Stroke. Introduction


Ischemic stroke continues to have a major impact on the public health of our nation. Ranking among the leading causes of death, stroke is far more disabling than fatal and results in enormous costs measured in both health-care dollars and lost productivity. Once considered untreatable, ischemic stroke has become subject to intensive scrutiny in recent years. Considerable research has led to a better delineation of risk factors, as well as an expanded understanding of pathophysiologic subtypes. Innovative acute therapies are being applied in a manner analogous to the treatment of acute myocardial infarction that emerged more than a decade ago. There are still many unanswered questions regarding the most effective therapies to prevent first or recurrent stroke, however recent clinical trials have helped clarify the best options for stroke prevention in a variety of settings.

Definitions of TIA and Stroke

Ischemic stroke is characterized by the abrupt or ictal onset of neurologic dysfunction due to inadequate perfusion of the brain. By conventional clinical definitions, if the neurological symptoms continue for more than 24 hours, a person is diagnosed with ischemic stroke. Otherwise, a focal neurological deficit lasting less than 24 hours is defined as a transient ischemic attack (TIA). However, with the advent of more sensitive brain imaging, acute cerebral infarcts have been identified even when symptoms last less than 24 hours. The most recent definition of ischemic stroke for clinical trials has required either symptoms lasting more than 24 hours or imaging an acute, clinically-relevant infarct among those with rapidly vanishing symptoms. When the diagnosis of stroke is made, the duration and severity of the clinical syndrome helps classify it as minor or major ischemic stroke.

2 Responses to Stroke. Introduction

  1. […] as cryptogenic infarction have no bruit or TIA ipsilateral to the hemisphere affected by stroke, no obvious history suggestive of cardiac embolism and usually do not present with a lacunar […]

  2. […] of people with high blood pressure are in this area and on a population level, the vast majority of strokes and myocardial and kidney disease from hypertension is in people who have this stage of disease so […]

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