[Differential diagnosis and prognosis of apoplexy]

In world wide mortality statistics, cerebral circulatory disturbances still are the third most frequent cause of death. Especially strokes resulting from thrombosis occure more frequent with increasing age, while embolism and haemorrhage tend to occur in the younger age groups, too. In every case of stroke, whether of ischaemic origin or caused by haemorrhage, a complete diagnostic program is essential to clarify aetiology and pathogenesis and to establish an adequate therapeutic strategy and prognostic assessment. Factors, that influence the prognosis quo ad vitam et quo ad sanationem in a favourable way are: early onset of therapy (especially within the first six hours), adaequate therapy of risk factors and secondary complications, younger age and a favourable social situation. On the other hand, the prognosis is worsened by marked psychopathological changes in the initial stage, a combination of several risk factors and delayed onset of therapy.