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. Due to the c ...

– April 14, 2012,

Albany, New York Albany ( ) is the capital of the U.S. state of New York, also the seat and largest city of Albany County. Albany is on the west bank of the Hudson River, about south of its confluence with the Mohawk River, and about north of New York City ...

) 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 occlusion of small penetrating arteries that provide blood to the brain's deep structures. Patients who present with symptoms of a lac ...

s, the identification of

transient ischemic attacks A transient ischemic attack (TIA), commonly known as a mini-stroke, is a minor stroke whose noticeable symptoms usually end in less than an hour. TIA causes the same symptoms associated with strokes, such as weakness or numbness on one side of ...

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 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 or pain often ...

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 The Temerty Faculty of Medicine (previously Faculty of Medicine) is the medical school of the University of Toronto. Founded in 1843, the faculty is based in Downtown Toronto and is one of Canada's oldest institutions of medical studies, being k ...

, 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 area in Detroit, Michigan. The flagship facility for the Henry Ford Health System, it was one of the first hos ...

in Detroit and Royal Victoria Hospital in

Montreal Montreal ( ; officially Montréal, ) is the List of the largest municipalities in Canada by population, second-most populous city in Canada and List of towns in Quebec, most populous city in the Provinces and territories of Canada, Canadian ...

. During World War II, Fisher served as a surgical lieutenant in the

Royal Canadian Navy The Royal Canadian Navy (RCN; french: Marine royale canadienne, ''MRC'') is the Navy, naval force of Canada. The RCN is one of three environmental commands within the Canadian Armed Forces. As of 2021, the RCN operates 12 frigates, four attack s ...

, and was aboard HMS ''Voltaire'' when it was sunk by German gunfire in 1941 off the coast of

Cape Verde , national_anthem = () , official_languages = Portuguese , national_languages = Cape Verdean Creole , capital = Praia , coordinates = , largest_city = capital , demonym ...

. 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: link=no, Université McGill) is an English-language public research university located in Montreal, Quebec, Canada. Founded in 1821 by royal charter granted by King George IV,Frost, Stanley Brice. ''McGill Universit ...

at the Royal Victoria Hospital. In 1946 he worked as a Fellow at the

Montreal Neurological Institute The McGill University Health Centre (MUHC; french: Centre universitaire de santé McGill) is one of two major healthcare networks in the city of Montreal, Quebec. It is affiliated with McGill University and is one of the largest medical complex in ...

. He then began working at

Massachusetts General Hospital Massachusetts General Hospital (Mass General or MGH) is the original and largest teaching hospital of Harvard Medical School located in the West End neighborhood of Boston, Massachusetts. It is the third oldest general hospital in the United Stat ...

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 A transient ischemic attack (TIA), commonly known as a mini-stroke, is a minor stroke whose noticeable symptoms usually end in less than an hour. TIA causes the same Symptoms of stroke, symptoms associated with strokes, such as weakness or numbn ...

("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 Anticoagulants, commonly known as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time. Some of them occur naturally in blood-eating animals such as leeches and mosquitoes, where the ...

s for stroke prevention in atrial fibrillation. 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 separation of the layers of the artery wall supplying oxygen-bearing blood to the head and brain and is the most common cause of stroke in young adults. ( Dissection is a blister-like de-lamination between the out ...

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 membrane and the pia mater surrounding the brain. Symptoms may include a severe headache of rapid onset, vomiting, decreased level of consci ...

due to

cerebral aneurysm An intracranial aneurysm, also known as a brain aneurysm, is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel. Aneurysms in the posterior circul ...

s. In 1956, he reported a variant of

, 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) occurs in the ventricles, and with normal or slightly elevated cerebrospinal fluid p ...

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, O ...

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