Ischemic stroke natural history: Difference between revisions

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==Prognosis==
==Prognosis==
Prognosis of stroke depends on factors such as:<ref name="pmid24049549">{{cite journal| author=Faraji F, Ghasami K, Talaie-Zanjani A, Mohammadbeigi A| title=Prognostic factors in acute stroke, regarding to stroke severity by Canadian Neurological Stroke Scale: A hospital-based study. | journal=Asian J Neurosurg | year= 2013 | volume= 8 | issue= 2 | pages= 78-82 | pmid=24049549 | doi=10.4103/1793-5482.116378 | pmc=3775186 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24049549  }} </ref><ref name="pmid16091575">{{cite journal| author=Holloway RG, Benesch CG, Burgin WS, Zentner JB| title=Prognosis and decision making in severe stroke. | journal=JAMA | year= 2005 | volume= 294 | issue= 6 | pages= 725-33 | pmid=16091575 | doi=10.1001/jama.294.6.725 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16091575  }} </ref><ref name="pmid9484351">{{cite journal| author=Heinsius T, Bogousslavsky J, Van Melle G| title=Large infarcts in the middle cerebral artery territory. Etiology and outcome patterns. | journal=Neurology | year= 1998 | volume= 50 | issue= 2 | pages= 341-50 | pmid=9484351 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9484351  }} </ref><ref name="pmid1045995">{{cite journal| author=Matthews WB, Oxbury JM| title=Prognostic factors in stroke. | journal=Ciba Found Symp | year= 1975 | volume=  | issue= 34 | pages= 279-89 | pmid=1045995 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1045995  }} </ref><ref name="pmid23512064">{{cite journal| author=Hankey GJ| title=Stroke in young adults: implications of the long-term prognosis. | journal=JAMA | year= 2013 | volume= 309 | issue= 11 | pages= 1171-2 | pmid=23512064 | doi=10.1001/jama.2013.2319 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23512064  }} </ref><ref name="pmid10582989">{{cite journal| author=Dávalos A, Toni D, Iweins F, Lesaffre E, Bastianello S, Castillo J| title=Neurological deterioration in acute ischemic stroke: potential predictors and associated factors in the European cooperative acute stroke study (ECASS) I. | journal=Stroke | year= 1999 | volume= 30 | issue= 12 | pages= 2631-6 | pmid=10582989 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10582989  }} </ref><ref><ref name="pmid8465357">{{cite journal| author=Censori B, Camerlingo M, Casto L, Ferraro B, Gazzaniga GC, Cesana B et al.| title=Prognostic factors in first-ever stroke in the carotid artery territory seen within 6 hours after onset. | journal=Stroke | year= 1993 | volume= 24 | issue= 4 | pages= 532-5 | pmid=8465357 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8465357  }}</ref></ref>
Prognosis of stroke depends on factors such as:<ref name="pmid24049549">{{cite journal| author=Faraji F, Ghasami K, Talaie-Zanjani A, Mohammadbeigi A| title=Prognostic factors in acute stroke, regarding to stroke severity by Canadian Neurological Stroke Scale: A hospital-based study. | journal=Asian J Neurosurg | year= 2013 | volume= 8 | issue= 2 | pages= 78-82 | pmid=24049549 | doi=10.4103/1793-5482.116378 | pmc=3775186 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24049549  }} </ref><ref name="pmid16091575">{{cite journal| author=Holloway RG, Benesch CG, Burgin WS, Zentner JB| title=Prognosis and decision making in severe stroke. | journal=JAMA | year= 2005 | volume= 294 | issue= 6 | pages= 725-33 | pmid=16091575 | doi=10.1001/jama.294.6.725 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16091575  }} </ref><ref name="pmid9484351">{{cite journal| author=Heinsius T, Bogousslavsky J, Van Melle G| title=Large infarcts in the middle cerebral artery territory. Etiology and outcome patterns. | journal=Neurology | year= 1998 | volume= 50 | issue= 2 | pages= 341-50 | pmid=9484351 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9484351  }} </ref><ref name="pmid1045995">{{cite journal| author=Matthews WB, Oxbury JM| title=Prognostic factors in stroke. | journal=Ciba Found Symp | year= 1975 | volume=  | issue= 34 | pages= 279-89 | pmid=1045995 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1045995  }} </ref><ref name="pmid23512064">{{cite journal| author=Hankey GJ| title=Stroke in young adults: implications of the long-term prognosis. | journal=JAMA | year= 2013 | volume= 309 | issue= 