Review of Related Literature

WHO defines stroke as the clinical syndrome of rapid onset of focal (or global, as
in subarachnoid haemorrhage) cerebral deficit, lasting more than 24 hours (unless
interrupted by surgery or death), with no apparent cause other than a vascular one (1).
In developed countries up to 7580% of strokes are attributed to brain ischemia, while
1015%

of

strokes

represent

primary intracerebral

haemorrhage

(ICH)

and

approximately 510% are subarachnoid haemorrhage (SAH).

Stroke is one of the main noncommunicable diseases of public health
importance. After coronary heart disease and cancer, stroke is the most common cause
of death in most industrialized countries. In general terms, stroke is a sudden
neurological deficit owing to localized brain ischemia or hemorrhage. Most strokes are
attributed to focal occlusion of the cerebral blood vessel (ischemic stroke) and the
remainder are the result of rupture of a blood vessel (haemorrhagic stroke).A stroke is
caused by the interruption of the blood supply to the brain, usually because a blood
vessel bursts or is blocked by a clot. This cuts off the supply of oxygen and nutrients,
causing damage to the brain tissue. The most common symptom of a stroke is sudden
weakness or numbness of the face, arm or leg, most often on one side of the body.
Other symptoms include: confusion, difficulty speaking or understanding speech;
difficulty seeing with one or both eyes; difficulty walking, dizziness, loss of balance or
coordination; severe headache with no known cause; fainting or unconsciousness. The
effects of a stroke depend on which part of the brain is injured and how severely it is
affected. A very severe stroke can cause sudden death (WHO).
According to the Department of Health, vascular disease is the second highest
cause of morbidity in the Philippines (Department of Health 2005). The prevalence of
stroke in the Philippines has increased in recent years, affecting more people at
younger ages, and causing a large burden on the Filipino health care system.
Furthermore, due to the low socio-economic status of most Filipinos, it is important that
stroke patients be able to return to work to support their families. If stroke patients are

unable to continue their occupation, issues of family burden and independence in daily
activities need to be addressed. It was previously thought that the majority of functional
recovery after a stroke is a result of spontaneous natural recovery from neurological
impairment (Dobkin 1989; Lind 1982). However, studies have since shown that
rehabilitation has an independent role in improving function beyond that explained by
neurological recovery alone (Rothet al. 1998). Elements of a stroke rehabilitation
program shown to contribute to a patients functional recovery include: patient
participation and motivation; early patient mobilization; intensity and timing of
physiotherapy; and compliance with stroke rehabilitation guidelines. Functional recovery
gained from a stroke rehabilitation program has likewise been shown to have both
short-term and long-term effects. Although the cost of a stroke rehabilitation program in
a stroke unit may initially seem to pose a significant economic burden, even in
developed countries, studies have shown that participation in a rehabilitation program
substantially reduces the length of a patients stay in a stroke unit and is more effective
in minimizing disability, thereby proving to be more cost-effective in the long term (Kalva
et al. 2005; Van Exel et al. 2003).
In 2009, the Philippine Health Statistics Data shows that about 35% of total
deaths or 167,000 Filipinos died from heart attack and stroke. Half of these tragic
deaths are related to high blood pressure. To date, there are almost 14million Filipino
adults aged 20 and above that is hypertensive and this is according to a study of Food
and Nutrition Research Institute of the Department of Science and Technology (FNRIDOST)
According to the latest WHO data published in April 2011 Stroke Deaths in
Philippines reached 40,245 or 9.55% of total deaths. The age adjusted Death Rate is
82.77 per 100,000 of population ranks Philippines #106 in the world. Review other
causes of death by clicking the links below or choose the full health profile.