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Abstract

Prevention and specialist management of complications that arise following stroke may improve both short-term and long-term outcome. Anticipating potential post-stroke complications may also expedite initiation of preventative and therapeutic measures in high-risk patients. Complications related to stroke are both dynamic and transitional in their onset and are heterogeneous in nature. Neurological issues as a direct influence of the stroke on the brain include cerebral oedema, haemorrhagic transformation of infarction, and seizure activity, as well as death subsequent to brain herniation. Neuropsychiatric complications include cognitive impairment, delirium, depression, and anxiety. Complications resulting from impairments after stroke include venous thromboembolism, urinary tract infections, aspiration pneumonia, pressure sores, falls, malnutrition, and complications arising from the cardiac systems. Patients with stroke should therefore be closely monitored for the early detection of these complications. Multidisciplinary stroke unit care provides the best environment to prevent and manage these complications effectively.

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References

  1. Johnston KC, Li JY, Lyden PD, Hanson SK, Feasby TE, Adams RJ, et al. Medical and neurological complications of ischaemic stroke; experience from the RANTTAS trial. Stroke. 1998;29:447–53.

    Article  CAS  PubMed  Google Scholar 

  2. Kalra L, Yu G, Wilson K, Roots P. Medical complications during stroke rehabilitation. Stroke. 1995;26:990–4.

    Article  CAS  PubMed  Google Scholar 

  3. Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C, et al. Medical complications after stroke. A multicentre study. Stroke. 2000;31:1223–9.

    Article  CAS  PubMed  Google Scholar 

  4. Weimar C, Roth MP, Zillessen G, Glahn J, Wimmer ML, Busse O, German Stroke Date Bank Collaborators, et al. Complications following acute ischaemic stroke. Eur Neurol. 2002;48:133–40.

    Article  PubMed  Google Scholar 

  5. Hong KS, Kang DW, Koo JS, Yu KH, Han MK, Cho YJ, et al. Impact of neurological and medical complications on 3-month outcomes in acute ischaemic stroke patients. Eur J Neurol. 2008;15:1324–31.

    Article  PubMed  Google Scholar 

  6. Davenport RJ, Dennis MS, Wellwood I, Warlow CP. Complications after acute stroke. Stroke. 1996;27:415–20.

    Article  CAS  PubMed  Google Scholar 

  7. Roth EJ, Lovell L, Harvey RL, Heinemann AW, Semik P, Diaz S. Incidence of and risk factors for medical complications during stroke rehabilitation. Stroke. 2001;32:523–9.

    Article  CAS  PubMed  Google Scholar 

  8. Indredavik B, Rohweder G, Naalsund E, Lydersen S. Medical complications in a comprehensive stroke unit and early supported discharge service. Stroke. 2008;39:414–20.

    Article  PubMed  Google Scholar 

  9. Bae HJ, Yoon DS, Lee J, Kim BK, Koo JS, Kwon O, et al. In-hospital medical complications and long-term mortality after ischaemic stroke. Stroke. 2005;36:2441–5.

    Article  PubMed  Google Scholar 

  10. Kumar S, Selim MH, Caplan LR. Medical complications after stroke. Lancet Neurol. 2010;9:105–18.

    Article  PubMed  Google Scholar 

  11. Dromerick A, Reding M. Medical and neurological complications during inpatient stroke rehabilitation. Stroke. 1994;25:358–61.

    Article  CAS  PubMed  Google Scholar 

  12. Adler M, Hamaty D, Brown CC, Potts H. Medical audit of stroke rehabilitation: a critique of medical care review. J Chronic Dis. 1977;30:461–71.

    Article  CAS  PubMed  Google Scholar 

  13. Dobkin BH. Neuromedical complications in stroke patients transferred for rehabilitation before and after diagnostic related groups. J Neurol Rehabil. 1987;1:3–7.

    Google Scholar 

  14. Oczkowski WJ, Ginsberg JS, Shin A, Panju A. Venous thromboembolism in patients undergoing rehabilitation for stroke. Arch Phys Med Rehabil. 1992;73:712–6.

    CAS  PubMed  Google Scholar 

  15. Miyamoto AT, Miller LS. Pulmonary embolism in stroke: prevention by early heparinisation of venous thrombosis detected by iodine-125 fibrinogen leg scans. Arch Phys Med Rehabil. 1980;61:584–7.

    CAS  PubMed  Google Scholar 

  16. Sioson ER, William EC, Dawson NV. Occult proximal deep vein thrombosis: its prevalence among patients admitted to a rehabilitation hospital. Arch Phys Med Rehabil. 1998;69:183–5.

    Google Scholar 

  17. Kauhanen ML, Korpelainen JT, Hiltunen P, Brusin E, Mononen H, Maatta R, et al. Post-stroke depression correlates with correlates with cognitive impairment and neurological deficits. Stroke. 1999;30:1875–80.

    Article  CAS  PubMed  Google Scholar 

  18. Silver FL, Norris JW, Lewis AJ, Hachinski VC. Early mortality following stroke: a prospective review. Stroke. 1984;15:492–6.

    Article  CAS  PubMed  Google Scholar 

  19. Bamford J, Dennis M, Sandercock P, Burn J, Warlow C. The frequency, causes and timing of death within 30 days of a first stroke: the Oxfordshire Community Stroke Project. J Neurol Neurosurg Psychiatry. 1990;53:824–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Viitanen M, Winbald B, Asplund K. Autopsy verified causes of death after stroke. Acta Med Scand. 1987;222:401–8.

    Article  CAS  PubMed  Google Scholar 

  21. Ingeman A, Andersen G, Hundborg H, Svendsen M, Johnsen P. In-hospital medical complications, length of stay and mortality among stroke unit patients. Processes of care and medical complications in patients with stroke. Stroke. 2011;42:3214–8.

    Article  PubMed  Google Scholar 

  22. Rocco A, Pasquini M, Cecconi E, Sirimarco G, Ricciardi MC, Vicenzi E, et al. Monitoring after the acute stage of stroke: a prospective study. Stroke. 2007;38:1225–8.

    Article  PubMed  Google Scholar 

  23. Bhalla A, Wolfe CD, Rudd AG. Management of acute physiological parameters. QJM. 2001;94:167–72.

    Article  CAS  PubMed  Google Scholar 

  24. Ingeman A, Andersen G, Hundborg H, Svendsen M, Johnsen P. Processes of care and medical complications in patients with stroke. Stroke. 2011;42:167–72.

    Article  PubMed  Google Scholar 

  25. Govan L, Langhorne P, Weir CJ, Stroke Unit Trialists Collaboration. Does the prevention of complications explain the survival benefit of organised inpatient (stroke unit) care?: further analysis of a systematic review. Stroke. 2007;38:2536–40.

    Article  PubMed  Google Scholar 

  26. Middleton S, McElduff P, Ward J, Grimshaw JM, dale S, D’Este C, et al. Implementation of evidence based treatment protocols to manage fever, hyperglycaemia and swallowing dysfunction in acute stroke (QASC): a cluster randomised controlled trial. Lancet. 2011;378:1699–706.

    Article  PubMed  Google Scholar 

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Correspondence to Ajay Bhalla MSc, MD, FRCP .

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Bhalla, A., Birns, J. (2015). Introduction. In: Bhalla, A., Birns, J. (eds) Management of Post-Stroke Complications. Springer, Cham. https://doi.org/10.1007/978-3-319-17855-4_1

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  • DOI: https://doi.org/10.1007/978-3-319-17855-4_1

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-17854-7

  • Online ISBN: 978-3-319-17855-4

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