Department of Neurology

Department of Neurosurgery

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Stroke and Brain Attack

Authors:

Harold Adams MD
Professor
Department of Neurology

Patricia Davis MD
Associate Professor
Department of Neurology

Karla Grimsman RN
Nurse
Department of Neurology

James Torner PhD
Professor
Department of Preventive Medicine and Environmental Health

Jeff Vande Berg MS
Department of Preventive Medicine and Environmental Health

The University of Iowa

Peer Review Status: Internally Peer Reviewed
First Published: January 1998
Last Revised: January 1998

The term Stroke is a common term that has come to describe a variety of conditions more accurately called Cerebrovascular Disease which all involve a disturbance in blood flow to the brain [1]. Stroke or Brain Attack most often describes the clogging of a cerebral blood vessel by a thrombus or embolism and the subsequent loss of oxygen to a part of the brain, or the rupture of a vessel with concomitant bleeding into the brain or pressure within the cranium. These two categories of stroke are referred to as Ischemic (Cerebral Thrombosis and Cerebral Embolism) and Hemorrhagic (Cerebral and Subarachnoid Hemorrhage). Ischemic strokes account for approximately 80% of strokes, while Hemorrhagic strokes are typically more lethal [2]. Stroke is both a disease and a symptom, indicating an underlying problem in blood vessels.

Some facts about Stroke and Brain Attack in the US:

• There are approximately 500,000 cases of stroke each year, with one occuring every minute, on average. [3]
• Stroke is the leading cause of serious, long-term disability and, in 1991-92, one million Americans age 15 and older had stroke related disabilities. [3]
• Stroke accounted for 158,061 deaths in 1995 (Age-Adjusted Death Rate: 26.7/100,000), which was 6.8% of all deaths that year. This Age-Adjusted Death Rate is slightly increased (<1% greater) from 1994, but is reduced 35.8% from 1979.[4]
• Stroke strikes males more frequently than females (Ratio=1: 2) and African-Americans more frequently than Whites (Ratio=1: 8). [4]

Stroke Information and Resources:

• "Stroke" by Dr. James Torner.
• For more, current information about Stroke, Brain Attack and Cerebrovascular Disease, may we suggest these additional web resources (and their published sources)
• Stroke and Brain Attack information for patients

Clinical Treatment Guidelines:

• The NIH Stroke Scale
• rtPA Protocols and Dosing
• Hemorrhagic Stroke Protocols: Subarachnoid Hemorrhage
• "Preventing Ischemic Stroke in Patients With Prior Stroke and Transient Ischemic Attack" from the American Heart Association

References

1. Cerebrovascular Disease, The Merck Manual, copyright 1996-97-Whitehouse Station, NJ.
2. Stroke (Brain Attack), Heart & Stroke A-Z Guide, copyright 1997 - American Heart Association.
3. Statistics: Stroke (Brain Attack), copyright 1997 - American Heart Association.
4. Anderson, RN, et al., Report of Final Mortality Statistics, Vol. 45, No. 11, Supp. 2, June 12, 1997 - National Center for Health Statistics.