Ischemic stroke natural history: Difference between revisions
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==Natural History== | ==Natural History== | ||
==Complications== | ==Complications== | ||
Common complications of ischemic stroke may include:<ref name="pmid21148436">{{cite journal| author=Ingeman A, Andersen G, Hundborg HH, Svendsen ML, Johnsen SP| title=Processes of care and medical complications in patients with stroke. | journal=Stroke | year= 2011 | volume= 42 | issue= 1 | pages= 167-72 | pmid=21148436 | doi=10.1161/STROKEAHA.110.599738 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21148436 }} </ref><ref name="pmid22224130">{{cite journal| author=Wira CR, Rivers E, Martinez-Capolino C, Silver B, Iyer G, Sherwin R et al.| title=Cardiac complications in acute ischemic stroke. | journal=West J Emerg Med | year= 2011 | volume= 12 | issue= 4 | pages= 414-20 | pmid=22224130 | doi=10.5811/westjem.2011.2.1765 | pmc=3236132 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22224130 }} </ref><ref name="pmid18096834">{{cite journal| author=Indredavik B, Rohweder G, Naalsund E, Lydersen S| title=Medical complications in a comprehensive stroke unit and an early supported discharge service. | journal=Stroke | year= 2008 | volume= 39 | issue= 2 | pages= 414-20 | pmid=18096834 | doi=10.1161/STROKEAHA.107.489294 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18096834 }} </ref> | |||
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*Expansion of the infarct/recurrent infarction | *Expansion of the infarct/recurrent infarction | ||
*Hemorrhagic transformation of the infarcted area | *Hemorrhagic transformation of the infarcted area | ||
*Seizure | *Seizure<ref name="pmid18096834">{{cite journal| author=Indredavik B, Rohweder G, Naalsund E, Lydersen S| title=Medical complications in a comprehensive stroke unit and an early supported discharge service. | journal=Stroke | year= 2008 | volume= 39 | issue= 2 | pages= 414-20 | pmid=18096834 | doi=10.1161/STROKEAHA.107.489294 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18096834 }} </ref> | ||
*Aspiration | *Aspiration pneumonia<ref name="pmid16269630">{{cite journal| author=Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R| title=Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. | journal=Stroke | year= 2005 | volume= 36 | issue= 12 | pages= 2756-63 | pmid=16269630 | doi=10.1161/01.STR.0000190056.76543.eb | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16269630 }} </ref> | ||
*Gastrointestinal ulcers and/or bleeding | *Gastrointestinal ulcers and/or bleeding | ||
*Deep vein thrombosis and pulmonary embolism | *Deep vein thrombosis and pulmonary embolism<ref name="pmid18096834">{{cite journal| author=Indredavik B, Rohweder G, Naalsund E, Lydersen S| title=Medical complications in a comprehensive stroke unit and an early supported discharge service. | journal=Stroke | year= 2008 | volume= 39 | issue= 2 | pages= 414-20 | pmid=18096834 | doi=10.1161/STROKEAHA.107.489294 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18096834 }} </ref><ref name="pmid9633711">{{cite journal| author=Kamran SI, Downey D, Ruff RL| title=Pneumatic sequential compression reduces the risk of deep vein thrombosis in stroke patients. | journal=Neurology | year= 1998 | volume= 50 | issue= 6 | pages= 1683-8 | pmid=9633711 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9633711 }} </ref> | ||
*[[Myocardial infarction]] | *[[Myocardial infarction]]<ref name="pmid18096834">{{cite journal| author=Indredavik B, Rohweder G, Naalsund E, Lydersen S| title=Medical complications in a comprehensive stroke unit and an early supported discharge service. | journal=Stroke | year= 2008 | volume= 39 | issue= 2 | pages= 414-20 | pmid=18096834 | doi=10.1161/STROKEAHA.107.489294 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18096834 }} </ref> | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |'''Late complications''' | | style="padding: 5px 5px; background: #DCDCDC;" |'''Late complications''' | ||
| Line 28: | Line 29: | ||
*Recurrent stroke | *Recurrent stroke | ||
*[[Seizure]] | *[[Seizure]] | ||
