The manuscripts in this book were generated from a conference occurring
at the University of Heidelberg in September 1996. These manuscripts
have been reviewed and updated by the designated authors in late 1997
for publication in early 1998. Conferences occur for a variety of
reasons. These include the need to exchange information where complex
activities are undergoing reassessment or change. For the emergency and
critical care man- agement of stroke this is certainly the situation.
Today, both the pri- mary care and the neurologic physician must provide
medical care in an environment where daily change in the knowledge base
of: brain function, disease mechanism(s), therapeutic efficacy, and cost
control are all occurring. In addition, patient advocacy has become
increasingly complex because government, employers, insurers, health
care providers as well as families all desire a voice in the phy- sician
relationship with the patient. Our conference subject was the
organization of rapid care delivery and the development of a ration- al
basis for treatment of a previously untreatable disorder acute stroke.
Thus, the obvious need for multiple open and free discus- sions about
priority setting and modification of current treatment plans. Clearly,
the face to face opportunities provided by this first conference on
Emergency Management And Critical Care Of Stroke (EMACCOS) are required
when patient care issues are as complex as these. Neuroscience is new to
the experience of active therapeutic inter- vention.