Hyperglycemia and Stroke

摘要

Cerebrovascular accident is the third most common leading cause of death worldwide, after coronary heart disease and cancer. The World Health Organisation defines stroke as “rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting for 24 hours or longer, or leading to death with no apparent cause other than of vascular origin”. Among 80% of all cerebrovascular accidents are ischemic, rest being due to haemorrhage. There are many factors which alter the outcome of stroke. Acute hyperglycemic response to stress has been recognized since Claude Bernard’s observations more than a century ago. This “diabetes of injury” exemplifies the obligatory metabolic rearrangements required to cope with critical stress. The concept evolved as glucose became identified as metabolic mirror of the severity and outcome of critical illness.