Meeting the challenge of stroke

It is the elderly who carry the burden of stroke. Whilst 130,000 people suffer a stroke in the UK every year, nearly three quarters of these cases occur over the age of 65 and nearly half occur over the age of 75. As the proportion of elderly in the population continues to grow, inevitably this burden will increase. With Scotland probably experiencing the highest stroke incidence in the UK and stroke already accounting for 5.5% of total hospital costs, challenges clearly lie ahead for the health service and Scottish society as a whole. The extent to which we are able to meet this challenge is becoming clearer. Thus far, therapeutic advance has been rather "low-tech", with organisation of services and the appropriate use of existing interventions showing modest and, just occasionally, dramatic benefits. In contrast, the high hopes raised by many "high-tech" solutions have largely been dashed or remain promising but unproven.