How serious are strokes?

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A stroke is always serious. Stroke is the third leading cause of death in the US. About 160,000 Americans die of stroke each year. The mortality rates are declining, however, and 80% of patients survive a stroke attack.

Ischemic versus Hemorrhagic Stroke. People who suffer ischemic strokes have a much better chance for survival than those who experience Hemorrhagic strokes. Among the ischemic stroke categories, the greatest dangers are posed by embolic strokes, followed by large-artery (thrombotic) and lacunar strokes.

Hemorrhagic stroke not only destroys brain cells, but it poses other complications as well, including increased pressure on the brain or spasms in the blood vessels, both of which can be very dangerous. (In one small study, however, survivors of Hemorrhagic stroke had a greater chance for recovering function than those who suffered ischemic stroke.)

Factors Affecting Recurrence. The risk for recurring Stroke is highest within the first few weeks and months. The risk is about 10% in the first year and 5% thereafter, so preventive measures should be instituted as soon as possible. Some specific risk factors for early recurrence are the following:

• Being older.

• Having evidence of blocked arteries (a history of coronary artery disease, peripheral artery disease, ischemic stroke, or TIA.
  
• Having had a hemorrhagic or embolic stroke.
  
• Being diabetic.
  
• Having alcoholism.
  
• Having valvular heart disease.
  
• Having atrial fibrillation.

Long-Term Outlook for Survivors. Over half of stroke victims survive beyond five years. Between 50% and 70% of stroke sufferers regain functional independence. Between 15% and 30% of those who survive either an ischemic or hemorrhage stroke suffer some permanent disability. On the encouraging side, about 90% of stroke survivors experience varying degrees of improvement after rehabilitation. Furthermore, one 1998 study reported that people who survived for many years after a stroke had a chance for independent living that was about the same as for their peers who had not suffered strokes. The stroke patients even appeared to be less depressed than the comparison group. 

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