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According to the Centers for Disease Control and Prevention CDC in 2015 stroke was the fifth leading cause of death in the United States US Those who survive are classified among the highest and most serious long term disability patients Stroke is a disease with a high social and economic impact Wechsler et al 2013 The incidence of stroke is about 800 000 cases per year Roger et al 2012 It has been estimated that the total cost of strokes in the U S was 38 6 billion in 2009 taking into consideration the expenses related to healthcare services medication and lost productivity Kulscar Gilchrist George 2014 In recent years treatments administered within the first few hours by a qualified specialist have shown to reduce mortality and improve prognosis in stroke patients by 30 The first 60 minutes after the onset of stroke symptoms is crucial to begin treatment in order to minimize long term disability or avert stroke death Bresnick 2013 It has been reported that in 2005 that nearly 1 1 million stroke survivors had reportedly struggled with performing basic daily activities Kulscar et al 2014 According to the 2013 Population statistic Census approximately 19 3 of the U S population lives in rural areas many of which lack permanent presence of an expert neurologist Telemedicine for stroke also known as telestroke helps to bridge the gap between treatment time and shortage of neurologists in rural underserved areas Nagao Koschel Haines Bolitho Yan 2011
