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  • Updated 10.26.2023
  • Released 06.07.2001
  • Expires For CME 10.26.2026

Medical complications of stroke



Medical complications following stroke account for significant morbidity and mortality. Early recognition and management result in a more favorable outcome. During the first week, the direct effects of ischemic stroke are responsible for most deaths. Other medical complications, including cardiac, infectious, 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 serious 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 require further testing.

• During the acute stroke phase, thrombolysis should be avoided for treatment of severe pulmonary embolism.

• Limited mobility following stroke is associated with osteoporosis, fractures, pressure sores, painful arthritis, and peripheral neuropathy.

• Post-stroke pain may be severely debilitating and refractory to conventional analgesics. Invasive neurosurgical procedures and noninvasive transcranial magnetic stimulation have shown promising results but require further testing.

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