A stroke is a sudden interruption of blood supply to part of the brain, causing rapid onset of neurological symptoms — weakness, speech difficulty, visual loss, headache or loss of consciousness. Ischaemic strokes (blocked artery, 87%) and haemorrhagic strokes (bleeding, 13%) are distinct in cause and treatment, but both are emergencies requiring immediate hospital care.

What are the warning signs of stroke?

The FAST mnemonic captures the most common signs: Face drooping (ask the person to smile — does one side droop?); Arm weakness (ask them to raise both arms — does one drift down?); Speech difficulty (is speech slurred or strange?); Time (call emergency services immediately). Other warning signs include sudden severe headache, visual disturbance, dizziness and sudden confusion.

Yes — ischaemic stroke is now one of medicine's most time-critical treatable emergencies. Intravenous thrombolysis (tPA) within 4.5 hours of symptom onset dissolves the clot and reduces disability. Mechanical thrombectomy — catheter-based clot removal — is highly effective within 6-24 hours for large vessel occlusion strokes. Stroke units with specialist nursing and early rehabilitation halve mortality and long-term disability.

What is the difference between a stroke and a TIA?

A transient ischaemic attack (TIA) is a brief episode of stroke-like symptoms that resolves completely within 24 hours (usually within minutes). It is caused by temporary artery blockage without permanent brain damage. However, a TIA is a medical emergency — the risk of a full stroke within 48 hours is up to 10%. Urgent evaluation and early treatment (antiplatelet therapy, statins, blood pressure management) dramatically reduces that risk.

The most important modifiable risk factor for stroke is hypertension — responsible for about 55% of strokes. Other major factors are atrial fibrillation (irregular heart rhythm that causes clots), smoking, diabetes, high cholesterol, obesity, physical inactivity, heavy alcohol use and psychosocial stress. The INTERSTROKE study showed that 10 modifiable factors account for 90% of global stroke risk — meaning the vast majority of strokes are preventable.

What is stroke rehabilitation?

Stroke rehabilitation uses physical, speech and occupational therapy to restore function after brain injury. The brain's neuroplasticity — its ability to reorganise and form new connections — allows meaningful recovery even weeks to months after stroke. Intensive early rehabilitation, ideally started in hospital within 24-48 hours of stabilisation, substantially improves outcomes. Organised stroke unit care is the single most impactful intervention for stroke recovery.

How can stroke be prevented?

Primary prevention targets the modifiable risk factors: controlling blood pressure (the most important); taking statins if indicated; treating atrial fibrillation (with anticoagulation); stopping smoking; managing diabetes; maintaining healthy weight and being physically active; limiting alcohol; and eating a healthy diet. Secondary prevention (after a stroke or TIA) adds antiplatelet or anticoagulant therapy and aggressive risk factor management.

Why do stroke outcomes differ between countries?

High-income countries with organised stroke systems — acute stroke units, rapid access to thrombolysis and thrombectomy, rehabilitation services — achieve far better outcomes. In LMICs, stroke often occurs at younger ages, presents later and is treated in general wards without specialist expertise. The global stroke treatment gap is enormous: thrombectomy, for example, is available in fewer than 15% of countries. The World Stroke Organization advocates for stroke system development globally.

What is the INTERSTROKE study?

INTERSTROKE (O'Donnell et al., Lancet 2016, PMID 27431356) was a large multinational case-control study in 32 countries showing that 10 modifiable risk factors account for 90.7% of the population-attributable risk of all stroke globally. Hypertension alone accounted for 47.9% of PAR. This study transformed stroke prevention policy by demonstrating the universality of modifiable risk factors across all regions and ethnicities.

What is the global stroke burden?

Stroke is the second leading cause of death and the leading cause of disability-adjusted life years (DALYs) globally. The World Stroke Organization estimates 12 million new strokes per year, 6.5 million deaths, and 101 million people living with stroke-related disability. 70% of the burden occurs in LMICs. The lifetime stroke risk for a 25-year-old today is 25% — one in four — making stroke prevention a lifelong public health priority.

How does atrial fibrillation cause stroke?

Atrial fibrillation (AF) — an irregular heart rhythm — allows blood to pool in the heart chambers and form clots. These clots can dislodge and travel to the brain, causing cardioembolic ischaemic stroke — typically more severe than other stroke types. Anticoagulation (warfarin or direct oral anticoagulants) reduces AF-related stroke risk by ~65%. AF is responsible for approximately 20-30% of all ischaemic strokes and becomes increasingly prevalent with age.

