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Stroke

All deaths by sex, compared with stroke deaths by sex, 2002, England, Wales, Scotland, Northern Ireland and United Kingdom

		England	Wales	Scotland	N. Ireland	UK
All causes	Men	239,931	15963	27,511	7,128	290,533
	Women	263,095	17538	30,288	7,775	318,696
	total	503,026	33,501	57,799	14,903	609,229
Stroke	Men	18,233	1,246	2,544	527	22,550
	Women	30,826	2,089	4,259	942	38,116
	total	49,059	3,335	6,803	1,469	60,666

[British heart foundation statistics database 2002]

There is usually little or no warning of a stroke. Immediate admission to hospital for assessment and treatment is essential so that a cause can be identified and treatment can begin. The after-effects of a stroke vary depending on the location and extent of the brain tissue affected. If the symptoms disappear within 24 hours, the condition is known as a transient ischaemic attack which is a warning sign of a possible future stroke.

In most people, the symptoms develop rapidly over a matter of seconds or minutes. The exact symptoms depend on the area of the brain affected and may include: - weakness or inability to move one side of the body - numbness on one side of the body - clumsiness, or loss of control of fine movements - visual disturbances, such as blurred vision or loss of vision in one eye - slurred speech - difficulty in finding words and understanding what others are saying - vomiting and difficulty in maintaining balance

If the stroke is severe, areas of the brain that control breathing and blood pressure may be affected or the person may lapse into a coma. In these circumstances, the outcome can be fatal.

Increasingly stroke is rightly being seen as a medical emergency which requires urgent or prompt specialist assessment and treatment, and usually hospital admission. There is clear evidence that admission to a stroke unit reduces deaths and disability and prevents complications of stroke. Most people with an acute stroke should have a brain scan (CT or MRI) within 48 hours of onset of symptoms, and sooner if unwell.

A proportion of those with an acute non-haemorrhagic stroke may be suitable for thrombolysis (clost-busting drugs) as for heart attack, although this treatment is not yet widely accepted or available. Ability to treat patients in this way requires urgent brain scanning and the patient to present ot hospital within a few hours of their stroke.

As for other vascular diseases, prevention of recurrence of strokes includes comprehensive treatment of vascular risk factors.

In 2005 the National Audit Office published Department of Health Reducing Brain Damage: Faster access to better stroke care based on a public awareness survey, analysis of data on GP practices, a survey of hospitals, economic research to model the burden of stroke and the benefits of different interventions and prevention measures, case study visits, and a patient/carer web forum and focus groups. The report recommended that the Department refer more explicitly to stroke in more of its campaigns, raise public awareness of the signs of stroke and that it requires a 999 response, improve acute care (brain scanning, thrombolysis and acute stroke units) and better management of stroke services.

Access further information using the links below:
- American Stroke Association
- BBCi Health – Stroke
- Brain and Spine Foundation – Stroke leaflet (PDF)
- Heart & Stroke Encyclopaedia (American Heart Association)
- MEDLINEplus Health topics – Stroke
- MEDLINEplus Medical Encyclopaedia – Stroke
- National Electronic library for health (NHS) – National clinical guidelines for stroke
- National Institute of Neurological Disorders and Stroke
- National Institute on Ageing (US) – Stroke
- National Stroke Association (US)
- NHS Direct Online
- Royal College of Physicians – Stroke
- Society for Research in Rehabilitation
- Stroke Association (UK)