In England and Wales, in 1986, stroke accounted for just over 12 per cent of mortality from all causes, most of it occurring in the elderly. Undoubtedly the death toll is considerable, however, it is the burden of morbidity and disability that stroke places on the community that is the real issue for concern. Each year approximately two people out of every 1,000 will experience a first stroke of whom about two-thirds will survive requiring some form of medical intervention. Indeed it is estimated in this paper that stroke patients consume just under one pound in every twenty-five of all National Health Service expenditure.

This paper begins with a description of the natural history of stroke, and goes on to analyse the incidence and mortality patterns associated with the disease. The wide spectrum of contemporary issues central to the field of stroke management are evaluated and discussed – from advances in medical procedures, through to the rehabilitation of stroke survivors, and the extent of the financial burden the disease places upon the country’s National Health Service.