*[[Aspiration pneumonitis]] | *[[Aspiration pneumonitis]]<ref name="pmid16269630">{{cite journal| author=Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R| title=Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. | journal=Stroke | year= 2005 | volume= 36 | issue= 12 | pages= 2756-63 | pmid=16269630 | doi=10.1161/01.STR.0000190056.76543.eb | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16269630 }} </ref> | ||
*[[Deep vein thrombosis]] and [[pulmonary embolism]] | *[[Deep vein thrombosis]] and [[pulmonary embolism]]<ref name="pmid18096834">{{cite journal| author=Indredavik B, Rohweder G, Naalsund E, Lydersen S| title=Medical complications in a comprehensive stroke unit and an early supported discharge service. | journal=Stroke | year= 2008 | volume= 39 | issue= 2 | pages= 414-20 | pmid=18096834 | doi=10.1161/STROKEAHA.107.489294 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18096834 }} </ref><ref name="pmid15322298">{{cite journal| author=Kelly J, Rudd A, Lewis RR, Coshall C, Moody A, Hunt BJ| title=Venous thromboembolism after acute ischemic stroke: a prospective study using magnetic resonance direct thrombus imaging. | journal=Stroke | year= 2004 | volume= 35 | issue= 10 | pages= 2320-5 | pmid=15322298 | doi=10.1161/01.STR.0000140741.13279.4f | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15322298 }} </ref><ref name="pmid21883879">{{cite journal| author=Dennis M, Mordi N, Graham C, Sandercock P, CLOTS trials collaboration| title=The timing, extent, progression and regression of deep vein thrombosis in immobile stroke patients: observational data from the CLOTS multicenter randomized trials. | journal=J Thromb Haemost | year= 2011 | volume= 9 | issue= 11 | pages= 2193-200 | pmid=21883879 | doi=10.1111/j.1538-7836.2011.04486.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21883879 }} </ref><ref name="pmid23391151">{{cite journal| author=Amin AN, Lin J, Thompson S, Wiederkehr D| title=Rate of deep-vein thrombosis and pulmonary embolism during the care continuum in patients with acute ischemic stroke in the United States. | journal=BMC Neurol | year= 2013 | volume= 13 | issue= | pages= 17 | pmid=23391151 | doi=10.1186/1471-2377-13-17 | pmc=3571887 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23391151 }} </ref> | ||
*Decubitus ulcer | *Decubitus ulcer | ||
*Permanent [[cognitive]] or language dysfunction | *Permanent [[cognitive]] or language dysfunction | ||
Revision as of 19:53, 10 November 2016
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Ischemic Stroke Microchapters |
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Case Studies |
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Ischemic stroke natural history On the Web |
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American Roentgen Ray Society Images of Ischemic stroke natural history |
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Risk calculators and risk factors for Ischemic stroke natural history |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Natural History
Complications
Common complications of ischemic stroke may include:[1][2][3]
| Duration | Complications |
|---|---|
| Early complications
( <7 days ) |
|
| Late complications
( >7 days ) |
|
Prognosis
Prognosis of stroke depends on factors such as:[10][11][12]
- 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
Infarct size and location
- Large size of infarct
- Severe neurological deficit
- Large volume of infarct (supratentorial infarcts)
- Infarct location and vascular supply[13][14][15]
- Cervical internal carotid artery
- Anterior choroidal artery
- Insular branch of middle cerebral artery
- Basilar artery
- Large intracranial artery
Presence of clinical complications
- Cerebral edema
- Fever
- Hyperglycemia >200mg/dl
Presence of other co morbid conditions
- Anemia
- Myocardial infarction
- Diabetes mellitus
- Atrial fibrillation
- Malnutrition
- Renal dysfunction
- Heart failure
- Cancer
- Coronary artery disease
Other
- Advanced age[16]
- Low socioeconomic status
- African American population
References
- ↑ 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.
- ↑ 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.
- ↑ 3.0 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.
- ↑ 4.0 4.1 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Senelick Richard C., Rossi, Peter W., Dougherty, Karla (1994). Living with Stroke: A Guide For Families. Contemporary Books, Chicago.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.