How Stroke Shaped the Course of History: An Uchronian Narrative Review

Historians once focused almost exclusively on momentous events and towering personalities, but in 1935, Marc Bloch challenged the "great man" paradigm when he asked Lucien Febvre, "Have you ever reflected on the problem of jam?," a call to study processes and ordinary lives that also shape the past. 1 While historians shifted focus towards larger processes, medicine took the opposite path, deriving universal principles through rigorous experimentation before evolving into precision care. 2 Stroke accounts for 10.7% of global deaths and 5.6% of all disability-adjusted life-years. 3Recent medical advancements have dramatically improved outcomes, including stroke unit care (1991), intravenous thrombolysis (1995), and mechanical thrombectomy (2015).With numbers needed to treat of 18.8, 10.9, and 2.6, respectively, these therapies showcase their profound gamechanging potential (Table 1). [4][5]][6] This narrative review investigates the effects of contemporary therapy on individual patients, enabling readers to consider the implications of treatment for each patient and how such interventions may alter an individual's life and, ultimately, influence the course of history.To do so, we explored the theoretical (mostly uchronian) potential impact of these treatments on human History.The question is: "How would history have unfolded if these great personalities were treated with modern knowledge?"Through this approach, we sought to illuminate the potential wider societal impacts of stroke care by influencing individual patients.