Introduction to the stroke series

THIS ARTICLE is an introduction to a series of articles outlining the priorities of stroke care. The aim of these articles is to raise nurses’ awareness of caring for stroke patients with complex problems in a range of care environments, to enhance knowledge and improve understanding of stroke. The focus is on evidence-based practice and the application of stroke competencies and national guidelines to help readers in their future clinical practice. Stroke is a clinical syndrome characterised by the rapid onset of focal cerebral deficits of vascular origin that last more than 24 hours or result in death. Transient ischaemic attack (TIA) refers to symptoms that last less than 24 hours (Hatano 1976). A stroke occurs when blood flow to part of the brain is interrupted, causing damage to the brain tissue. The two main types of stroke are ischaemic and haemorrhagic: ischaemic stroke is caused by blood clots blocking arteries in the neck or brain and accounts for 80% of stroke cases; haemorrhagic stroke results from arterial bleeding into (intracerebral) or around (subarachnoid) the brain and accounts for 20% of stroke cases (Feigin et al 2003). The degree and type of disability that follows a stroke depends on which artery is affected and which areas of the brain are damaged. Patients may experience: paralysis or problems controlling movement (particularly on one side of the body); sensory disturbances, including pain; problems using or understanding language; swallowing or visual problems; incontinence; loss of balance or co-ordination; problems with thinking, memory and reasoning; cognitive and emotional disturbances; and loss of consciousness