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Stroke 
Stroke or cerebrovascular accident (CVA) is the rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain. This can either be due to ischemia (lack of blood supply) or hemorrhage. Stroke is the third leading cause of death in the West, after heart disease and cancer, but could soon be the most common cause of death worldwide.
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2. In an ischemic stroke, blood supply to part of the brain is decreased, leading to dysfunction and necrosis of the brain tissue in that area. There are four reasons why this might happen:
- thrombosis: obstruction of a blood vessel by a blood clot forming locally;
- embolism: due to a blood clot from elsewhere in the body;
- systemic hypoperfusion: general decrease in blood supply, e.g. in shock; and
- venous thrombosis.
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3. Intracranial hemorrhage is the accumulation of blood anywhere within the skull vault. A distinction is made between intra-axial hemorrhage (blood inside the brain) and extra-axial hemorrhage (blood inside the skull but outside the brain). Intra-axial hemorrhage is due to intraparenchymal hemorrhage or intraventricular hemorrhage (blood in the ventricular system). Most of the hemorrhagic stroke syndromes have specific symptoms, e.g. headache or previous head injury.
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4. Stroke symptoms typically develop rapidly (seconds to minutes). The symptoms of a stroke are related to the anatomical location of the damage, and can therefore vary widely in terms of the nature and severity. Ischemic strokes usually affect only regional areas of the brain perfused by the blocked artery. Hemorrhagic strokes, on the other hand, often cause more global symptoms, due to bleeding and increased intracranial pressure. On the basis of the history and neurological examination, as well as the presence of risk factors, a doctor can rapidly diagnose which part of the brain is affected, even if the exact cause is not yet known.
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5. Stroke is diagnosed through several techniques: a neurological examination, CT scans or MRI scans, Doppler ultrasound, and arteriography. The diagnosis of stroke itself is clinical, with assistance from the imaging techniques.
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6. As ischemic stroke is due to a thrombus (blood clot) occluding a cerebral artery, a patient is given antiplatelet medication (aspirin, clopidogrel, dipyridamole), or anticoagulant medication (warfarin), depending on the cause. Hemorrhagic stroke must be ruled out with medical imaging, since this therapy would be harmful to patients with that type of stroke.
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7. Patients with bleeding into (intracerebral hemorrhage) or around the brain (subarachnoid hemorrhage), require neurosurgical evaluation to detect and treat the cause of the bleeding. Anticoagulants and antithrombotics, key in treating ischemic stroke, can make bleeding worse and cannot be used in intracerebral hemorrhage.
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8. Stroke rehabilitation, lasting anywhere from a few days to several months, should be started as immediately as possible to help them return to normal life by regaining and relearning the skills of everyday living. For most stroke patients, physical therapy (PT) and occupational therapy (OT) are the cornerstones of the rehabilitation process. more... at Wikipedia
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