Miller Fisher
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Charles Miller Fisher (December 5, 1913,
Waterloo, Ontario Waterloo is a city in the Canadian province of Ontario. It is one of three cities in the Regional Municipality of Waterloo (formerly Waterloo County, Ontario, Waterloo County). Waterloo is situated about west-southwest of Toronto, but it is n ...
– April 14, 2012,
Albany, New York Albany ( ) is the List of capitals in the United States, capital city of the U.S. state of New York (state), New York. It is located on the west bank of the Hudson River, about south of its confluence with the Mohawk River. Albany is the oldes ...
) was a Canadian neurologist whose notable contributions include the first detailed descriptions of
lacunar stroke Lacunar stroke or lacunar cerebral infarct (LACI) is the most common type of ischemic stroke, resulting from the Vascular occlusion, occlusion of small penetrating artery, arteries that provide blood to the brain's deep structures. Patients who pr ...
s, the identification of transient ischemic attacks as stroke precursors, the identification of the link between carotid atherosclerosis and stroke, and the description of a variant form of
Guillain–Barré syndrome Guillain–Barré syndrome (GBS) is a rapid-onset Paralysis, muscle weakness caused by the immune system damaging the peripheral nervous system. Typically, both sides of the body are involved, and the initial symptoms are changes in sensation ...
which bears his name.


Education and career

Fisher received a B.A. from Victoria University in Toronto in 1935. He then attended the University of Toronto Medical School, where he received his M.D. in 1938. He continued training at
Henry Ford Hospital Henry Ford Hospital (HFH) is an 877-bed tertiary care hospital, education and research complex at the western edge of the New Center, Detroit, New Center area in Detroit, Michigan. The flagship facility for the Henry Ford Health System, it wa ...
in Detroit and Royal Victoria Hospital in
Montreal Montreal is the List of towns in Quebec, largest city in the Provinces and territories of Canada, province of Quebec, the List of the largest municipalities in Canada by population, second-largest in Canada, and the List of North American cit ...
. During World War II, Fisher served as a surgical lieutenant in the
Royal Canadian Navy The Royal Canadian Navy (RCN; , ''MRC'') is the Navy, naval force of Canada. The navy is one of three environmental commands within the Canadian Armed Forces. As of February 2024, the RCN operates 12 s, 12 s, 4 s, 4 s, 8 s, and several auxiliary ...
, and was aboard HMS ''Voltaire'' when it was sunk by German gunfire in 1941 off the coast of
Cape Verde Cape Verde or Cabo Verde, officially the Republic of Cabo Verde, is an island country and archipelagic state of West Africa in the central Atlantic Ocean, consisting of ten volcanic islands with a combined land area of about . These islands ...
. Fisher was captured and spent 3.5 years in a German prison camp, until late 1944 when he was released. Following his return to Canada, Fisher began his residency at
McGill University McGill University (French: Université McGill) is an English-language public research university in Montreal, Quebec, Canada. Founded in 1821 by royal charter,Frost, Stanley Brice. ''McGill University, Vol. I. For the Advancement of Learning, ...
at the Royal Victoria Hospital. In 1946 he worked as a Fellow at the
Montreal Neurological Institute The McGill University Health Centre (MUHC; ) is one of two major healthcare networks in the city of Montreal, Quebec. It is affiliated with McGill University and one of the largest medical complexes in Montreal. It is the largest hospital system i ...
of
McGill University McGill University (French: Université McGill) is an English-language public research university in Montreal, Quebec, Canada. Founded in 1821 by royal charter,Frost, Stanley Brice. ''McGill University, Vol. I. For the Advancement of Learning, ...
. He then began working at
Massachusetts General Hospital Massachusetts General Hospital (Mass General or MGH) is a teaching hospital located in the West End neighborhood of Boston, Massachusetts. It is the original and largest clinical education and research facility of Harvard Medical School/Harvar ...
on the stroke service, beginning a long career in stroke neurology.


Contributions

Fisher is credited with describing the clinical syndrome of the transient ischemic attack ("mini-stroke"). Fisher proved, by a series of pathological studies, the relationship between stroke and the formation of blood clots in the heart in patients with atrial fibrillation. He also showed the relationship between stroke and carotid artery stenosis, which made preventive surgery possible and greatly reduced the incidence of subsequent strokes. He was a founder of Massachusetts General Hospital Stroke Service. He contributed greatly towards the current use of
anticoagulant An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which ...
s for stroke prevention in
atrial fibrillation Atrial fibrillation (AF, AFib or A-fib) is an Heart arrhythmia, abnormal heart rhythm (arrhythmia) characterized by fibrillation, rapid and irregular beating of the Atrium (heart), atrial chambers of the heart. It often begins as short periods ...
. He contributed greatly to the understanding of stroke, more specifically carotid artery disease and lacunar infarcts and their syndromes. With regard to the lacunar syndromes he described the concept, the "pure motor stroke", the "pure sensory stroke", and the mechanism underlying the different stroke syndromes. He made a number of contributions to the understanding of Cervical artery dissection (
carotid artery dissection Carotid artery dissection is a serious condition in which a tear forms in one of the two main carotid arteries in the neck, allowing blood to enter the artery wall and separate its layers (dissection). This separation can lead to the formation of ...
and
vertebral artery dissection Vertebral artery dissection (VAD) is a flap-like tear of the inner lining of the vertebral artery, which is located in the neck and supplies blood to the brain. After the tear, blood enters the arterial wall and forms a blood clot, thickening t ...
) in the 1970s, and that of
subarachnoid hemorrhage Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid (brain), arachnoid membrane and the pia mater surrounding the human brain, brain. Symptoms may include a thunderclap headache, severe heada ...
due to
cerebral aneurysm An intracranial aneurysm, also known as a cerebral aneurysm, is a Cerebrovascular disease, cerebrovascular disorder characterized by a localized dilation or ballooning of a blood vessel in the brain due to a weakness in the vessel wall. These a ...
s. In 1956, he reported a variant of
Guillain–Barré syndrome Guillain–Barré syndrome (GBS) is a rapid-onset Paralysis, muscle weakness caused by the immune system damaging the peripheral nervous system. Typically, both sides of the body are involved, and the initial symptoms are changes in sensation ...
, nowadays known as Miller Fisher Syndrome. The "Fisher test" is also used to describe the CSF tap test which may be required in the diagnosis of
normal pressure hydrocephalus Normal pressure hydrocephalus (NPH), also called malresorptive hydrocephalus, is a form of communicating hydrocephalus in which excess cerebrospinal fluid (CSF) builds up in the Ventricles (brain), ventricles, leading to normal or slightly elevate ...
.


Personal life

C. Miller Fisher was married to Doris M. Fisher for 68 years until her death in 2008. He had two sons and one daughter.


Awards and honors

In 1952 he was the recipient of the Royal College of Physicians of Canada's Prize in Medicine, and in 1998 he entered the
Canadian Medical Hall of Fame __NOTOC__ The Canadian Medical Hall of Fame is a Canadian charitable organization, founded in 1994, that honours Canadians who have contributed to the understanding of disease and improving the health of people. It has an exhibit hall in London, ...
.


Death

Fisher died April 14, 2012, in St. Peter's Nursing & Rehabilitation Center in Albany, New York. He was 98 years old.


References


External links

*
C. Miller Fisher Papers, 1827-2004 (inclusive). H MS c230. Harvard Medical Library, Francis A. Countway Library of Medicine, Boston, Mass.
{{DEFAULTSORT:Fisher, C. Miller Canadian expatriates in the United States Canadian neurologists University of Toronto alumni 1913 births 2012 deaths People from Waterloo, Ontario