Cerebrovascular disease or the term stroke is used to describe the effects of an interruption of the blood supply to a localised area of the brain. It is characterized by rapid focal or global impairment of cerebral function lasting more than 24 hours or leading to death (Hatano, 1976). As such it is a clinically defined syndrome and should not be regarded as a single disease. Stroke affects 174-216 people per 10,000 population in the UK per year and accounts for 11% of all deaths in England and Wales (Mant et al, 2004). The risk of recurrent stroke within 5 years is between 30-43%. One problem is that the incidence of stroke rises steeply with age and the number of elderly people in the UK is on the increase. To date people who experience a stroke occupy around 20 per cent of all acute hospital beds and 25 per cent of long term beds (Stroke Association, 2004). The British Government now identifies stroke as a major economic burden on the National Health Service (DoH, 2002).
Fifty percent of stroke survivors will experience some residual impairment (physical and cognitive), which is devastating to the individual and their families (Rudd et al, 2002). It is therefore vital for patients and resources that maximum functional recovery is achieved as fast as possible. The physiotherapist has a key role to play in the management of stroke patients, through assessment, prevention strategies, acute management and recovery. This essay aims to critically discuss physiotherapeutic management and examine how it has and may be influenced by a number of factors (e.g. type of organized system for the delivery of post stroke care, setting of therapy, evidence based practice from which National Guidelines are produced etc). The first stage is to outline stroke pathology, of which forms the basis of appropriate management.
There are two major stroke sub groups, those resulting from infarction (ischemic stroke) and those resulting from haemorrhage (intracerebral and subarachnoid). Each of the types can produce clinical symptoms that fulfil the definition of stroke. The types often differ with respect to survival and long-term disability, from recovery in a day to incomplete recovery, severe disability and death (Warlow et al, 2001).
Ischemic stroke is the most common type of stroke, which accounts for approximately 85% of all cases (Rudd et al, 2002). It affects 35 people per 100,000 of the population per year (Coull et al, 2004).
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Americans are faced with health complications such as stroke each and every day. Stroke, also called “brain attack” is the third leading cause of deaths in the United States, killing more women each year than breast cancer. According to World Health Organization, fifteen million people suffer from stroke worldwide each year and about 700,000 in the United States. Among the people, it can be inferred that there is a poor public awareness of stroke. There are also many myths about stroke and one of them states that stroke is not preventable. It is also said that strokes cannot be treated, can only strike the elderly and its recovery happens for a few months post-stroke. When in reality, about 80% of strokes are preventable, it requires critical emergency treatment, can happen to anyone of any age, and occurs in the brain. It is also imperative to know that its recovery can continue throughout life.
A stroke can happen at any age but for patients who are 55 and older, their risk factor will increase due to age and physical activity. “While stroke is common among the elderly, a lot of people under 65 also have strokes”(“About Stroke” page 1). Also at risk are African Americans because of other health issues that can trigger a stroke, for example: high blood pressure, diabetes and obesity. Caucasians and Hispanics are also at. Not only does Ethnicity and age play a factor, but so does other health conditions. Patients who suffer from high blood pressure, diabetes, heart disease, obesity, alcohol and drug
The bleeding of the brain also causes increased pressure on the brain and it presses against the skull. Symptoms of a hemorrhagic stroke vary upon the amount of blood tissues affected and the location of the bleeding. A transient ischemic attack only lasts for a few hours of the day or a day and it doesn't cause permanent brain damage like an ischemic stroke would. (TIA) transient ischemic attack is not considered to be a stroke, it is referred to as a warning signal before having a stroke. Ask yourself how does a stroke change a person's everyday life drastically? People who suffer from strokes have to live with a mental or physical disability that causes them to be limited.
It goes without saying that everyone’s health is important and should be taken care carefully. Everyone has heard of strokes before but many people do not really know its meaning, types, and the number of individuals of that dies due to this issue. According to Centers for Disease Control and Prevention (2015), strokes kills an average of 130,000 people a year and it is one of the most common deaths that happen in the United States. An average of 800,000 of people die from cardiovascular disease and strokes and it is also a reason of long-term disability (Centers of Disease Control and Prevention, 2015). Strokes, which can also be called cerebrovascular accident or CVA happen when the blood supply to the brain is interrupted or the blood vessel going towards the brain burst. Then part of the brain dies or become seriously injured because the brain cells do not receive oxygen and they eventually die. People’s lifestyle may also impact seriously on their health and increase the possibility of having a stroke. Some of the risk that can severely increase the cause of stroke would be high blood pressure, heart disease, diabetes, cigarette smoking, as well as strokes that
Strokes are not only the leading cause of mentally disabling adults, but they are also the third most common reason for deaths worldwide (Jarvis, 2012). In general, a stroke, also called a “cerebrovascular accident,” occurs when blood flow of the vascular system is blocked from reaching parts of the brain (Jarvis, 2012). There are two types of stroke, an ischemic stroke or a hemorrhagic stroke, and they differ in the way they affect the vascular system. An ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes, and it is due to a thrombus or embolus blocking blood vessels supplying the brain (Durukan & Tatlisumak, 2007). A hemorrhagic stroke is less common, but is caused by the rupturing of a blood vessel in the brain and causes bleeding (Jarvis, 2012).
