Stroke medicine

Doctors working in stroke medicine provide acute care and on-going rehabilitation to patients who have suffered from a stroke. They provide accurate diagnosis and use investigations to provide safe and appropriate management of stroke.  

This page provides useful information on the nature of the work, the common procedures/interventions and other roles that may interest you.

Nature of the work

A stroke is caused when there is interruption to the blood supply to the brain, which is often the result of a blood clot in a cerebral (brain) artery (ischaemic stroke). It may also be caused by the rupturing of a blood vessel in or near the brain (haemorrhagic stroke).

Doctors in stroke medicine are skilled in identifying patients who have symptoms that may mimic a stroke, but are due to other underlying diseases such as epilepsy.

Some patients may suffer from a transient ischaemic attack (TIA), which is sometimes known as a “mini-stroke”, because the symptoms last less than 24 hours. Other patients have symptoms that mimic a stroke, and may also be seen by stroke physicians.

Stroke results in a range of debilitating symptoms and is the most common cause of death and disability in the UK, accounting for over 5% of NHS resources. This is likely to increase, given Britain’s growing ageing population.

Stroke medicine encompasses elements of a number of clinical skills including; cardiovascular disease, general and geriatric medicine, rehabilitation and palliative care

Consultants with training in stroke medicine contribute to and lead stroke services throughout the UK. Patients who have suffered a stroke often receive specialist care in acute and rehabilitation stroke units or via a neurovascular unit. Stroke physicians contribute to the provision of skilled acute and rehabilitation care as part of a multidisciplinary stroke service.

The specialist care and early interventions that stroke physicians provide result in better survival rates for patients with the aim of reducing disability. The knowledge and skills they provide are also vital in stroke prevention. They also provide a key role in developing hospital and community stroke services.

Helping patients to regain their strength and recover function is an important part of stroke rehabilitation. Movement and sensation on either side of the body may be affected, and patients may also have problems with breathing, swallowing, balance, vision and communication. Helping patients to adapt to the impact of their health problems following stroke and to manage their own condition are all vital aspects of the work.

Stroke physicians work very closely with vascular surgeons, referring patients for surgery where necessary; with neurosurgeons, referring patients for surgery where necessary; and increasingly with interventional neuroradiologists, referring patients for clot retrieval therapy.

The nature of the work can vary, as stroke medicine is a sub-specialty of the following areas of medicine:

For example, a neurologist with sub-specialty training in stroke medicine may contribute to the provision of an acute stroke service and TIA clinic. Within geriatric medicine, the stroke physician may focus on a rehabilitation stroke unit, though there is considerable overlap

All doctors working in this specialty develop treatment and management plans for patients living with stroke illness. This includes rehabilitation, health promotion, secondary prevention and long-term support.

Common procedures/interventions

Stroke medicine benefits from an exciting range of new techniques and treatments that have greatly improved recovery rates.

Common procedures and interventions include:

New techniques are being developed all the time, such as brain-cooling techniques that can be used in the early stages of a stroke to protect the brain from further damage.

Sub-specialties

Stroke medicine is a sub-specialist branch of medicine in its own right and has only been recognised as such since 2007.  

Doctors working in stroke medicine may also be consultants in another specialty. See the training and development section for more information.

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