREBRAL ISCHEMIA CLINICAL. Chapter 36 Utility of Plasminogen Activators in Myocardial Ischemia Relative to Stroke. Chapter 37 Intravenous Infusion of Plasminogen, Activators in Focal Cerebral Ischemia: i historical setting, ii u-PA and streptokinase, iii rt-PA, iv future approaches, v other agents. Chapter 38 Intra-Arterial Infusion of Plasminogen, Activators in Focal Cerebral Ischemai: i historical setting, ii u-PA and streptokinase, iii other agents, iv future approaches. SECTION PREFACE 9 OTHER VASCULAR APPROACHES WHICH MODULATE INFLAMMATION. Chapter 39 Inhibition of Adhesion Receptors and Modulation of Inflammation. Chapter 40 Neuroprotection and its Relationship to Vascular Responses. SECTION PREFACE 10 SYNTHESIS FOR THE CLINICIAN MANAGEMTNS OF PATIENTS WITH ACUTE ISCHEMIC STROKE. Chapter 41 Early Acquisition of the Stroke Patient. Chapter 42 Medical Management of Acute Ischemic Stroke. Chapter 43 Plasminogen Activators in Acute Ischemic Stroke/Intravenous. Chapter 44 Plasminogen Actvators in Acute Ischeumie Stroke/Intra-Arterial. Chapter 45 Antiplatelet Agents in the Early Management of Stroke. Chapter 46 Anticoagulant Agents in the Early Management of Stroke. Chapter 47 Other Agents/Approaches: i antihypertension agents, ii statine. Chapter 48 Surgical Management of Cerebral Ischemia. Chapter 49 Risk Factor Analysis. Chapter 50 Intensive Care Unit: Role in Acute Ischemic Stroke