Historical diagnostic and therapeutic changes of ischemic stroke based on the highly cited articles

Purpose: Stroke is a global economic burden of health, which means that it is critical to evaluate changes of optimal diagnoses and treatments. The aim of the study reported herein was to identify the most-cited articles in the field of ischemic stroke and assess their characteristics. Methods: We searched all included articles that had been cited more than 100 times using the "Cited Reference Search" in February 2016 from Web of Science Core Collection. Among a total of 2,651 articles, we excluded articles on basic science and which involved only hemorrhagic strokes and identified the top-100 cited articles on ischemic stroke. Results: The number of citations for the articles analyzed in this study ranged from 5,182 to 580. Most of the articles were published in The Lancet (25%) and Stroke (23%), and originated from the United States of America (n=44). Most of them were original articles (65%) and dealt with stroke risk factors (32%) and stroke management (30%). A novel study of hyperacute treatment involving recombinant-tissue plasminogen activator was described in the top-ranked article. Conclusion: Reviews on highly cited articles can help physicians identify trends in the diagnosis and treatment of ischemic stroke in the past. This bibliometric analysis can provide a unique perspective on historical developments in this field.