How does GMJ News cover stroke?

GMJ News tracks World Stroke Organization reports, thrombectomy trial results, stroke system development and the INTERSTROKE risk factor framework. Georgia has among the highest stroke mortality rates in Europe — a critical public health challenge for PHIG and the Georgian Medical Journal. Stroke prevention, acute care quality and rehabilitation access are all relevant to PHIG's accreditation and health system work.

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Stroke

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Stroke strikes someone in the world every few seconds: over 12 million people have a stroke each year and about 6.5 million die, making it the second leading cause of death and a leading cause of adult disability — and one in four adults will experience a stroke in their lifetime (World Stroke Organization). The INTERSTROKE study showed around 90% of stroke risk is attributable to modifiable factors, led by hypertension; and treatment is a race against the clock, where rapid recognition (FAST), thrombolysis and mechanical thrombectomy can reverse what was once permanent damage. Prevention, acute systems of care and rehabilitation access are the storylines GMJ News follows.

Key messages

Second leading killer

Stroke is the second leading cause of death and a leading cause of adult disability worldwide: over 12 million new strokes per year, 6.5 million deaths and 101 million people currently living with its effects (World Stroke Organization).

Lifetime risk

One in four adults worldwide will have a stroke during their lifetime — making it one of the most commonly experienced neurological events. Around 87% are ischaemic (blocked artery); 13% are haemorrhagic (bleeding).

Time is brain

Every minute of stroke, approximately 1.9 million neurons are lost. Rapid recognition (FAST — Face drooping, Arm weakness, Speech difficulty, Time to call emergency services) and treatment within hours dramatically improves outcomes.

Ischaemic stroke is treatable

Intravenous thrombolysis (tPA) within 4.5 hours and mechanical thrombectomy — removal of the clot with a catheter device — can reverse stroke deficits and save lives, but require specialist stroke unit care.

90% of risk is modifiable

The landmark INTERSTROKE study showed that 10 risk factors — hypertension, smoking, diabetes, physical inactivity, waist-to-hip ratio, diet, alcohol, psychosocial stress, cardiac causes and dyslipidaemia — account for 90% of stroke risk.

Rehabilitation matters

Intensive post-stroke rehabilitation — physiotherapy, speech therapy, occupational therapy — substantially improves functional recovery. Early mobilisation and organised inpatient care in stroke units halves mortality and disability.

Key statistics

12M

new strokes/year

WSO/GBD

6.5M

stroke deaths/year

WSO/GBD

1 in 4

lifetime risk

WSO

101M

living with stroke effects

WSO/GBD

90%

of risk is modifiable

INTERSTROKE

87%

of strokes are ischaemic

WHO

Global stroke deaths per year (millions) 2000-2019 — GBD / World Stroke Organization

Source: Global Burden of Disease study and World Stroke Organization Global Stroke Fact Sheet.

Glossary of key terms

Ischaemic stroke
WHO/AHAA stroke caused by a blocked artery supplying the brain — either a clot (thrombotic) or embolus from the heart or another artery. Accounts for ~87% of strokes. Treatable with thrombolysis and thrombectomy within hours.

Haemorrhagic stroke
WHO/ESOBleeding into or around the brain — intracerebral haemorrhage or subarachnoid haemorrhage. Accounts for ~13% of strokes but a higher proportion of deaths. Blood pressure control is the primary prevention.

TIA (transient ischaemic attack)
WHO/AHAA brief episode of neurological dysfunction caused by temporary artery blockage — resolving within 24 hours. A TIA is a medical emergency: the risk of stroke in the following 48 hours is up to 10%. Urgent evaluation and treatment dramatically reduces that risk.

FAST
Stroke Associations worldwideFace drooping; Arm weakness; Speech difficulty; Time to call emergency services. The internationally used mnemonic for stroke recognition, enabling rapid identification of stroke symptoms by the public.

Mechanical thrombectomy
ESO/AHA/NICEA catheter-based procedure to mechanically remove a clot from a large cerebral artery causing ischaemic stroke. Highly effective within 6-24 hours of onset in eligible patients; dramatically improves outcomes vs thrombolysis alone. Requires specialist neuro-interventional centres.

Stroke unit
ESO/CochraneA geographically defined area of the hospital specialising in acute stroke care. Meta-analyses consistently show stroke unit care reduces death and dependency by approximately 14% compared to general ward care — the most impactful system-level intervention for stroke outcomes.