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BACKGROUND

Stroke rehabilitation is simultaneously a complex, challenging, and gratifying experience, which is often both physically demanding and emotionally charged. As stroke is often the most common diagnostic category on an acute inpatient rehabilitation unit,1 it is typically considered a “prototype” rehabilitation condition. The disorder serves as a model for the development and application of principles and practices that can be applied to the rehabilitation care of patients with other diagnoses.

Stroke is defined by the World Health Organization2 as a syndrome consisting of rapidly developing clinical manifestations reflecting disturbances in cerebral functioning derived from vascular disease origin and lasting more than 24 hours. Roughly 80% or more of all strokes are ischemic in nature; most of the remainder are hemorrhagic.3 The ischemic strokes can be further divided into common and uncommon causes (Table 10–1). Determining the particular cause is of great importance to rehabilitation physicians, as it will eventually determine the medical treatment strategy, including the type and duration of anticoagulation utilized for the secondary prevention of a subsequent stroke.

Table 10–1Causes of Ischemic Stroke

Transient ischemic attacks (TIAs), in contrast, last briefly and are characterized by stroke symptoms or signs that last less than 24 hours in duration; most TIAs last less than an hour.4 Regardless of the duration of symptoms, once brain imaging has identified cerebral infarction, the condition is classified as a stroke. TIAs are generally ischemic in nature and result as a consequence of a temporary occlusion of an intracranial vessel. Most alarming for the rehabilitation team is that almost 15% of patients who suffer a TIA will have a stroke within 3 months, with the majority ...

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