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  • Updated 09.29.2022
  • Released 06.07.2001
  • Expires For CME 09.29.2025

Medical complications of stroke



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.

• During acute stroke phase, thrombolysis is contraindicated for treatment of severe pulmonary embolism.

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

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

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