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| __NOTOC__ | | __NOTOC__ |
| {{Stroke}} | | {{Stroke}} |
| {{CMG}} {{AE}} {{AA}}; {{TarekNafee}}; {{SaraM}}
| | '''For patient information, click [[Stroke (patient information)|here]]''' |
| ==Overview==
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| ==Historical Perspective==
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| *[[Hippocrates]] (460 to 370 BC) was first to describe the phenomenon of sudden [[paralysis]].
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| *[[Apoplexy]], from the [[Greek language|Greek]] word meaning "struck down with violence,” first appeared in Hippocratic writings to describe this phenomenon.<!--
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| --><ref name="Stroke1996-Thompson">{{cite journal | author=Thompson JE | title=The evolution of surgery for the treatment and prevention of stroke. The Willis Lecture | journal=Stroke | year=1996 | pages=1427–34 | volume=27 | issue=8 | id=PMID 8711815 | url=http://stroke.ahajournals.org/cgi/content/full/27/8/1427}}</ref>
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| *The word ''stroke'' was used as a synonym for apoplectic seizure as early as 1599,<ref>R. Barnhart, ed. ''The Barnhart Concise Dictionary of Etymology'' (1995)</ref> and is a fairly literal translation of the Greek term.
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| *In 1658, in his ''Apoplexia'', [[Johann Jakob Wepfer|Johann Jacob Wepfer]] (1620–1695) identified the cause of hemorrhagic stroke when he suggested that people who had died of apoplexy had bleeding in their brains.<ref name="Stroke1996-Thompson"/>
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| *Wepfer also identified the main arteries supplying the brain, the [[vertebral artery|vertebral]] and [[carotid artery|carotid arteries]], and identified the cause of ischemic stroke when he suggested that apoplexy might be caused by a blockage to those vessels.
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| ==Synopsis==
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| {|
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| ! rowspan="2" |Diseases
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| ! colspan="4" |Laboratory Findings
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| ! colspan="4" |Physical Examination
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| ! colspan="4" |History and Symptoms
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| ! rowspan="2" |Other Findings
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| !Lab Test 1
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| !Lab Test 2
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| !Lab Test 3
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| !Lab Test 4
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| !Physical Finding 1
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| !Physical Finding 2
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| !Physical Finding 3
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| !Physical Finding 4
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| !Finding 1
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| !Finding 2
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| !Finding 3
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| !Finding 4
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| |style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
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| |style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
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| |style="background: #F5F5F5; padding: 5px;" |✔
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| |style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
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| |style="background: #F5F5F5; padding: 5px;" |'''↑'''
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| |style="background: #F5F5F5; padding: 5px;" |✘
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| |style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
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| |style="background: #F5F5F5; padding: 5px;" |
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| |style="background: #F5F5F5; padding: 5px;" |↓
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| |style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
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| |style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
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| |}
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| | {{CMG}}; {{AE}} {{MHP}} |
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| ==Epidemiology ==
| | {{SK}} |
| ===Stroke in USA===
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| *Stroke is a leading cause of serious long-term disability
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| *In USA, the incidence and mortality rates of stroke has significantly decreased compared to previous years.
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| *From year 2003 to 2013, the mortality rates due to stroke declined by 18.5%.<ref name="pmid26673558">{{cite journal| author=Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ et al.| title=Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. | journal=Circulation | year= 2016 | volume= 133 | issue= 4 | pages= e38-360 | pmid=26673558 | doi=10.1161/CIR.0000000000000350 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26673558 }} </ref>
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| *In 2013, stroke became the fifth leading cause of death.
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| *The case fatality rate of stroke is estimated to be 41.7 deaths per 100, 000 population<ref name="pmid26673558">{{cite journal| author=Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ et al.| title=Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. | journal=Circulation | year= 2016 | volume= 133 | issue= 4 | pages= e38-360 | pmid=26673558 | doi=10.1161/CIR.0000000000000350 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26673558 }} </ref>
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| *The incidence of new (610, 000) or recurrent stroke (185, 000) is estimated to be 795000 people annually or 250 cases per 100, 000.<ref name="pmid26673558">{{cite journal| author=Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ et al.| title=Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. | journal=Circulation | year= 2016 | volume= 133 | issue= 4 | pages= e38-360 | pmid=26673558 | doi=10.1161/CIR.0000000000000350 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26673558 }} </ref>
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| *It is estimated that one incidence of stroke happens every 4 sec with death occuring every 4 min.<ref name="pmid26673558">{{cite journal| author=Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ et al.| title=Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. | journal=Circulation | year= 2016 | volume= 133 | issue= 4 | pages= e38-360 | pmid=26673558 | doi=10.1161/CIR.0000000000000350 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26673558 }} </ref>
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| *About 87% of all strokes are ischemic strokes<ref name=CDCstroke> http://www.cdc.gov/stroke/facts.htm Accessed on November 3, 2016</ref>
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| *Stroke costs the United States an estimated $34 billion each year<ref name=CDCstroke> http://www.cdc.gov/stroke/facts.htm Accessed on November 3, 2016</ref>
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| ===Worldwide===
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| *According to WHO, the incidence of stroke is estimated to be 15 million people annually, worldwide.<ref name=WHOSTROKE>Mackay, Judith, et al. The atlas of heart disease and stroke. World Health Organization, 2004 Accessed on November 3 2016</ref>.
