The work presented for examination in this thesis concerns the investigation and management of patients with stroke. The underlying theme which unites the chapters is that of outcome following stroke, and how it may be influenced or predicted. Chapter one is a broad overview of stroke disease, incorporating a brief summary of the socio-economic burden of stroke in the Western world. Chapter two reports a randomised, double blind placebo-controlled study designed to investigate the effect of the angiotensin converting enzyme inhibitor perindopril upon cerebral and renal perfusion in hypertensive stroke patients with carotid artery disease. Chapter three reports a study to investigate the feasibility of rigorous control of blood glucose in hyperglycaemic patients following stroke. The prognostic significance of triglyceride concentration following ischaemic stroke is investigated in chapter four. In chapter five the prognostic significance of visible infarction on computed tomography in patients with lacunar stroke is examined. In chapter six the development and implementation of a novel diffusion- weighted magnetic resonance sequence is reported. In chapter seven, preliminary experience with the use of recombinant tissue plasminogen activator in a UK stroke centre is reported. Chapter eight contains a synopsis of the work presented, together with a brief discussion of the results in the context of our current understanding of stroke disease Future directions of study arising from the research are identified and discussed. (Abstract shortened by ProQuest.)
