Stroke — master index¶
Last curated: 2026-10-27 · status: audited 2026-08-30; October sweep edits pending independent audit
The condition in five sentences. Stroke is symptomatic central-nervous-system infarction or non-traumatic intracranial hemorrhage, requiring an immediate imaging branch between reperfusion and hemorrhage control (Sacco 2013, PMID 23652265; Greenberg 2022, PMID 35579034). GBD 2021 estimated 11.9 million incident strokes, 93.8 million prevalent cases, 7.3 million deaths, and 160.5 million DALYs, with substantial regional and socioeconomic inequality (GBD 2021 Stroke Risk Factor Collaborators 2024, PMID 39304265). Alteplase and tenecteplase are intravenous thrombolytic options, while thrombectomy produces a large disability shift for selected large-vessel occlusion and remains effective in tissue-selected patients up to 24 hours after last known well (NINDS 1995, PMID 7477192; Menon 2022, PMID 35779553; Goyal 2016, PMID 26898852; Nogueira 2018, PMID 29129157). Stroke-unit care improves survival and independence, and recurrent-stroke prevention must match mechanism through risk-factor control, antiplatelet or anticoagulant therapy, and selected vascular or PFO procedures (Langhorne 2020, PMID 32324916; Kleindorfer 2021, PMID 34024117). The frontier joins fast equitable systems to better selection for reperfusion and hemorrhage treatment, then extends measurement beyond 90-day global disability to cognition, communication, fatigue, participation, work, and caregiver outcomes (Bernhardt 2017, PMID 28697708; Chen 2019, PMID 31110106).
Start here: overview.md. Research frontier: OPEN-QUESTIONS.md. Growth history: LOG.md.
At a glance¶
| Layer | Built content |
|---|---|
| Canonical wiki pages | 18/18; 10 curated, 8 draft after the October sweeps |
| Distinct live-resolved PMIDs in the condition | 448 in the bibliography (5 new records + 12 citation-inventory repairs on 2026-10-27) |
| Distinct live-resolved NCT records | 40 re-queried on 2026-10-27 (37 previously cited + 3 new) |
| Landmark paper notes | 5 |
| Guideline records / maintained sets | 39 (includes rehabilitation erratum) |
| Verified patient organizations | 12, plus 2 public story hubs |
| Open questions | 26 (18 Tier 1, 8 Tier 2) |
| Dots-not-yet-connected junctions | 4 |
Reading paths¶
| Need | Path |
|---|---|
| Rapid orientation | Overview → classification and workup → red flags |
| Acute ischemic stroke | Penumbra biology → acute ischemic stroke → systems of care |
| Hemorrhagic stroke | Intracerebral hemorrhage → subarachnoid hemorrhage → guidelines |
| Mechanism and recurrence | Small-vessel disease → cardioembolic/cryptogenic stroke → secondary prevention |
| Recovery and lived outcome | Rehabilitation → outcomes → patient experience |
| Research design | Biomarkers → trial landscape → open questions |
Pages¶
The canonical page list for this condition (per CONVENTIONS.md §5).
| File | Scope | Status |
|---|---|---|
| overview.md | Stroke types, burden, acute treatment, prevention, and recovery map | curated |
| classification-and-diagnostic-workup.md | Ischemic stroke, ICH, SAH, TIA, mimics, imaging, etiologic classification | curated |
| epidemiology-and-burden.md | Incidence, prevalence, mortality, DALYs, age and geographic inequities | curated |
| cerebrovascular-biology-and-penumbra.md | Ischemic core, penumbra, collateral flow, excitotoxicity, reperfusion injury | curated |
| cerebral-small-vessel-disease.md | Lacunes, white-matter injury, microbleeds, mechanisms, cognitive effects | curated |
| acute-ischemic-stroke.md | Triage, IV thrombolysis, thrombectomy, imaging selection, systems of care | draft |
| intracerebral-hemorrhage.md | Hematoma expansion, reversal, blood pressure, surgery, prognosis | draft |
| subarachnoid-hemorrhage.md | Aneurysmal SAH, securing aneurysms, vasospasm, delayed ischemia | draft |
| stroke-units-and-systems-of-care.md | Prehospital recognition, transfer, comprehensive centers, quality metrics | curated |
| secondary-prevention.md | Risk-factor control, antithrombotics, lipid lowering, mechanism-specific care | draft |
| cardioembolic-and-cryptogenic-stroke.md | AF, ESUS, rhythm monitoring, PFO, anticoagulation | curated |
| rehabilitation-and-recovery.md | Early rehabilitation, motor/language/cognitive recovery, dose and timing | draft |
| outcomes-and-prognostication.md | NIHSS, mRS, recurrence, mortality, patient-centered outcomes | curated |
| guidelines.md | AHA/ASA, ESO and global recommendations and disagreements | draft |
| biomarkers-and-imaging-markers.md | Blood, imaging, collateral, core and recovery markers | curated |
| clinical-trials-landscape.md | Reperfusion, neuroprotection, hemorrhage and recovery trials | draft |
| patient-experience-and-advocacy.md | Disability, communication, caregiver burden, organizations and priorities | draft |
| red-flags-and-safety-concerns.md | Recognition, posterior signs, hemorrhage, deterioration, recurrence | curated |
Literature layer¶
| Resource | Contents | Status |
|---|---|---|
| BIBLIOGRAPHY.md | 448 live-resolved PubMed records, grouped and cross-indexed to every use | October additions and inventory repairs pending audit |
| notes/ | Five structured landmark notes: NINDS, HERMES, DAWN, INTERACT2, stroke units | audited |
| guidelines/REGISTRY.md | 39 current, superseded, focused, web, living and correction records with disagreements/watch list | October edits pending audit |
| statistics/STATISTICS.md | Burden, recurrence, systems, complications, unmet-need, and caregiver quick-reference tables | October edits pending audit |
| patient-voice/README.md | Public-source method, ethics, limitations, and navigation | audited |
| patient-voice/organizations.md | Twelve fetched organizations and explicit failed-fetch quarantine | October edits pending audit |
| patient-voice/themes.md | Ten aggregate themes, each supported by at least two sources | audited |
| patient-voice/sources.md | Annotated organization, story-hub, and published qualitative evidence | October edits pending audit |
Curation state¶
The October literature sweeps leave eight wiki pages draft pending independent audit; five were edited on 2026-10-27. Full-text and correction-content limits are recorded in the sweep log. See LOG.md. Before the October sweeps, this condition was audited as of 2026-08-30. At that earlier audit, all 18 canonical pages passed a separate claim-level citation audit; all 407 distinct PMIDs and 30 NCT records resolved live, quoted results and metadata were rechecked, stale evidence-gap and guideline searches were rerun, and that audit recorded no unresolved substantive or verification-flag issue.