and thus more often killed. some risk factors for stroke apply only to women. primary among these are pregnancy, childbirth, menopause, and the treatment thereof (hrt). history hippocrates first described the sudden paralysis that is often associated with stroke. episodes of stroke and familial stroke have been reported from the 2nd millennium bc onward in ancient mesopotamia and persia. hippocrates (460 to 370 bc) was first to describe the phenomenon of sudden paralysis that is often associated with ischemia. apoplexy, from the greek word meaning "struck down with violence", first appeared in hippocratic writings to describe this phenomenon. the word stroke was used as a synonym for apoplectic seizure as early as 1599, and is a fairly literal translation of the greek term. the term apoplectic stroke is an archaic, nonspecific term, for a cerebrovascular accident accompanied by haemorrhage or haemorrhagic stroke. martin luther was described as having an apoplectic stroke that deprived him of his speech shortly before his death in 1546. in 1658, in his apoplexia, johann jacob wepfer (1620–1695) identified the cause of hemorrhagic stroke when he suggested that people who had died of apoplexy had bleeding in their brains. wepfer also identified the main arteries supplying the brain, the vertebral and carotid arteries, and identified the cause of a type of ischemic stroke known as a cerebral infarction when he suggested that apoplexy might be caused by a blockage to those vessels. rudolf virchow first described the mechanism of thromboembolism as a major factor. the term cerebrovascular accident was introduced in 1927, reflecting a "growing awareness and acceptance of vascular theories and (...) recognition of the consequences of a sudden disruption in the vascular supply of the brain". its use is now discouraged by a number of neurology textbooks, reasoning that the connotation of fortuitousness carried by the word accident insufficiently highlights the modifiability of the underlying risk factors. cerebrovascular insult may be used interchangeably. the term brain attack was introduced for use to underline the acute nature of stroke according to the american stroke association, which has used the term since 1990, and is used colloquially to refer to both ischemic as well as hemorrhagic stroke. research as of 2017, angioplasty and stents were under preliminary clinical research to determine the possible therapeutic advantages of these procedures in comparison to therapy with statins, antithrombotics, or antihypertensive drugs.