Stroke, a clinical diagnosis of acute, suddenonset neurological deficit, is one of the main causes of death and permanent disability in the industrialized world. Pathologically the process may be an ischaemic or a haemorrhagic event, or both. About 85% of cerebrovascular accidents result from ischaemia, predominantly secondary to carotid thromboembolism.

The stroke patient may clinically present with typical symptoms of focal neurological deficit, a combination of deficit with coma, a meningeal irritation syndrome in the form of headache, vomiting and neck stiffness, or less frequently with the gradual appearance of an extrapyramidal or pseudo-bulbar syndrome often
associated with progressive mental deterioration.

The clinical picture in stroke patients can be classified according to how long the neurological deficit lasts, or alternatively whether or not the deficit is permanent. Four different such clinical categories can be distinguished. The transient ischaemic attack (TIA) is represented by a sudden, focal non-convulsive onset of a neurological deficit that usually subsides in a few minutes and always resolves within 24 hours; the reversible ischaemic neurological deficit (RIND) lasts at most for a period of 48 hours followed by a return to complete normality within 3 weeks; progressive ictus is a tem temporally worsening clinical condition during the first 24 to 48 hours following acute onset associated  with persistent functional deficit; complete
ictus is a clinically stable condition, with the deficit being present from the outset, though some improvement may be observed in the long term.

Related Content

Subscribe to the post comments feeds or Leave a trackback