11 | pages= 1171-2 | pmid=23512064 | doi=10.1001/jama.2013.2319 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23512064  }} </ref><ref name="pmid10582989">{{cite journal| author=Dávalos A, Toni D, Iweins F, Lesaffre E, Bastianello S, Castillo J| title=Neurological deterioration in acute ischemic stroke: potential predictors and associated factors in the European cooperative acute stroke study (ECASS) I. | journal=Stroke | year= 1999 | volume= 30 | issue= 12 | pages= 2631-6 | pmid=10582989 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10582989  }} </ref><ref><ref name="pmid8465357">{{cite journal| author=Censori B, Camerlingo M, Casto L, Ferraro B, Gazzaniga GC, Cesana B et al.| title=Prognostic factors in first-ever stroke in the carotid artery territory seen within 6 hours after onset. | journal=Stroke | year= 1993 | volume= 24 | issue= 4 | pages= 532-5 | pmid=8465357 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8465357  }}</ref><ref name="pmid12675701">{{cite journal| author=Sumer MM, Ozdemir I, Tascilar N| title=Predictors of outcome after acute ischemic stroke. | journal=Acta Neurol Scand | year= 2003 | volume= 107 | issue= 4 | pages= 276-80 | pmid=12675701 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12675701  }} </ref>
*Age of the patient
*Age of the patient
*Location of infarct
*Location of infarct
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| style="padding: 5px 5px; background: #F5F5F5;" |Large size and volume of infarct
| style="padding: 5px 5px; background: #F5F5F5;" |Large size and volume of infarct<ref name="pmid17082505">{{cite journal| author=Schiemanck SK, Kwakkel G, Post MW, Prevo AJ| title=Predictive value of ischemic lesion volume assessed with magnetic resonance imaging for neurological deficits and functional outcome poststroke: A critical review of the literature. | journal=Neurorehabil Neural Repair | year= 2006 | volume= 20 | issue= 4 | pages= 492-502 | pmid=17082505 | doi=10.1177/1545968306289298 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17082505  }} </ref>
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| style="padding: 5px 5px; background: #F5F5F5;" |Severe neurological deficit<ref name="pmid16091575" /><ref name="pmid1045995">{{cite journal| author=Matthews WB, Oxbury JM| title=Prognostic factors in stroke. | journal=Ciba Found Symp | year= 1975 | volume=  | issue= 34 | pages= 279-89 | pmid=1045995 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1045995  }} </ref><ref name="pmid15767504">{{cite journal| author=Weimar C, Mieck T, Buchthal J, Ehrenfeld CE, Schmid E, Diener HC et al.| title=Neurologic worsening during the acute phase of ischemic stroke. | journal=Arch Neurol | year= 2005 | volume= 62 | issue= 3 | pages= 393-7 | pmid=15767504 | doi=10.1001/archneur.62.3.393 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15767504  }} </ref><ref name="pmid25328876">{{cite journal| author=Racosta JM, Di Guglielmo F, Klein FR, Riccio PM, Giacomelli FM, González Toledo ME et al.| title=Stroke Severity Score based on Six Signs and Symptoms The 6S Score: A Simple Tool for Assessing Stroke Severity and In-hospital Mortality. | journal=J Stroke | year= 2014 | volume= 16 | issue= 3 | pages= 178-83 | pmid=25328876 | doi=10.5853/jos.2014.16.3.178 | pmc=4200591 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25328876  }} </ref><ref name="pmid23471266">{{cite journal| author=Heldner MR, Zubler C, Mattle HP, Schroth G, Weck A, Mono ML et al.| title=National Institutes of Health stroke scale score and vessel occlusion in 2152 patients with acute ischemic stroke. | journal=Stroke | year= 2013 | volume= 44 | issue= 4 | pages= 1153-7 | pmid=23471266 | doi=10.1161/STROKEAHA.111.000604 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23471266  }} </ref>
