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 UK-TIA 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 hits by the end of August 2005; even more notable is that of the latest 100 publications he was the first author in 15); his efficiency in getting so much important research done with limited means; his love of teaching, reflected in the Advanced Clinical Neurology Course that was started during his time in Oxford and continued in Edinburgh (this year the 27th course was held); his anti-authoritarian attitude, which he also managed to pass on to his collaborators, at least three of whom became professors in their own right; and finally his unconventionality - instead of accepting the editorship of an existing journal he preferred to start a new one, 'Practical Neurology', in his own style. That achievement also serves to prove that he is more than a great 'strokologist' - as is his growing interest in the borderland between neurology and psychiatry.
British Neurology has known quite a few stars since Willis and his Oxford circle; Charles Warlow is unquestionably one of them.
Jan van Gijn MD FRCP FRCP(Edin), September 2005