- Stroke: Acute stroke is a brain injury, resulting in persistent neurologic deficits caused by a sudden interruption in the cerebral circulation. Stroke can be due either to blockage of an artery (ischemic stroke) or to arterial rupture (hemorrhagic stroke) (StopSTROKE 2004). The majority of strokes, 80%, are ischemic, and the remaining 20% are hemorrhagic in origin.
- Ischemic stroke: Ischemic stroke is most commonly caused by blockage of an artery (StrokeSTOP, 2004). This blockage is usually the result of a blood clot, which may be either thrombotic or embolic in nature. However, blockage may also occur because of progressive blood vessel occlusion, due to atherosclerosis.
- Hemorrhagic stroke: Hemorrhagic stroke is caused by arterial rupture. A hemorrhagic etiology is responsible for approximately 20% of all strokes, and results from either an intracerebral or subarachnoid hemorrhage. Of all hemorrhagic strokes, approximately half are due to intracerebral hemorrhage (ICH), including hypertensive intracerebral hemorrhage and lobar intracerebral hemorrhage. The remaining half are due to subarachnoid hemorrhage (SAH) or bleeding from an arteriovenous malformation (StopSTROKE, 2004; The Internet Stroke Center, 2004).
- Transient Ischemic Attack (TIA): Ischemic stroke may be preceded by one or more transient ischemic attacks (The Internet Stroke Center, 2004), the sudden occurrence of a focal neurologic deficit that disappears completely within 24 hours. Symptoms of most TIAs, however, usually resolve within minutes to approximately an hour, and in 50% of individuals with TIA, the deficit resolves within 30 minutes.
- Assessment: Determining the scope, importance and value of a medical or psychological condition, social or environmental situation, or treatment (AHCPR, 1995).
- Screening: Examinations aimed at detecting medical conditions early in their course or before they become symptomatic, often with the purpose of implementing treatment that will prevent or ameliorate the problem (AHCPR, 1995).
- Continuum of Stroke Care: Includes stroke recognition, stroke prevention, pre-hospital care; emergency management; acute treatment; transition management; rehabilitation management; and community re-engagement (Heart and Stroke Foundation of Ontario, 2003).
Stroke Assessment Across the Continuum of Care