Globally the leading reason for mortality and morbidity rate is stroke. Nearly twenty million individuals can suffer from stroke annually and around five million individuals won't survive . The developing countries account for a median of 85% of worldwide deaths from stroke . Stroke ends up in practical impairments with a median rate of two hundredth survivors who need institutional care once an amount of three months and 15%-30% are going to be disabled for good .
Panagos, P. (2008). The approach to optimising stroke care. The American Journal of Emergency Medicine, 26, 808−816. doi:10.1016/j.aejm.2007.11.014
A stroke is the acute neurologic injury that come as a result of an effect of ischemia or haemorrhage of the encephalon. Ischemia is caused by diminished supply of arterial blood which carries sugar and oxygen to brain tissue. Haemorrhagic stroke is due to intracerebral or subarachnoid bleeding and it damages the brain directly at the site of the bleeding by compressing the encircling tissue. Ischemic strokes can be embolic or thrombotic. Thrombotic stroke consequences from clot formation in the arterial blood vessel that provides blood to the encephalon, and can bear upon either large vessel or small vessel.
According to the American Heart Association / American Stroke Association’s About Stroke (2014) “stroke is the number four cause of death and the leading cause of adult disability in the United States” (para.1). On average, a stroke happens every 40 seconds in the United States (Impact of Stroke, para. 1) About 4% to 17% of all patients with stroke experience symptom onset while hospitalized (Cumbler, et al., 2014). This amounts to about 35,000-75,000 in-hospital strokes in the United States annually.
The main aim of this report is to present and analyse the disease called Cerebrovascular Accident popularly known as stroke. This disease affects the cerebrovascular system, which is a part of the cardiovascular system. To achieve this aim this report will firstly talk about the cerebrovascular system with its structure and functions. The main body of this report will look at causes, symptoms, diagnosis, treatments and prevention of stroke.
“Time is brain” is the repeated catch phrase when addressing the treatment and management of stroke (Saver, 2006). Access to prompt and appropriate medical care during the first few hours of stroke onset is critical to patient survival and outcomes. Recent changes in the guidelines for acute stroke care released by the American Heart Association (AHA) and the American Stroke Association (ASA) have improved patient access to treatment. Stroke treatment now follows the model of myocardial infarction treatment. Hospitals are categorized into four levels based on stroke treatment capability. The most specialized treatment is available in comprehensive stroke centers followed by primary stroke centers, acute stroke-ready hospitals, and community hospitals. The use of telemedicine now enables even community hospitals, with limited specialized capabilities, to care for stroke patients. Telemedicine puts emergency hospital personnel in contact with neurologists providing expertise in the evaluation of a stroke patient and determination of their eligibility for treatment with thrombolytic medication (Jefferey, 2013).
Stroke is a serious medical condition that affects people of all ages specifically older adults. People suffer from a stroke when there is decreased blood flow to the brain. Blood supply decreases due to a blockage or a rupture of a blood vessel which then leads to brain tissues dying. The two types of stroke are ischemic stroke and hemorrhagic stroke. An ischemic stroke is caused by a blood clot blocking the artery that brings oxygenated blood to the brain. On the other hand, a hemorrhagic stroke is when an artery in the brain leaks or ruptures (“About Stroke,” 2013). According to the Centers for Disease Control and Prevention (CDC), “Stroke is the fourth leading cause of death in the United States and is a major cause of adult disability” (“About Stroke,” 2013). Stroke causes a number of disabilities and also leads to decreased mobility in over half of the victims that are 65 and older. The CDC lists several risk factors of stroke such as heredity, age, gender and ethnicity as well as medical conditions such as high blood pressure, high cholesterol, diabetes and excessive weight gain that in...
Stroke is a commonly known disease that is often fatal. This cellular disease occurs when blood flow to the brain is interrupted by either a blood clot halting the progress of blood cells in an artery, called an Ischemic stroke, or a blood vessel in the brain bursting or leaking causing internal bleeding in the brain, called a hemorrhagic stroke. When this happens, brain cells are deprived of oxygen and nutrients because the blood cells carrying these essential things are stopped, causing them to die. When the cells in the brain die, sensation or movement in a limb might be cut off and may limit an organism’s abilities. A person with stroke is affected depending on where in the brain the stroke occurs. In other words, symptoms of a stroke