Grading of Functional Recovery From Strokes

The World Health definition of stroke is 'an acute disturbance of cerebral function of presumed vascular origin with disability lasting more than 24 hours ' (Report of the Working Party on Strokes, 1974). This covers a much wider range of impairment than hemiplegia, a unilateral cortico-spinal lesion most often in the territory of the middle cerebral artery. All strokes in the wider sense imply some degree of impairment, temporary or more permanent, but most people think of rehabilitation ^ and functional recovery after stroke in terms of the motor and sensory deficits of hemiplegia and the disorders of speech, intellect and posture so often associated with them. A method of classifying functional recovery is probably needed most for strokes defined in this narrower sense, but it should be reliable if applied also to strokes in general to forecast and to measure response to care, as a target for patient and therapist, a3 a guide to results, and as a basis for reliable comparison. This urge to classify reflects the desire for more knowledge of the natural history of strokes, now a foremost cause of disability and of demand on health service resources.