Stroke

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Stroke Main page

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Overview

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Hemorrhagic stroke
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Historical Perspective

  • Hippocrates (460 to 370 BC) was first to describe the phenomenon of sudden paralysis.
  • Apoplexy, from the Greek word meaning "struck down with violence,” first appeared in Hippocratic writings to describe this phenomenon.[1]
  • The word stroke was used as a synonym for apoplectic seizure as early as 1599,[2] and is a fairly literal translation of the Greek term.
  • In 1658, in his Apoplexia, 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.[1]

Epidemiology

Stroke in USA

  • Stroke is a leading cause of serious long-term disability
  • In USA, the incidence and mortality rates of stroke has significantly decreased compared to previous years.
  • From year 2003 to 2013, the mortality rates due to stroke declined by 18.5%.[3]
  • In 2013, stroke became the fifth leading cause of death.
  • The case fatality rate of stroke is estimated to be 41.7 deaths per 100, 000 population[3]
  • The incidence of new (610, 000) or recurrent stroke (185, 000) is estimated to be 795000 people annually or 250 cases per 100, 000.[3]
  • It is estimated that one incidence of stroke happens every 4 sec with death occuring every 4 min.[3]
  • About 87% of all strokes are ischemic strokes[4]
  • Stroke costs the United States an estimated $34 billion each year[4]

Worldwide

  • According to WHO, the incidence of stroke is estimated to be 15 million people annually, worldwide.[5].
  • Out of these, 5 million die and 5 million are left permanently disbaled.[5].

Demographics

Age

  • 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. [4]
  • According to WHO, stroke also occurs in about 8% of children with sickle cell disease.[5].
  • In 2009, 34% of people hospitalized for stroke were younger than 65 years[4]
  • The incidence of stroke in people aged 18 to 50 years is estimated to be approximately 10%. [3]

The rate of decline in mortality rates of stroke in different age groups is as follows:[3]

  • >65 years of age: from 534.1 to 245.2 per 100,000
  • 45-65 years of age: from 43.5 to 20.2 per 100,000
  • 18 to 44 years of age: from from 3.7 to 2.0 per 100,000

Gender

There is increased incidence of stroke in men as compared to women.

Race

  • The risk of incidence of first stroke is twice in african american population as compared to whites with increased mortality rates.[4]
  • Hispanics’ risk for stroke falls between that of whites and blacks [4]

Geographical distribution

  • 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.
  • In USA, the highest death rates from stroke are in the southeastern United States.[4]

Synopsis

References

  1. 1.0 1.1 Thompson JE (1996). "The evolution of surgery for the treatment and prevention of stroke. The Willis Lecture". Stroke. 27 (8): 1427–34. PMID 8711815.
  2. R. Barnhart, ed. The Barnhart Concise Dictionary of Etymology (1995)
  3. 3.0 3.1 3.2 3.3 3.4 3.5 Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ; et al. (2016). "Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association". Circulation. 133 (4): e38–360. doi:10.1161/CIR.0000000000000350. PMID 26673558.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 http://www.cdc.gov/stroke/facts.htm Accessed on November 3, 2016
  5. 5.0 5.1 5.2 Mackay, Judith, et al. The atlas of heart disease and stroke. World Health Organization, 2004 Accessed on November 3 2016

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