Description

• Stroke is a compromise in blood supply to an area of the nervous system, secondary to hemorrhage or occlusion, with resultant infarction of nervous tissue.
• Stroke is the 3rd leading cause of death and the leading cause of long-term disability in the US (1).
• Rehabilitation refers to the process of restoring a debilitated person toward baseline level of functionality.
• Specific rehabilitation techniques should be used depending on the individual and based on particular deficits and brain-regions impacted.
• Rehabilitation involves cycling through the following (2):
  • Assessment of patient with the goal of identification and quantification of the needs of the individual.
  • Setting of objectives that are realistic, concrete, and attainable.
  • Repetition of assessment to gauge changes in status, with subsequent alteration of techniques as necessary
• Motor impairment is the most commonly recognized impairment secondary to stroke.
• Speech, and language, swallowing, vision, sensation, and cognition are also commonly impaired.

Epidemiology

• Each year, about 795,000 people suffer a stroke, ~610,000 of which are 1st attacks and 185,000 are recurrent attacks (3).
• ∼14% of survivors of stroke reach full recovery in physical function, but 25–50% require assistance poststroke (1).
• According to the World Health Organization, 15 million people suffer stroke worldwide each year. Of these, 5 million die and another 5 million are permanently disabled.

• ~7 million Americans ≥20 years old have had a stroke (~3%) (3).
• ~50 million stroke survivors worldwide (4)
• >1/2 of strokes in people <65 result in death within 8 years (1).

Risk Factors

Risk factors for stroke are discussed in the topics “Stroke, Acute” and “Atherosclerosis.”

General Prevention

See “Stroke, Acute.”

Pathophysiology

Stroke involves a compromise in blood supply to an area, usually by either rupture or blockage of a vessel.

Etiology

Of all strokes, 87% are ischemic, 10% intracerebral hemorrhage, and 3% subarachnoid hemorrhage (3).