"...the frontloading of stroke care..."

Int J Stroke. 2014 Feb;9(2):188-90. doi: 10.1111/ijs.12233.

Stroke: More than a 'brain attack'.

Teasell R, Hussein N, McClure A, Meyer M.

Author information

• Lawson Health Research Institute, London, Ontario, Canada; St. Joseph's Health Care London, Parkwood Hospital, London, Ontario, Canada; Department of Physical Medicine & Rehabilitation, Western University, London, Ontario, Canada.

Abstract

Stroke is a life-altering event that potentially affects stroke survivors, their families, healthcare resources, and society in general. Stroke has often been described as 'brain attack', denoting emergency emphasis on the vascular pathology. Consequently, many national and provincial stroke strategies have emphasized vascular care through primary prevention strategies and thrombolysis. Despite being important initiatives, this has resulted in a stroke system that emphasizes the frontloading of stroke care, focusing on the vascular pathology. The advent of thrombolysis therapy has benefited a small proportion of patients while a vast majority are still affected by stroke-related impairments. Management of the vascular elements of stroke is important; however, the impact of rehabilitation on stroke recovery has been relatively undervalued. Stroke care is in need of arevolution toward a more comprehensive and balanced approach. It is anticipated that the major focus of stroke care will include promoting recovery, in line with the growing evidence on stroke rehabilitation interventions. A paradigm shift is necessary to ensure that comprehensive and balanced stroke care which incorporates rehabilitation is taken into account, leading to a stroke care system where patient needs are managed both as a 'brain attack' and an 'injured brain'.