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  • Updated 07.21.2021
  • Released 06.07.2001
  • Expires For CME 07.21.2024

Medical complications of stroke

Introduction

Overview

Medical complications following stroke account for significant morbidity and mortality, and conditions need to be recognized early and managed effectively for a more favorable outcome. Direct effects of ischemic stroke account for most deaths within the first week. Other medical complications that include cardiac abnormalities, infections, and venous thromboembolism increase mortality thereafter. In this article, the author discusses the medical complications of stroke-related deficits, their workup, and treatment modalities.

Key points

• Venous thromboembolism is one of the most common and potentially dangerous complications of stroke because of impaired limb mobility. In the case of intracerebral hemorrhage, early anticoagulation is of concern.

• Although promising, the new oral anticoagulants need further testing before they may be used as anticoagulants of choice.

• In the context of acute stroke, treatment of hemodynamically unstable pulmonary embolism requires specialized care because intravenous thrombolysis is contraindicated.

• Limited mobility following stroke increases the risk of osteoporosis, fractures, pressure sores, painful arthritis, and peripheral neuropathy.

• Post-stroke pain may be severely debilitating but difficult to control with conventional analgesics. More testing is needed for invasive neurosurgical and noninvasive transcranial magnetic stimulation.

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