Canadian Medical Association

Dr. Vladimir Hachinski

Fifty years ago, there was no treatment available for strokes. Doctors in the United States had tried to establish acute stroke units, but the lack of successful outcomes soon forced them to close.

That wasn't acceptable to neurologist Dr. Vladimir Hachinski. Early in his career, he teamed up with a colleague, Dr. John W. Norris, and they devoted themselves to caring for and studying stroke patients, establishing what would become the world's first successful acute stroke unit out of Sunnybrook Hospital in Toronto.

"We knew we probably couldn't help everyone, but we thought surely we can help some people," says Dr. Hachinski.

That turned out to be something of an understatement. Dr. Hachinski and his partner ended up defining a protocol for early intervention complemented by early rehabilitation that remains the standard of care for strokes today. The rehabilitation component of their work was led by Josephine Somerville.

No one turned away

Dr. Hachinski's clinic first focused on younger patients, presuming they might have higher chances of success. But he and Dr. Norris found themselves unwilling to turn away anyone who needed their help. They were soon conducting meticulous examinations of every patient who came to their door.

That deep effort paid off because it led them to see that early intervention was critical to recovery. They established protocols that could be applied as soon as possible after a stroke to improve outcomes dramatically.

The other success factor, Dr. Hachinski realized, was awareness. Taking his lead from previous campaigns on the signs and risks of heart attacks, he coined the term "brain attack" for strokes —reinforcing the urgency of getting medical attention as soon as the warning signs present, instead of waiting until a full stroke occurs.

Tracing connections to other conditions

Dr. Hachinski and his colleagues also identified links between strokes and heart conditions and found that strokes can increase the incidence of certain types of dementia: it may be possible to prevent some people from developing dementia by preventing them from having strokes.

"It's all connected," says Dr. Hachinski. "There is no health without brain health, so the importance of funding this kind of research cannot be overstated."

Today, Dr. Hachinski and his team are looking into the environmental factors that affect stroke risk and dementia, and are putting together a proposal for funding in hopes of expanding their research and methods.

"Over a 12-year period, we saw a 32% decrease in stroke incidence and a 7% decrease in dementia cases in Ontario," he says. "We would love to be able to isolate the sum of little things that make the biggest difference so we can extend those same results across Canada."

A team effort

Dr. Hachinski is extremely humbled to be receiving this prestigious award but notes that he wouldn't have been able to do any of it on his own.

"Everything I've ever done has been plural," he says. "So this recognition for me is also recognition for the students and colleagues I've worked with and especially the patients who have taken part in the research. I can't thank them enough for their contributions."

Dr. Vladimir Hachinski is receiving the F.N.G. Starr Award in recognition of his outstanding and inspiring lifetime achievement.

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