What is Stroke?

A Pre-Lecture Handout

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What is stroke?

Key points

• Stroke is the third most common cause of death (after heart disease and cancer) in developed countries.
• Stroke is a disease of the brain (not the heart) caused by a blockage or rupture of the essential blood supply.
• A transient ischaemic attack (TIA), or 'mini-stroke' is a major warning sign of impending major stroke and needs to be taken seriously.
• 'Brain attack' has been suggested as a useful new name for the first 24 hours of a stroke or TIA .

Stroke has been recognized for thousands of years and is the third most common cause of death in developed countries after heart attacks and all cancers combined). Although it can affect people of all ages, it is most common in old age. Perhaps because of the association between stroke and old age, or terminal disease, it has not had the profile of other perhaps less serious or rarer disorders and thus is less well known to the general public. However, stroke is so common that most people will know someone who has had a stroke or have a close family member who has had a stroke. […]

A stroke occurs when the blood supply to the brain is disrupted, and part of the brain stops working. This produces sudden characteristic symptoms ranging from a rapidly fatal illness to a barely perceived loss of sensation on one side of the body. This variability causes many problems. It is hard for the layman to understand what a stroke is (or is not) as there are so many variants. It is also often hard for doctors and nurses to make the correct diagnosis, as many illnesses mimic stroke. Surveys of public knowledge of stroke have shown that this common disorder is not well understood. Many people are not aware that the problem lies within the brain. It is certainly not the same thing as a heart attack, which has quite different symptoms (usually severe chest pain). Stroke is not usually accompanied by severe pain. If pain is present, it is usually a headache and may be a sign that the stroke has been due to a brain haemorrhage.

The underlying cause of stroke

There are actually two main causes of stroke which, confusingly, can present in exactly the same manner. About 80 per cent of all strokes are due to blockage or occlusion of the blood supply to the brain, usually from a blood clot Blood clots can develop along a blood vessel or may have travelled along the blood vessel from a source further away. […] This type of stroke is commonly called ischaemic stroke. The other main pathological cause of stroke is brain haemorrhage, which is caused when a blood vessel in the brain (the cerebral artery) leaks or bursts. This type of stroke is called primary intracerebral haemorrhage. About 15 per cent of strokes are of this type. *specialist information* The final 5 per cent of strokes are caused by a condition called subarachnoid haemorrhage which has a very different presentation, assessment, and treatment from ischaemic stroke and primary intracerebral haemorrhage.