| style="padding: 5px 5px; background: #F5F5F5;" |Severe neurological deficit<ref name="pmid16091575" /><ref name="pmid1045995">{{cite journal| author=Matthews WB, Oxbury JM| title=Prognostic factors in stroke. | journal=Ciba Found Symp | year= 1975 | volume=  | issue= 34 | pages= 279-89 | pmid=1045995 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1045995  }} </ref><ref name="pmid15767504">{{cite journal| author=Weimar C, Mieck T, Buchthal J, Ehrenfeld CE, Schmid E, Diener HC et al.| title=Neurologic worsening during the acute phase of ischemic stroke. | journal=Arch Neurol | year= 2005 | volume= 62 | issue= 3 | pages= 393-7 | pmid=15767504 | doi=10.1001/archneur.62.3.393 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15767504  }} </ref><ref name="pmid25328876">{{cite journal| author=Racosta JM, Di Guglielmo F, Klein FR, Riccio PM, Giacomelli FM, González Toledo ME et al.| title=Stroke Severity Score based on Six Signs and Symptoms The 6S Score: A Simple Tool for Assessing Stroke Severity and In-hospital Mortality. | journal=J Stroke | year= 2014 | volume= 16 | issue= 3 | pages= 178-83 | pmid=25328876 | doi=10.5853/jos.2014.16.3.178 | pmc=4200591 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25328876  }} </ref><ref name="pmid23471266">{{cite journal| author=Heldner MR, Zubler C, Mattle HP, Schroth G, Weck A, Mono ML et al.| title=National Institutes of Health stroke scale score and vessel occlusion in 2152 patients with acute ischemic stroke. | journal=Stroke | year= 2013 | volume= 44 | issue= 4 | pages= 1153-7 | pmid=23471266 | doi=10.1161/STROKEAHA.111.000604 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23471266 }} </ref><ref name="pmid12675701">{{cite journal| author=Sumer MM, Ozdemir I, Tascilar N| title=Predictors of outcome after acute ischemic stroke. | journal=Acta Neurol Scand | year= 2003 | volume= 107 | issue= 4 | pages= 276-80 | pmid=12675701 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12675701 }} </ref>
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| style="padding: 5px 5px; background: #F5F5F5;" |NIHSS score >=16<ref><ref name="pmid10408548">{{cite journal| author=Adams HP, Davis PH, Leira EC, Chang KC, Bendixen BH, Clarke WR et al.| title=Baseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). | journal=Neurology | year= 1999 | volume= 53 | issue= 1 | pages= 126-31 | pmid=10408548 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10408548  }}</ref></ref><ref><ref name="pmid11061250">{{cite journal| author=Frankel MR, Morgenstern LB, Kwiatkowski T, Lu M, Tilley BC, Broderick JP et al.| title=Predicting prognosis after stroke: a placebo group analysis from the National Institute of Neurological Disorders and Stroke rt-PA Stroke Trial. | journal=Neurology | year= 2000 | volume= 55 | issue= 7 | pages= 952-9 | pmid=11061250 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11061250  }}</ref></ref><ref><ref name="pmid8841337">{{cite journal| author=Muir KW, Weir CJ, Murray GD, Povey C, Lees KR| title=Comparison of neurological scales and scoring systems for acute stroke prognosis. | journal=Stroke | year= 1996 | volume= 27 | issue= 10 | pages= 1817-20 | pmid=8841337 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8841337  }}</ref></ref>
| style="padding: 5px 5px; background: #F5F5F5;" |NIHSS score >=16<ref name="pmid10408548">{{cite journal| author=Adams HP, Davis PH, Leira EC, Chang KC, Bendixen BH, Clarke WR et al.| title=Baseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). | journal=Neurology | year= 1999 | volume= 53 | issue= 1 | pages= 126-31 | pmid=10408548 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10408548  }}</ref><ref name="pmid11061250">{{cite journal| author=Frankel MR, Morgenstern LB, Kwiatkowski T, Lu M, Tilley BC, Broderick JP et al.| title=Predicting prognosis after stroke: a placebo group analysis from the National Institute of Neurological Disorders and Stroke rt-PA Stroke Trial. | journal=Neurology | year= 2000 | volume= 55 | issue= 7 | pages= 952-9 | pmid=11061250 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11061250  }}</ref></ref><ref><ref name="pmid8841337">{{cite journal| author=Muir KW, Weir CJ, Murray GD, Povey C, Lees KR| title=Comparison of neurological scales and scoring systems for acute stroke prognosis. | journal=Stroke | year= 1996 | volume= 27 | issue= 10 | pages= 1817-20 | pmid=8841337 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8841337  }}</ref>
