Description

• Stroke is a compromise in blood supply to an area of the nervous system, caused by hemorrhage or occlusion, which leads to infarction of nervous tissue.
• Stroke is the fifth leading cause of death and the leading cause of long-term disability in the United States (1).
• Stroke rehabilitation refers to the process of restoring functionality and independence after a stroke.
• Rehabilitation is tailored to the specific deficits of the individual. This typically is accomplished through a multidisciplinary team.
• During a stroke patient’s acute inpatient care, a formal assessment of their needs is made before discharge to aid in disposition to an inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), or early supported discharge to home.
• Rehabilitation involves continually assessing and quantifying an individual’s needs and adjusting realistic goals as needed (2).
• Motor impairment is the most commonly recognized impairment secondary to stroke.
• Speech/language, swallowing, vision, sensation, cognition, bladder/bowel control, activities of daily living (ADLs), and balance are also commonly impaired.

Epidemiology

Incidence

• Each year in the United States, ~795,000 people suffer stroke, ~610,000 are first attacks, and 185,000 are recurrent attacks (3).
• Age-adjusted incidence of initial stroke is significantly lower for whites (0.88/1,000) than for blacks (1.91/1,000) and Hispanics (1.49/1,000) (3).
• Women have a higher lifetime risk of stroke compared to men (3).

Prevalence
~7.2 million Americans ≥20 years old have had a stroke (3).

Etiology and Pathophysiology

Stroke involves a compromise in blood supply to an area of the brain resulting in tissue damage seen on imaging, usually by either rupture or blockage of a blood vessel. Of all strokes, 87% are ischemic, 10% are intracerebral hemorrhage, and 3% are subarachnoid hemorrhage (3).

Risk Factors

Risk factors for stroke are discussed in the topics “Stroke, Acute (Cerebrovascular Accident [CVA])” and “Peripheral Arterial Disease.”

General Prevention

See “Stroke, Acute (Cerebrovascular Accident [CVA]).”