About Stroke

But I have seen a severely wounded brain healed.

Galen of Pergamum (129-216)

Cerebrovascular accident (CVA), commonly known as a stroke or brain attack, is caused by sudden interruption or significant impairment of the blood supply to the brain [1]. The immediate results of a stroke can be devastating and include weakness or paralysis, speech problems, vision problems, memory loss, and even death [2,3]. Further consequences such as cognitive impairment and eventually dementia can come on quickly or take longer to develop even if the victims are lucky enough to survive a stroke [2].

There are two types of stroke: ischemic (clots) and hemorrhagic (bleeds). Acute ischemic stroke (AIS) accounts for about 87% of all stroke cases [5] and hemorrhagic strokes represent 13% of all strokes [12]. The two most common subtypes of hemorrhagic stroke are intracerebral hemorrhage (10%) and subarachnoid hemorrhage (3%) [12].

Stroke as the second leading cause of death is considered the leading cause of long-term physical disability and cognitive impairment in human diseases worldwide [4,6-8]. Stroke is a common and devastating disease that affects 15 million people globally each year [8-10]. Among them, more than 5 million people die and another 5 million are permanently disabled [8,11]. Globally, one in four people over age 25 will have a stroke in their lifetime [13].

The facts above clearly establish stroke as a leading contributor to morbidity and mortality worldwide, and developing more effective approaches for stroke prevention and therapy is a key objective in medical research [11].

References

  1. Heiss WD. PET imaging in ischemic cerebrovascular disease: current status and future directions. Neurosci Bull. 2014; 30(5): 713–732.

  2. The Heart and Stroke Foundation of Canada. Mind the connection: Preventing stroke and dementia. 2016 Stroke Report.

  3. Pullicino PM, Alexandrov AV, Shelton JA, et al. Mass effect and death from severe acute stroke. Neurology 1997; 49(4): 1090-1095.

  4. Musuka TD, Wilton SB, Traboulsi M, et al. Diagnosis and management of acute ischemic stroke: speed is critical. CMAJ. 2015; 187(12): 887–893.

  5. Schaefer PW and Roccatagliata L. Cerebrovascular Emergencies. In: Abujudeh H, editor. Emergency Radiology. New York, NY: Oxford University Press, 2016. p.10

  6. AHA/ASA, 2017 Stroke Fact Sheet.

  7. Chui HC and Ramirez Gomez L. Vascular Contributions to Cognitive Impairment in Late Life. Neurol Clin. 2017; 35(2): 295-323.

  8. Harpaz D, Eltzov E, Seet RCS, et al. Point-of-Care-Testing in Acute Stroke Management: An Unmet Need Ripe for Technological Harvest. Biosensors 2017; 7(3): 30.

  9. Tyagi S, Koh GC, Nan L, et al. Healthcare utilization and cost trajectories post-stroke: role of caregiver and stroke factors. BMC Health Serv Res. 2018; 18(1): 881.

  10. Braeuninger S, Kleinschnitz C. Rodent models of focal cerebral ischemia: procedural pitfalls and translational problems. Exp Transl Stroke Med. 2009; 1: 8.

  11. Neuhaus AA, Couch Y, Hadley G, et al. Neuroprotection in stroke: the importance of collaboration and reproducibility. Brain 2017; 140(8): 2079-2092.

  12. Khattar NK, Williams BJ, Ding D, et al. Chapter 22 Neuroprotective Strategies in Hemorrhagic Stroke. In: Lapchak PA, YANG GY, editors. Translational Research in Stroke. Singapore: Springer Singapore, 2017. P492.

  13. Feigin VL, Brainin M, Norrving B, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. Int J Stroke. 2022; 17(1): 18-29.