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| style="padding: 5px 5px; background: #F5F5F5;" |Location of the infarct<ref name="pmid10582989" /><ref name="pmid15767504" /><ref name="pmid19747656">{{cite journal| author=Huttner HB, Schwab S| title=Malignant middle cerebral artery infarction: clinical characteristics, treatment strategies, and future perspectives. | journal=Lancet Neurol | year= 2009 | volume= 8 | issue= 10 | pages= 949-58 | pmid=19747656 | doi=10.1016/S1474-4422(09)70224-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19747656  }} </ref><ref name="pmid8929152">{{cite journal| author=Hacke W, Schwab S, Horn M, Spranger M, De Georgia M, von Kummer R| title='Malignant' middle cerebral artery territory infarction: clinical course and prognostic signs. | journal=Arch Neurol | year= 1996 | volume= 53 | issue= 4 | pages= 309-15 | pmid=8929152 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8929152  }} </ref><ref name="pmid20354047">{{cite journal| author=Treadwell SD, Thanvi B| title=Malignant middle cerebral artery (MCA) infarction: pathophysiology, diagnosis and management. | journal=Postgrad Med J | year= 2010 | volume= 86 | issue= 1014 | pages= 235-42 | pmid=20354047 | doi=10.1136/pgmj.2009.094292 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20354047  }} </ref>
| style="padding: 5px 5px; background: #F5F5F5;" |Location of the infarct<ref name="pmid10582989" /><ref name="pmid15767504" /><ref name="pmid19747656">{{cite journal| author=Huttner HB, Schwab S| title=Malignant middle cerebral artery infarction: clinical characteristics, treatment strategies, and future perspectives. | journal=Lancet Neurol | year= 2009 | volume= 8 | issue= 10 | pages= 949-58 | pmid=19747656 | doi=10.1016/S1474-4422(09)70224-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19747656  }} </ref><ref name="pmid8929152">{{cite journal| author=Hacke W, Schwab S, Horn M, Spranger M, De Georgia M, von Kummer R| title='Malignant' middle cerebral artery territory infarction: clinical course and prognostic signs. | journal=Arch Neurol | year= 1996 | volume= 53 | issue= 4 | pages= 309-15 | pmid=8929152 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8929152  }} </ref><ref name="pmid20354047">{{cite journal| author=Treadwell SD, Thanvi B| title=Malignant middle cerebral artery (MCA) infarction: pathophysiology, diagnosis and management. | journal=Postgrad Med J | year= 2010 | volume= 86 | issue= 1014 | pages= 235-42 | pmid=20354047 | doi=10.1136/pgmj.2009.094292 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20354047 }} </ref><ref name="pmid16530226">{{cite journal| author=Di Carlo A, Lamassa M, Baldereschi M, Pracucci G, Consoli D, Wolfe CD et al.| title=Risk factors and outcome of subtypes of ischemic stroke. Data from a multicenter multinational hospital-based registry. The European Community Stroke Project. | journal=J Neurol Sci | year= 2006 | volume= 244 | issue= 1-2 | pages= 143-50 | pmid=16530226 | doi=10.1016/j.jns.2006.01.016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16530226 }} </ref>
*Severe middle cerebral artery infarction
*Severe middle cerebral artery infarction<ref name="pmid18509572">{{cite journal| author=Schiemanck SK, Kwakkel G, Post MW, Kappelle LJ, Prevo AJ| title=Impact of internal capsule lesions on outcome of motor hand function at one year post-stroke. | journal=J Rehabil Med | year= 2008 | volume= 40 | issue= 2 | pages= 96-101 | pmid=18509572 | doi=10.2340/16501977-0130 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18509572  }} </ref><ref name="pmid16566012">{{cite journal| author=Abboud H, Berroir S, Labreuche J, Orjuela K, Amarenco P, GENIC Investigators| title=Insular involvement in brain infarction increases risk for cardiac arrhythmia and death. | journal=Ann Neurol | year= 2006 | volume= 59 | issue= 4 | pages= 691-9 | pmid=16566012 | doi=10.1002/ana.20806 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16566012  }} </ref><ref name="pmid16020766">{{cite journal| author=Colivicchi F, Bassi A, Santini M, Caltagirone C| title=Prognostic implications of right-sided insular damage, cardiac autonomic derangement, and arrhythmias after acute ischemic stroke. | journal=Stroke | year= 2005 | volume= 36 | issue= 8 | pages= 1710-5 | pmid=16020766 | doi=10.1161/01.STR.0000173400.19346.bd | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16020766  }} </ref>
*Cervical internal carotid artery
*Cervical internal carotid artery
*Brainstem infarction
*Brainstem infarction
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| style="padding: 5px 5px; background: #F5F5F5;" |A
