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    INTRODUCTION

    Strokes are, by far, the most common cause of neurological disability in the
    adult population. They are responsible for about a quarter of all deaths in
    the developed countries and account for much disability in the elderly. Of
    patients who suffer a stroke, about a third will die; a third will survive but
    with severe disability and the remainder will make a good recovery with
    functional independence. The onset is usually sudden with maximum deficit
    at the outset, so the shock to patients and relatives is extreme. Stroke or
    the cerebrovascular accident is the major cause of the residual hemiplegia
    in the population.
    The 1990 global burden of disease (GBD) study provided the first global
    estimate on the burden of 135 diseases and cerebrovascular diseases ranked
    as the second leading cause of death after ischemic heart disease. Data on
    causes of death from the 1990s have shown that cerebrovascular diseases
    remain a leading cause of death. In 2001, it was estimated that cerebrovascular
    diseases (stroke) accounted for 5.5 million deaths worldwide, equivalent to
    9.6% of all deaths. Two-thirds of these deaths occurred in people living in
    developing countries and 40% of the subjects were aged less than 70 years.
    Additionally, cerebrovascular disease is the leading cause of disability in adults
    and each year, millions of stroke survivors have to adapt to a life with restrictions
    in activities of daily living as a consequence of cerebrovascular disease. Many
    surviving stroke patients will often depend on other people’s continuous support
    to survive. Cerebrovascular diseases can be prevented to a large extent and
    providing an entry point for public health initiatives to reduce the burden
    of stroke within a population.

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