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Stroke Learning Center
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The following Clinical Topic Tour provides an overview of stroke and was adapted from materials published by the National Institute of Neurological Disorders and Stroke and the Centers for Disease Control and Prevention.
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Stroke is an increasing public health concern throughout the world as the leading cause of long-term disability. It is well known that there exist differences related to epidemiology, pathophysiology, comorbidity, and functional outcome of stroke patients with advanced age compared with the young.
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A stroke is an interruption of blood circulation to the brain causing a neurologic deficit reflecting the area of the brain affected. Stroke can be ischemic or hemorrhagic. 1 Ischemic stroke is most prevalent.
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What?s new? The risk of recurrent stroke after TIA or minor stroke is higher than previously thought The early risk of recurrent stroke can be calculated using a simple clinical score, the ?ABCD? score The MATCH trial has shown no additional benefit with clopidogrel and aspirin over clopidogrel alone in prevention of recurrent stroke or vascular events The ESPRIT trial has shown benefit of aspirin and dipyridamole over aspirin alone in the secondary prevention of stroke The efficacy of carotid surgery for secondary prevention of stroke in patients with symptomatic carotid stenosis is highly dependent on the timing of surgery There are various clinical and pathological subtypes of stroke, and identification of the subtype is necessary for correct management.
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In populations, blood pressures fit a normal distribution, but the attendant risks of heart disease and stroke increase curvilinearly with increasing levels of blood pressure, without any obvious breakpoint ( Fig. 63-1 ). Thus, the separation of normal from high blood pressure is arbitrary, and the definition of hypertension has been a moving target.
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