Stroke

A stroke occurs when the blood supply to the part of the brain is suddenly interrupted (ischaemic) or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding the brain cells (haemorrhagic). This may result in:

- sudden numbness or weakness (especially on one side of the body)
- sudden confusion or trouble speaking or understanding speech
- sudden trouble seeing in one or both eyes
- sudden trouble walking
- dizziness
- loss of balance or coordination.
- paralysis or trouble swallowing.

It is the abrupt onset of a non-convulsive and focal neurologic deficit that is referred to as a stroke, a cerebrovascular accident (CVA), or apoplexy. Cerebrovascular diseases predominate in the middle and late years of life. Ischaemia and infarction constitute 85 to 90% of stroke cases in western countries, while 10 to 15% are intra-cranial haemorrhages.

Signs of a stroke can develop in minutes or over days and include headache, visual disturbance, dizziness, slurred or loss of speech, paralysis and trouble swallowing. Risk factors include age (three out of four strokes occur in the over-65s), high blood pressure, atherosclerosis (narrowing of the arteries), heart disease, diabetes, smoking, drinking and lack of exercise. In the UK 100,000 people suffer a first stroke each year, of whom 20,000 will die within a month. Half will die or become dependent due to severe disability within a year. In total, stroke claims 60,000 lives a year. It is the single biggest cause of severe disability.

The incidence of stroke is about two per 1000 population pa. Approximately 30% die within the first 3 weeks, 30% will recover completely, and about 40% will be left with a disability, ie 80 new cases per 100,000 population per year. About 12 patients per 100,000 population will be in hospital at any one time for acute care, about 10 of which will be left with such severe disability that they will eventually require long-term management in hospital or residential accommodation.

Prevalence is estimated at about 600 per 100,000 of whom 360 (60%) will be disabled. Stroke survivors constitute about 24% of all severely disabled people living in the community. About 10% of bed day costs are consumed by acute stroke patients representing about 4% of the health service revenue budget.

Improving Services for younger stroke survivors and their families

Chest, Heart and Stroke Scotland

Stroke Services Draft Standard (pdf)

Stroke Research, Glasgow

Different Strokes (younger people)