Ischemic stroke natural history

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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

  • 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
  • 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
  • Low socioeconomic status

References

  1. Senelick Richard C., Rossi, Peter W., Dougherty, Karla (1994). Living with Stroke: A Guide For Families. Contemporary Books, Chicago.

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