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stroke
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Stroke is defined by the World Health Organization as a clinical syndrome consisting of 'rapidly developing clinical signs of focal (at times global) disturbance of cerebral function, lasting more than 24 h or leading to death with no apparent cause other than that of vascular origin' (1).

  • a transient ischaemic attack (TIA) is defined as stroke symptoms and signs that resolve within 24 hours
  • strokes result from:
    • cerebral infarction (84%):
      • secondary to thrombosis (53%); or
      • embolus (31%)
    • primary intracerebral haemorrhage (10%)
    • subarachnoid haemorrhage (6%)
  • a non-disabling stroke is defined as a stroke with symptoms that last for more than 24 hours but later resolve, leaving no permanent disability

Notes:

  • there are limitations to these definitions of stroke and TIA outlined
    • for example, they do not include retinal symptoms (sudden onset of monocular visual loss), which should be considered as part of the definition of stroke and TIA. The symptoms of a TIA usually resolve within minutes or a few hours at most, and anyone with continuing neurological signs when first assessed should be assumed to have had a stroke
    • definition of stroke excludes transient ischaemic attacks, subdural haematomas, and infarction or haemorrhage due to infection or tumour. However, practically it is often difficult to discriminate between a small stroke and a transient ischaemic attack
    • the term 'brain attack' is sometimes used to describe any neurovascular event and may be a clearer and less ambiguous term to use

 

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