Stroke, malignant MCA infarct, decompressive craniectomy
Stroke is the second commonest cause of death (10-12%), consumes >4% total healthcare costs, and is commonest cause of adult disability in western world. 80-85% are ischaemic (thrombotic or embolic) and 15-20% the more lethal haemorrhagic stroke (including 5% SAH), of which over 50% will die by 1 month.
A few years ago I was looking after an elderly woman in the emergency department who had suffered a stroke. She was aphasic — unable to understand speech or create comprehensible sentences. I explained to her family what had happened to her. Then her daughter asked me a question for which I hadn’t prepared an answer: “What does it feel like to have a stroke?”