Ischemic stroke natural history: Difference between revisions

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:*Coronary artery disease
:*Coronary artery disease
=====Other=====
=====Other=====
*Advanced age
*Advanced age<ref name="pmid9737218">{{cite journal| author=Wijdicks EF, Diringer MN| title=Middle cerebral artery territory infarction and early brain swelling: progression and effect of age on outcome. | journal=Mayo Clin Proc | year= 1998 | volume= 73 | issue= 9 | pages= 829-36 | pmid=9737218 | doi=10.4065/73.9.829 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9737218  }} </ref>
*Low socioeconomic status
*Low socioeconomic status
*African American population
*African American population

Revision as of 15:37, 10 November 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Natural History

Complications

Duration Complications
Early complications

( <7 days )

  • Cerebral edema and herniation (within 96 hr)
  • Expansion of the infarct/recurrent infarction
  • Hemorrhagic transformation of the infarcted area
  • Seizure
  • Aspiration pneumonitis
  • Gastrointestinal ulcers and/or bleeding
  • Deep vein thrombosis and pulmonary embolism
  • Myocardial infarction
Late complications

( >7 days )

Prognosis

Prognosis of stroke depends on factors such as:[2][3][4]

  • 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[5][6][7]
  • 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[8]
  • Low socioeconomic status
  • African American population

References

  1. Senelick Richard C., Rossi, Peter W., Dougherty, Karla (1994). Living with Stroke: A Guide For Families. Contemporary Books, Chicago.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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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