Stroke

Epidemiology
Stroke is the third leading cause of death in the United States, causing almost 150,000
deaths in the year 2005.
Approximately 00,000 people experience either an initial or recurrent stoke each year.
An estimated 50,000 more !omen than men suffer a stroke annually, and the risk for a
first"e#er stroke is almost t!o times greater for $lacks.
%schemic strokes, !hich are closely related to #ascular stenosis, account for &' of all
strokes.(#erall, the estimated pre#alence of carotid stenosis is 0.5' at 50 years of age
and 10' at 0 years of age.
Stroke is the num$er one cause of long"term disa$ility, !ith 20' of #ictims needing
institutional care ) months after the e#ent. *urthermore, nearly a +uarter of all stroke
patients !ill die !ithin 1 year follo!ing the e#ent, and this num$er is e#en higher for
those !ho are a$o#e age ,5.
-alaysia
Stroke is one of the top fi#e leading causes of death and one of the top 10 causes
for hospitali.ation in -alaysia.
Stroke is also in the top fi#e diseases !ith the greatest $urden of disease, $ased on
disa$ility"ad/usted life years.
0rognosis
%nfluenced $y a num$er of factors, the most important $eing the nature and
severity of the resulting neurologic deficit.
The patients age, the cause of stroke, and coexisting medical disorders also
affect prognosis.
(#erall, some!hat fe!er than 0' of patients !ith stroke sur#i#e for at least 1
month, and 10"year sur#i#al rates in the neigh$orhood of )5' ha#e $een cited.
-ortality rate 1ecurrent stroke
%n 1 year time 22.5' .0'
%n 2 3ears time 21.)' 1.1'
1eference4 10,)55 patients hospitali.ed !ith stroke in the United States
%n that study, mortality !as higher in patients !ith intracere$ral or su$arachnoid
hemorrhage.
Early causes of death are usually neurologic in origin 6cere$ral edema, raised intracranial
pressure7 or medical complications of dependence 6e.g., aspiration pneumonia7
(f patients !ho sur#i#e stroke, t!o"thirds are left !ith chronic disa$ility. %n addition,
patients !ith stroke are at increased risk for myocardial infarction, hip fracture,
pneumonia, and repeated hospital admission.
Transient Ischaemic Attack (TIA)
Epidemiology
Incidence
A total of 25 cases of 8%A occur per 100,000 persons per year in the U.S.
Age25"524 1,9100,000 cases
Age50"554 25")9100,000 cases
An estimated 200,000 to 500,000 episodes are reported annually $y physicians in the
U.S
eak Incidence
After age ,0 years
redominant Sex and !ace
-ales : females; African American : <aucasian
rognosis
8%As are often !arning signs that a person is at risk for a more serious and de$ilitating
stroke.
A$out one"third of those !ho ha#e a 8%A !ill ha#e an acute stroke in the future.
=ematology4 >asic 0rinciples and 0ractice , Sixth Edition
1onald =offman, Ed!ard ?. >en., @eslie E. Sil$erstein, =elen E. =eslop, ?effrey %. Aeit., and ?ohn Anastasi
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*erriGs <linical Ad#isor 2012
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