We have compared the frequency with which various drugs were used in patients with cerebrovascular disease in five countries (UK, Italy, Indonesia, Spain and Yugoslavia). There were very large variations in the use of anti-oedema agents, ‘cerebral vasodilators’, and vitamins, which were not explained by differences in the populations studied. This variation has probably less to do with any scientific validation for the various treatments, which in most cases does not exist, than with medical ‘fashion’ and commercial pressures. Large variations in prescribing habits for what is thought to be the same disease are undesirable, and reflect a dearth of facts and adequate clinical trials.

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