Deteriorating Stroke: Diagnostic Criteria, Predictors, Mechanisms and Treatment

Neurological deterioration in the hours following the onset of stroke is not rare. Depending on the diagnostic criteria and the time from onset of symptoms to the first evaluation, neurological deterioration has been reported in 26–43% of cerebral infarcts (CI) [1–8], and 33–51% of intracerebral hemorrhages (ICH) [9, 10]. In both types of stroke, neurological deterioration is associated with increased mortality and morbidity [3, 5, 6, 8, 11]. Early detection and prediction of neurological deterioration, identification of the responsible mechanisms and their correction, are the basis of an effective therapy.