| style="padding: 5px 5px; background: #F5F5F5;" |Presence of co morbid conditions<ref name="pmid10582989">{{cite journal| author=Dávalos A, Toni D, Iweins F, Lesaffre E, Bastianello S, Castillo J| title=Neurological deterioration in acute ischemic stroke: potential predictors and associated factors in the European cooperative acute stroke study (ECASS) I. | journal=Stroke | year= 1999 | volume= 30 | issue= 12 | pages= 2631-6 | pmid=10582989 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10582989  }} </ref>
| style="padding: 5px 5px; background: #F5F5F5;" |Presence of co morbid conditions<ref name="pmid10582989">{{cite journal| author=Dávalos A, Toni D, Iweins F, Lesaffre E, Bastianello S, Castillo J| title=Neurological deterioration in acute ischemic stroke: potential predictors and associated factors in the European cooperative acute stroke study (ECASS) I. | journal=Stroke | year= 1999 | volume= 30 | issue= 12 | pages= 2631-6 | pmid=10582989 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10582989 }} </ref><ref name="pmid21300951">{{cite journal| author=Saposnik G, Kapral MK, Liu Y, Hall R, O'Donnell M, Raptis S et al.| title=IScore: a risk score to predict death early after hospitalization for an acute ischemic stroke. | journal=Circulation | year= 2011 | volume= 123 | issue= 7 | pages= 739-49 | pmid=21300951 | doi=10.1161/CIRCULATIONAHA.110.983353 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21300951 }} </ref>
*Anemia
*Anemia
*Myocardial infarction
*Myocardial infarction
*Diabetes mellitus
*Diabetes mellitus<ref name="pmid21300951">{{cite journal| author=Saposnik G, Kapral MK, Liu Y, Hall R, O'Donnell M, Raptis S et al.| title=IScore: a risk score to predict death early after hospitalization for an acute ischemic stroke. | journal=Circulation | year= 2011 | volume= 123 | issue= 7 | pages= 739-49 | pmid=21300951 | doi=10.1161/CIRCULATIONAHA.110.983353 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21300951  }} </ref>
*Atrial fibrillation
*Atrial fibrillation
*Malnutrition
*Malnutrition
*Renal dysfunction
*Renal dysfunction<ref name="pmid21300951">{{cite journal| author=Saposnik G, Kapral MK, Liu Y, Hall R, O'Donnell M, Raptis S et al.| title=IScore: a risk score to predict death early after hospitalization for an acute ischemic stroke. | journal=Circulation | year= 2011 | volume= 123 | issue= 7 | pages= 739-49 | pmid=21300951 | doi=10.1161/CIRCULATIONAHA.110.983353 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21300951  }} </ref><ref name="pmid11071969">{{cite journal| author=Iseki K, Fukiyama K, Okawa Dialysis Study (OKIDS) Group| title=Clinical demographics and long-term prognosis after stroke in patients on chronic haemodialysis. The Okinawa Dialysis Study (OKIDS) Group. | journal=Nephrol Dial Transplant | year= 2000 | volume= 15 | issue= 11 | pages= 1808-13 | pmid=11071969 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11071969  }} </ref>
*Heart failure
*Heart failure
*Cancer
*Cancer

Revision as of 23:47, 10 November 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Natural History

Complications

Common complications of ischemic stroke may include:[1][2][3][4]

Duration Complications
Early complications

( <7 days )

Late complications

( >7 days )

Prognosis

Prognosis of stroke depends on factors such as:[18][19][20][21][22][23][24]

  • Age of the patient
  • Location of infarct
  • Size and volume of infarct
  • Extent of neurological damage
  • Time to seek medical help
  • Comorbid conditions such as
  • Intevention such as thrombolysis
  • Quality of rehabilition care
  • Complications
Good prognostic factors Bad Prognostic factors
A Large size and volume of infarct[25]
A Severe neurological deficit[19][21][26][27][28][24]
A NIHSS score >=16[29][30]</ref>
A Location of the infarct[23][26][31][32][33][34]
  • Severe middle cerebral artery infarction[35][36][37]
  • Cervical internal carotid artery
  • Brainstem infarction
  • Anterior choroidal artery
A Presence of fever, cerebral edema, hyperglycemia[23][26][38][39]
A Presence of co morbid conditions[23][40]
  • Anemia
  • Myocardial infarction
  • Diabetes mellitus[40]
  • Atrial fibrillation
  • Malnutrition
  • Renal dysfunction[40][41]
  • Heart failure
  • Cancer
  • Coronary artery disease[23]
A Advanced age[21][42]
A Low socioeconomic status
A

References

  1. ↑ Ingeman A, Andersen G, Hundborg HH, Svendsen ML, Johnsen SP (2011). "Processes of care and medical complications in patients with stroke". Stroke. 42 (1): 167–72. doi:10.1161/STROKEAHA.110.599738. PMID 21148436.
