An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American heart association/American stroke association

Ralph L. Sacco, Scott E. Kasner, Joseph P. Broderick, Louis R. Caplan, J. J. Connors, Antonio Culebras, Mitchell S.V. Elkind, Mary G. George, Allen D. Hamdan, Randall T. Higashida, Brian L. Hoh, L. Scott Janis, Carlos S. Kase, Dawn O. Kleindorfer, Jin Moo Lee, Michael E. Moseley, Eric D. Peterson, Tanya N. Turan, Amy L. Valderrama, Harry V. Vinters

Research output: Contribution to journalArticle

942 Scopus citations

Abstract

Despite the global impact and advances in understanding the pathophysiology of cerebrovascular diseases, the term "stroke" is not consistently defined in clinical practice, in clinical research, or in assessments of the public health. The classic definition is mainly clinical and does not account for advances in science and technology. The Stroke Council of the American Heart Association/American Stroke Association convened a writing group to develop an expert consensus document for an updated definition of stroke for the 21st century. Central nervous system infarction is defined as brain, spinal cord, or retinal cell death attributable to ischemia, based on neuropathological, neuroimaging, and/or clinical evidence of permanent injury. Central nervous system infarction occurs over a clinical spectrum: Ischemic stroke specifically refers to central nervous system infarction accompanied by overt symptoms, while silent infarction by definition causes no known symptoms. Stroke also broadly includes intracerebral hemorrhage and subarachnoid hemorrhage. The updated definition of stroke incorporates clinical and tissue criteria and can be incorporated into practice, research, and assessments of the public health.

Original languageEnglish (US)
Pages (from-to)2064-2089
Number of pages26
JournalStroke
Volume44
Issue number7
DOIs
StatePublished - Jul 2013

Keywords

  • AHA Scientific Statements
  • cerebral hemorrhage
  • cerebral infarction
  • stroke
  • subarachnoid hemorrhage
  • transient ischemic attack

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

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    Sacco, R. L., Kasner, S. E., Broderick, J. P., Caplan, L. R., Connors, J. J., Culebras, A., Elkind, M. S. V., George, M. G., Hamdan, A. D., Higashida, R. T., Hoh, B. L., Janis, L. S., Kase, C. S., Kleindorfer, D. O., Lee, J. M., Moseley, M. E., Peterson, E. D., Turan, T. N., Valderrama, A. L., & Vinters, H. V. (2013). An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American heart association/American stroke association. Stroke, 44(7), 2064-2089. https://doi.org/10.1161/STR.0b013e318296aeca