6. Prevention and Management of Poststroke Complications

  1. Kevin M. Barrett MD, MSc2 and
  2. James F. Meschia MD3
  1. Raid G. Ossi MD

Published Online: 7 MAY 2013

DOI: 10.1002/9781118560730.ch6

Stroke

Stroke

How to Cite

Ossi, R. G. (2013) Prevention and Management of Poststroke Complications, in Stroke (eds K. M. Barrett and J. F. Meschia), John Wiley & Sons, Oxford. doi: 10.1002/9781118560730.ch6

Editor Information

  1. 2

    Mayo Clinic, Jacksonville, FL, USA

  2. 3

    Mayo Clinic, Jacksonville, FL, USA

Author Information

  1. Department of Neurology, Mayo Clinic Florida, Jacksonville, Florida

Publication History

  1. Published Online: 7 MAY 2013
  2. Published Print: 22 APR 2013

ISBN Information

Print ISBN: 9780470674369

Online ISBN: 9781118560730

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Keywords:

  • ischemic stroke;
  • hemorrhagic stroke;
  • tissue-plasminogen activator;
  • venous thromboembolism;
  • hemorrhagic transformation

Summary

Prevention and proper management of medical and neurological complications that arise shortly after ischemic or hemorrhagic stroke may improve both short-term and long-term outcomes. Anticipating potential poststroke complications can expedite initiation of preventive and therapeutic measures. Complications related to stroke, resulting in morbidity and mortality, are common and may result from medical or neurological causes. Medical causes include venous thromboembolism (deep vein thrombosis and pulmonary embolism) urinary tract infections, aspiration pneumonia, nonbleeding complications of recombinant tissue plasminogen activator, pressure sores and ulcerations, falls, malnutrition, pain, and complications involving the gastrointestinal or cardiac systems. Neuropsychiatric disturbances such as delirium may also occur. Neurological complications include postinfarct cerebral edema, hemorrhagic transformation, seizures, headache, sleep disorders, and sleep-disordered breathing. Patients with stroke should therefore be monitored closely for early detection of these complications. Care is best when a patient is admitted to a specialized stroke unit. The multidisciplinary approach provided by stroke units, including specialized medical, nursing, and rehabilitation therapies, reduces the duration of hospitalization and improves functional outcome.