Acute stroke is a commonly-used term in clinical practice and in standard texts, but tends to reinforce a widely-held perception of stroke as a short-term condition. Arguably, this brief, time-limited approach to stroke care has become more dominant, with the reliable evidence that hospital-based stroke care, using the model of a stroke rehabilitation unit, confers improved patient outcomes. For patients disabled by stroke, however, the substrate for longer-term problems is obvious, and stroke as a chronic condition is a more helpful and user-centred health care paradigm.