  2. ↑ Wira CR, Rivers E, Martinez-Capolino C, Silver B, Iyer G, Sherwin R; et al. (2011). "Cardiac complications in acute ischemic stroke". West J Emerg Med. 12 (4): 414–20. doi:10.5811/westjem.2011.2.1765. PMC 3236132. PMID 22224130.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 Indredavik B, Rohweder G, Naalsund E, Lydersen S (2008). "Medical complications in a comprehensive stroke unit and an early supported discharge service". Stroke. 39 (2): 414–20. doi:10.1161/STROKEAHA.107.489294. PMID 18096834.
  4. ↑ 4.0 4.1 Minet LR, Peterson E, von Koch L, Ytterberg C (2015). "Occurrence and Predictors of Falls in People With Stroke: Six-Year Prospective Study". Stroke. 46 (9): 2688–90. doi:10.1161/STROKEAHA.115.010496. PMID 26243230.
  5. ↑ Ropper AH, Shafran B (1984). "Brain edema after stroke. Clinical syndrome and intracranial pressure". Arch Neurol. 41 (1): 26–9. PMID 6606414.
  6. ↑ Sherman DG, Easton JD (1980). "Cerebral edema in stroke: a common, often fatal complication". Postgrad Med. 68 (1): 107–13, 116, 119–20. PMID 6771748.
  7. ↑ 7.0 7.1 Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R (2005). "Dysphagia after stroke: incidence, diagnosis, and pulmonary complications". Stroke. 36 (12): 2756–63. doi:10.1161/01.STR.0000190056.76543.eb. PMID 16269630.
  8. ↑ Davenport RJ, Dennis MS, Warlow CP (1996). "Gastrointestinal hemorrhage after acute stroke". Stroke. 27 (3): 421–4. PMID 8610306.
  9. ↑ O'Donnell MJ, Kapral MK, Fang J, Saposnik G, Eikelboom JW, Oczkowski W; et al. (2008). "Gastrointestinal bleeding after acute ischemic stroke". Neurology. 71 (9): 650–5. doi:10.1212/01.wnl.0000319689.48946.25. PMID 18685137.
  10. ↑ Kamran SI, Downey D, Ruff RL (1998). "Pneumatic sequential compression reduces the risk of deep vein thrombosis in stroke patients". Neurology. 50 (6): 1683–8. PMID 9633711.
  11. ↑ Kelly J, Rudd A, Lewis RR, Coshall C, Moody A, Hunt BJ (2004). "Venous thromboembolism after acute ischemic stroke: a prospective study using magnetic resonance direct thrombus imaging". Stroke. 35 (10): 2320–5. doi:10.1161/01.STR.0000140741.13279.4f. PMID 15322298.
  12. ↑ Dennis M, Mordi N, Graham C, Sandercock P, CLOTS trials collaboration (2011). "The timing, extent, progression and regression of deep vein thrombosis in immobile stroke patients: observational data from the CLOTS multicenter randomized trials". J Thromb Haemost. 9 (11): 2193–200. doi:10.1111/j.1538-7836.2011.04486.x. PMID 21883879.
  13. ↑ Amin AN, Lin J, Thompson S, Wiederkehr D (2013). "Rate of deep-vein thrombosis and pulmonary embolism during the care continuum in patients with acute ischemic stroke in the United States". BMC Neurol. 13: 17. doi:10.1186/1471-2377-13-17. PMC 3571887. PMID 23391151.
