ABN Medallist 2005

Charles Warlow has been a major influence on international neurology over the last 25 years, especially on stroke neurology. His first recorded publication (The Lancet, 1969) was on “burns encephalopathy” in children, but soon his interests turned towards haematological factors in thrombosis and embolism. Finally, with the advent of aspirin as an antithrombotic agent, the emphasis in his research shifted from the venous to the arterial side of the circulation.

In the early 1980s Charles Warlow grew into his role of a leader in stroke research by organising clinical trials. It all started with the UK­TIA aspirin trial, which compared two different doses of aspirin with placebo. Out of this collaboration grew his most conspicuous research accomplishment, the European Carotid Surgery Trial. In hindsight this was a hazardous undertaking – initially only UK centres collaborated and there was little funding, while the resistance from vascular surgeons was formidable. Nevertheless Charles managed to spread the “light of doubt” across his own country and continental Europe. His 1984 review article in Stroke “Carotid endarterectomy: does it work?” shows all the elements of the mature Warlow style: comprehensive, persuasive, slightly provocative, and peppered with irony. Once it became clear the European study would provide useful answers a similar but heavily funded “steamroller trial” from North America was launched; it was no small feat of diplomacy from the part of Charles Warlow that the two studies were eventually welded into a single, solid block of clinical evidence.

It is a fortuitous combination of personal characteristics that has resulted in Charles Warlow’s continuing success: his vision to collaborate with Richard Peto in applying epidemiological principles to clinical neurology before this became a common mantra; his capacity for hard work (a PubMed search – for what it is worth – provided 314 …