How serious is stroke?

“Stroke remains the second-leading cause of death and the third-leading cause of death and disability combined (as expressed by disability-adjusted life-years lost – DALYs) in the world.” WSO https://www.world-stroke.org/news-and-blog/news/wso-global-stroke-fact-sheet-2022.

The World Stroke Organisation estimates that there are over 12 million new strokes and that there are over 6.5 million deaths due to stroke every year. Where specialist acute stroke services are available, the proportion of people dying from stroke may be less.  In the US, for example, 66% of stroke survivors are still alive after three years. And according to the  US Stroke Foundation  about half of those people will be left with a permanent disability. https://thestrokefoundation.org/disability-after-a-stroke/

The impact of a stroke is hugely variable and everyone’s stroke is different. The type of stroke, where in the brain it occurs and the length of time it continues, all affect the amount and type of brain damage that results. When a stroke starts, it is impossible to predict how serious it is. That is why treating every stroke as a medical emergency is vital.

When stroke symptoms resolve within twenty four hours, a diagnosis of transient ischaemic attack (TIA) is norm ally given. Some people describe their TIA as like having a “funny turn” or “a moment of dizziness and confusion”. TIA could be a sign that a major stroke is on the way.  Scans of the carotid artery which carries blood through the neck to the brain can reveal whether there is a build-up of deposits which can break off and travel into the brain and surgery can clear these deposits and/or a stent can be inserted into the artery.

If someone is having an ischaemic stroke and gets access to a specialist acute stroke unit within the first few hours following the onset of their symptoms, treatments can halt the stroke and prevent further brain damage. Thrombolysis involves administering a drug that dissolves the blood clot. Thrombectomy involves mechanically removing the blood clot through keyhole surgery. Both require a brain scan to determine the type of stroke (thrombolysis administered to someone with a haemorrhagic stroke would be fatal), and, for thrombectomy, where the clot is.  In the majority of cases, these interventions can dramatically improve outcomes so that patients may avoid serious disability and be able to leave hospital much more quickly.