  14. ↑ 14.0 14.1 Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C; et al. (2000). "Medical complications after stroke: a multicenter study". Stroke. 31 (6): 1223–9. PMID 10835436.
  15. ↑ Korpelainen JT, Kauhanen ML, Kemola H, Malinen U, Myllylä VV (1998). "Sexual dysfunction in stroke patients". Acta Neurol Scand. 98 (6): 400–5. PMID 9875618.
  16. ↑ Senelick Richard C., Rossi, Peter W., Dougherty, Karla (1994). Living with Stroke: A Guide For Families. Contemporary Books, Chicago.
  17. ↑ Korpelainen JT, Nieminen P, Myllylä VV (1999). "Sexual functioning among stroke patients and their spouses". Stroke. 30 (4): 715–9. PMID 10187867.
  18. ↑ Faraji F, Ghasami K, Talaie-Zanjani A, Mohammadbeigi A (2013). "Prognostic factors in acute stroke, regarding to stroke severity by Canadian Neurological Stroke Scale: A hospital-based study". Asian J Neurosurg. 8 (2): 78–82. doi:10.4103/1793-5482.116378. PMC 3775186. PMID 24049549.
  19. ↑ 19.0 19.1 Holloway RG, Benesch CG, Burgin WS, Zentner JB (2005). "Prognosis and decision making in severe stroke". JAMA. 294 (6): 725–33. doi:10.1001/jama.294.6.725. PMID 16091575.
  20. ↑ Heinsius T, Bogousslavsky J, Van Melle G (1998). "Large infarcts in the middle cerebral artery territory. Etiology and outcome patterns". Neurology. 50 (2): 341–50. PMID 9484351.
  21. ↑ 21.0 21.1 21.2 Matthews WB, Oxbury JM (1975). "Prognostic factors in stroke". Ciba Found Symp (34): 279–89. PMID 1045995.
  22. ↑ Hankey GJ (2013). "Stroke in young adults: implications of the long-term prognosis". JAMA. 309 (11): 1171–2. doi:10.1001/jama.2013.2319. PMID 23512064.
  23. ↑ 23.0 23.1 23.2 23.3 23.4 Dávalos A, Toni D, Iweins F, Lesaffre E, Bastianello S, Castillo J (1999). "Neurological deterioration in acute ischemic stroke: potential predictors and associated factors in the European cooperative acute stroke study (ECASS) I." Stroke. 30 (12): 2631–6. PMID 10582989.
  24. ↑ 24.0 24.1 Sumer MM, Ozdemir I, Tascilar N (2003). "Predictors of outcome after acute ischemic stroke". Acta Neurol Scand. 107 (4): 276–80. PMID 12675701.
  25. ↑ Schiemanck SK, Kwakkel G, Post MW, Prevo AJ (2006). "Predictive value of ischemic lesion volume assessed with magnetic resonance imaging for neurological deficits and functional outcome poststroke: A critical review of the literature". Neurorehabil Neural Repair. 20 (4): 492–502. doi:10.1177/1545968306289298. PMID 17082505.
  26. ↑ 26.0 26.1 26.2 Weimar C, Mieck T, Buchthal J, Ehrenfeld CE, Schmid E, Diener HC; et al. (2005). "Neurologic worsening during the acute phase of ischemic stroke". Arch Neurol. 62 (3): 393–7. doi:10.1001/archneur.62.3.393. PMID 15767504.
  27. ↑ Racosta JM, Di Guglielmo F, Klein FR, Riccio PM, Giacomelli FM, González Toledo ME; et al. (2014). "Stroke Severity Score based on Six Signs and Symptoms The 6S Score: A Simple Tool for Assessing Stroke Severity and In-hospital Mortality". J Stroke. 16 (3): 178–83. doi:10.5853/jos.2014.16.3.178. PMC 4200591. PMID 25328876.
  28. ↑ Heldner MR, Zubler C, Mattle HP, Schroth G, Weck A, Mono ML; et al. (2013). "National Institutes of Health stroke scale score and vessel occlusion in 2152 patients with acute ischemic stroke". Stroke. 44 (4): 1153–7. doi:10.1161/STROKEAHA.111.000604. PMID 23471266.
  29. ↑ Adams HP, Davis PH, Leira EC, Chang KC, Bendixen BH, Clarke WR; et al. (1999). "Baseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST)". Neurology. 53 (1): 126–31. PMID 10408548.
