Pathogenesis, Diagnosis and Epidemiology of Stroke

Stroke is the third leading cause of death, after cardiac disease and cancer, in most industrialised countries. Moreover, stroke is an important cause of long term disability and is the most common life-threatening neurological disease. During past years, there has been a declining trend in stroke incidence, mortality and case-fatality; the reasons for this are unclear and there is no evidence of the persistence of this favourable trend since 1980. The improved knowledge and, consequently, improved management of stroke risk factors and new trends in acute stroke treatment seem to account for this evolution. We present a review of stroke epidemiology, aetiology and emergency clinical and diagnostic aspects, paying particular attention to ischaemic strokes, which have been the subject of most of the research and clinical trials carried out in recent years. Moreover, we propose a brief guideline for diagnosis of stroke in the acute phase.