The Post-Stroke Collapse Cascade (PSCC): A Five-Phase Cascade Model of Post-Stroke Collapse

Stroke does not produce a single crisis — for a significant subset of survivors, it can initiate a cascade. This paper introduces the Post-Stroke Collapse Cascade (PSCC) as a working construct: a theoretical framework awaiting empirical validation, not a clinical diagnosis. The PSCC describes how an acute neurological event systematically destabilises identity, administrative functioning, social support structures, and financial stability in a structurally coupled sequence. At its core is a mechanism not previously integrated into a cascade model: executive dysfunction — the selective impairment of sequential planning capacity — collides with an administrative support system that silently presupposes intact executive function. The result is not a personal failure of adaptation. It is a predictable system consequence. The five collapse phases — K1 (neurological), K2 (identity and administrative), K3 (social), K4 (financial), and K5 (premature mortality) — are causally linked: each phase generates the conditions for the next. K5 is named explicitly as the structural terminus of an untreated cascade, not as an optional worst-case endpoint. The PSCC is offered as a working construct with explanatory and generative power, not a validated clinical entity. It synthesises evidence from neurology, neuropsychology, medical sociology, and health economics. The framework provides the theoretical foundation for the ID360 Personal Continuity Management platform and the NEURO-PERSIST clinical cohort study (Heilemann & Müller, 2026; DOI: 10.5281/zenodo.19954313).