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| *Out of these, 5 million die and 5 million are left permanently disbaled.<ref name=WHOSTROKE>Mackay, Judith, et al. The atlas of heart disease and stroke. World Health Organization, 2004 Accessed on November 3 2016</ref>.
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| ==Demographics==
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| ===Age===
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| *Stroke can occur in all age groups. However, the incidence of stroke is less among individuals age less than 40 years of age and the risk increases with increasing age. <ref name=CDCstroke> http://www.cdc.gov/stroke/facts.htm Accessed on November 3, 2016</ref>
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| *According to WHO, stroke also occurs in about 8% of children with sickle cell disease.<ref name=WHOSTROKE>Mackay, Judith, et al. The atlas of heart disease and stroke. World Health Organization, 2004 Accessed on November 3 2016</ref>.
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| *In 2009, 34% of people hospitalized for stroke were younger than 65 years<ref name=CDCstroke> http://www.cdc.gov/stroke/facts.htm Accessed on November 3, 2016</ref>
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| *The incidence of stroke in people aged 18 to 50 years is estimated to be approximately 10%. <ref name="pmid26673558">{{cite journal| author=Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ et al.| title=Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. | journal=Circulation | year= 2016 | volume= 133 | issue= 4 | pages= e38-360 | pmid=26673558 | doi=10.1161/CIR.0000000000000350 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26673558 }} </ref>
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| The rate of decline in mortality rates of stroke in different age groups is as follows:<ref name="pmid26673558">{{cite journal| author=Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ et al.| title=Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. | journal=Circulation | year= 2016 | volume= 133 | issue= 4 | pages= e38-360 | pmid=26673558 | doi=10.1161/CIR.0000000000000350 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26673558 }} </ref>
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| *>65 years of age: from 534.1 to 245.2 per 100,000
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| *45-65 years of age: from 43.5 to 20.2 per 100,000
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| *18 to 44 years of age: from from 3.7 to 2.0 per 100,000
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| ===Gender===
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| There is increased incidence of stroke in men as compared to women.
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| ===Race===
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| *The risk of incidence of first stroke is twice in african american population as compared to whites with increased mortality rates.<ref name=CDCstroke> http://www.cdc.gov/stroke/facts.htm Accessed on November 3, 2016</ref>
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| *Hispanics’ risk for stroke falls between that of whites and blacks <ref name=CDCstroke> http://www.cdc.gov/stroke/facts.htm Accessed on November 3, 2016</ref>
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| ===Geographical distribution===
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| *There is increased incidence and mortality rates of stroke in developing countries as compared to developed countries due to low socio economic status and heath facilites.
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| *In USA, the highest death rates from stroke are in the southeastern United States.<ref name=CDCstroke> http://www.cdc.gov/stroke/facts.htm Accessed on November 3, 2016</ref>
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| ==References== | | ==[[Stroke overview|Overview]]== |
| {{reflist|2}}
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| {{WS}}
| | ==[[Stroke historical perspective|Historical Perspective]]== |
| {{WH}}
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| | ==[[Stroke classification|Classification]]== |
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| | ==[[Stroke pathophysiology|Pathophysiology]]== |
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| | ==[[Stroke causes|Causes]]== |
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| | ==[[Stroke differential diagnosis|Differentiating Stroke from other Diseases]]== |
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| | ==[[Stroke epidemiology and demographics|Epidemiology and Demographics]]== |
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| | ==[[Stroke risk factors|Risk Factors]]== |
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| | ==[[Stroke screening|Screening]]== |
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| | ==[[Stroke natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| | ==Diagnosis== |
| | [[Stroke diagnostic study of choice|Diagnostic study of choice]] | [[Stroke history and symptoms|History and Symptoms]] | [[Stroke physical examination|Physical Examination]] | [[Stroke laboratory findings|Laboratory Findings]] | [[Stroke electrocardiogram|Electrocardiogram]] | [[Stroke x ray|X-Ray Findings]] | [[Stroke echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Stroke CT scan|CT-Scan Findings]] | [[Stroke MRI|MRI Findings]] | [[Stroke other imaging findings|Other Imaging Findings]] | [[Stroke other diagnostic studies|Other Diagnostic Studies]] |
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| | ==Treatment== |
| | [[Stroke medical therapy|Medical Therapy]] | [[Stroke interventions|Interventions]] | [[Stroke surgery|Surgery]] | [[Stroke primary prevention|Primary Prevention]] | [[Stroke secondary prevention|Secondary Prevention]] | [[Stroke cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Stroke future or investigational therapies|Future or Investigational Therapies]] |
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| | ==Case Studies== |
| | [[Stroke case study one|Case #1]] |
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| | [[Category: (name of the system)]] |