  30. ↑ Frankel MR, Morgenstern LB, Kwiatkowski T, Lu M, Tilley BC, Broderick JP; et al. (2000). "Predicting prognosis after stroke: a placebo group analysis from the National Institute of Neurological Disorders and Stroke rt-PA Stroke Trial". Neurology. 55 (7): 952–9. PMID 11061250.
  31. ↑ Huttner HB, Schwab S (2009). "Malignant middle cerebral artery infarction: clinical characteristics, treatment strategies, and future perspectives". Lancet Neurol. 8 (10): 949–58. doi:10.1016/S1474-4422(09)70224-8. PMID 19747656.
  32. ↑ Hacke W, Schwab S, Horn M, Spranger M, De Georgia M, von Kummer R (1996). "'Malignant' middle cerebral artery territory infarction: clinical course and prognostic signs". Arch Neurol. 53 (4): 309–15. PMID 8929152.
  33. ↑ Treadwell SD, Thanvi B (2010). "Malignant middle cerebral artery (MCA) infarction: pathophysiology, diagnosis and management". Postgrad Med J. 86 (1014): 235–42. doi:10.1136/pgmj.2009.094292. PMID 20354047.
  34. ↑ Di Carlo A, Lamassa M, Baldereschi M, Pracucci G, Consoli D, Wolfe CD; et al. (2006). "Risk factors and outcome of subtypes of ischemic stroke. Data from a multicenter multinational hospital-based registry. The European Community Stroke Project". J Neurol Sci. 244 (1–2): 143–50. doi:10.1016/j.jns.2006.01.016. PMID 16530226.
  35. ↑ Schiemanck SK, Kwakkel G, Post MW, Kappelle LJ, Prevo AJ (2008). "Impact of internal capsule lesions on outcome of motor hand function at one year post-stroke". J Rehabil Med. 40 (2): 96–101. doi:10.2340/16501977-0130. PMID 18509572.
  36. ↑ Abboud H, Berroir S, Labreuche J, Orjuela K, Amarenco P, GENIC Investigators (2006). "Insular involvement in brain infarction increases risk for cardiac arrhythmia and death". Ann Neurol. 59 (4): 691–9. doi:10.1002/ana.20806. PMID 16566012.
  37. ↑ Colivicchi F, Bassi A, Santini M, Caltagirone C (2005). "Prognostic implications of right-sided insular damage, cardiac autonomic derangement, and arrhythmias after acute ischemic stroke". Stroke. 36 (8): 1710–5. doi:10.1161/01.STR.0000173400.19346.bd. PMID 16020766.
  38. ↑ Bruno A, Biller J, Adams HP, Clarke WR, Woolson RF, Williams LS; et al. (1999). "Acute blood glucose level and outcome from ischemic stroke. Trial of ORG 10172 in Acute Stroke Treatment (TOAST) Investigators". Neurology. 52 (2): 280–4. PMID 9932944.
  39. ↑ Baird TA, Parsons MW, Phan T, Phanh T, Butcher KS, Desmond PM; et al. (2003). "Persistent poststroke hyperglycemia is independently associated with infarct expansion and worse clinical outcome". Stroke. 34 (9): 2208–14. doi:10.1161/01.STR.0000085087.41330.FF. PMID 12893952.
  40. ↑ 40.0 40.1 40.2 Saposnik G, Kapral MK, Liu Y, Hall R, O'Donnell M, Raptis S; et al. (2011). "IScore: a risk score to predict death early after hospitalization for an acute ischemic stroke". Circulation. 123 (7): 739–49. doi:10.1161/CIRCULATIONAHA.110.983353. PMID 21300951.
  41. ↑ Iseki K, Fukiyama K, Okawa Dialysis Study (OKIDS) Group (2000). "Clinical demographics and long-term prognosis after stroke in patients on chronic haemodialysis. The Okinawa Dialysis Study (OKIDS) Group". Nephrol Dial Transplant. 15 (11): 1808–13. PMID 11071969.
  42. ↑ Wijdicks EF, Diringer MN (1998). "Middle cerebral artery territory infarction and early brain swelling: progression and effect of age on outcome". Mayo Clin Proc. 73 (9): 829–36. doi:10.4065/73.9.829. PMID 9737218.


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