Stroke

Excerpt

According to the World Health Organization’s Global Health Estimates, stroke was the second-leading cause of death and the third-leading cause of disability-adjusted life years (DALYs) lost globally in 2012. In certain low- and middle-income countries (LMICs), such as China, the disease burden of stroke increased significantly over the past two decades, accounting for the most years of life lost in 2010. This chapter—the first on stroke in the history of the Disease Control Priorities publications—presents evidence on the disease burden of stroke, describing the epidemiology, disability, and socioeconomic burdens, then discusses modifiable and other risk factors for stroke. The chapter describes primary prevention, treatment, and management of stroke during the acute phase as well as secondary prevention and rehabilitation, with a focus on cost-effective strategies in LMICs, where such evidence exists. The chapter concludes with recommendations for policy makers and future research directions.

There are two main types of stroke—ischemic, including transient ischemic attack, and hemorrhagic, including intracerebral and subarachnoid. The term stroke refers to all subtypes. The two main subtypes are distinguished from one another when appropriate because the etiology and management of these subtypes can be very different. Within the hemorrhagic subtype, we focus mainly on intracerebral hemorrhage, given that subarachnoid hemorrhage occurs spontaneously, usually from a ruptured cerebral aneurysm, or results from a head injury.