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Of all health problems, stroke probably has the greatest consequences: maily for the patient and his family, and also for the health system and society as a whole, both in social and economic aspects. Every day we know more cases of CVA (Cerebrovascular Accident): not only among the elderly, but also among young adults. It is the second leading cause of death in the world, and the leading cause of disability. To put it in more graphic terms: across the globe, a person suffers a stroke every 53 seconds, and a stroke death occurs every 3.3 minutes. Knowing more about this condition is essential to prevent it and to act effectively and quickly when it occurs.
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Stroke: Cerebrovascular Accident
Each day we learn of more cases of stroke (Cerebrovascular Accident or CVA): not only among the elderly, but also among young adults. It is the second leading cause of death in the world, and the leading cause of disability. To put it in more graphic terms: across the globe, a person suffers a stroke every 53 seconds, and a stroke death occurs every 3.3 minutes.
Stroke rates remain stable and mortality rates have decreased in recent decades, but both the number of stroke episodes and related deaths and disability-adjusted life years (DALYs) are increasing year after year.
The history of stroke is really very old. Hippocrates, the so called “father of medicine”, wrote about stroke more than 2,400 years ago. At that time the obstruction or cerebral hemorrhage was called “apoplexy” (a term that was used until a few years ago) that in Greek means “violent attack”, which described precisely what happened to patients: they suffered a sudden attack that produced sudden paralysis and prevented them from carrying on with their normal lives, and often caused their death.
Stroke is caused by the obstruction of blood flow in the brain: lack of oxygen can damage cells, alter the body´s biochemical processes and cause brain damage. The brain, as we know, allows us to control movements, communication and speech, and therefore any damage that occurs in that area can have serious consequences.
Of all the health problems, stroke is probably the one that has the greatest consequences: both for the patient and his family, as well as for the health system and society in general in social and economic aspects. In the United States, the costs related to stroke between 2017 and 2018 have been estimated at $53 billion dollars (including health services, medicines and lost work days).
In addition to causing a high number of deaths, stroke survivors often have physical disabilities such as the inability to move a limb (arm or leg) or difficulties walking or speaking, and also psychological effects such as depression or anxiety.
Knowing more about stroke is essential. On the one hand, it is one of the main causes of death and disability in the world. But in addition, its immediate recognition and treatment increases the chances of survival and reduces the risk of disability. It is important to learn what a stroke is and especially how to recognize it, because the first few minutes after a stroke can be crucial.
The following pages explain what causes stroke, the different types, how to recognize it and what to do, what treatments are available, and what are the risk factors. In addition, we´ll review the epidemiological aspect of this disease, and examine why women, Afro-descendants and Hispanics are at greater risk of suffering from it, and why long working hours have appeared in recent years as a new risk factor.
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Transient Ischemic Attack or Mini-Stroke
Back in 1970, the WHO defined stroke as “rapidly developed clinical signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than of vascular origin”.1 This definition is still largely used, but several organizations such as the American Stroke Association consider it outdated as new technologies allow recognizing “silent symptoms” and help doctors deliver diagnosis even when clinical manifestations are not that evident or last for shorter periods.
