Complications following Acute Ischemic Stroke

The objective of this study was to assess typical early-onset complications following ischemic stroke in a large, hospital-based cohort to provide clinical data for future randomized trials and quality standards in clinical routine. 3,866 patients with acute ischemic stroke were prospectively documented in 14 Neurology Departments with an acute stroke unit. Within the first week after admission, increased intracranial pressure (7.6%) and recurrent cerebral ischemia (5.1%) were the most frequent neurological complications. Fever >38°C (13.2%), severe arterial hypertension (7.5%) and pneumonia (7.4%) were the most frequent medical complications. Multivariate regression analysis yielded brain stem infarction and large-artery atherosclerosis as independent predictors for early recurrent ischemic stroke. This study provides representative data on onset and severity of early neurological and medical complications as well as possible predictors for early recurrent cerebral ischemia following acute ischemic stroke.

[1]  P. Sandercock,et al.  Long‐term Survival After First‐Ever Stroke: The Oxfordshire Community Stroke Project , 1993, Stroke.

[2]  S M Davis,et al.  Epileptic seizures in acute stroke. , 1990, Archives of neurology.

[3]  J. Slattery,et al.  Antithrombotic therapy in acute ischaemic stroke: an overview of the completed randomised trials. , 1993, Journal of neurology, neurosurgery, and psychiatry.

[4]  R. Sacco,et al.  Mortality and causes of death after first ischemic stroke: The Northern Manhattan Stroke Study , 2001 .

[5]  I. König,et al.  Predicting functional outcome and survival after acute ischemic stroke , 2002, Journal of Neurology.

[6]  P. Sandercock,et al.  Low-molecular-weight heparins or heparinoids versus standard unfractionated heparin for acute ischaemic stroke. , 2017, The Cochrane database of systematic reviews.

[7]  J. Cairns,et al.  Prevention of stroke in patients with nonvalvular atrial fibrillation , 1998, Neurology.

[8]  W. Hauser,et al.  Population-based study of seizure disorders after cerebral infarction , 1996, Neurology.

[9]  J. G. Evans,et al.  The epidemiology of stroke. , 1979, Age and ageing.

[10]  G. Murray,et al.  Medical complications after stroke: a multicenter study. , 2000, Stroke.

[11]  W R Clarke,et al.  Baseline NIH Stroke Scale score strongly predicts outcome after stroke , 1999, Neurology.

[12]  C. Warlow,et al.  Complications after acute stroke. , 1996, Stroke.

[13]  W Hacke,et al.  Brain temperature monitoring and modulation in patients with severe MCA infarction , 1997, Neurology.

[14]  H. Karibe,et al.  Mild Intraischemic Hypothermia Reduces Postischemic Hyperperfusion, Delayed Postischemic Hypoperfusion, Blood-Brain Barrier Disruption, Brain Edema, and Neuronal Damage Volume after Temporary Focal Cerebral Ischemia in Rats , 1994, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[15]  P. Sandercock,et al.  Is there still a role for intravenous heparin in acute stroke? No. , 1999, Archives of neurology.

[16]  T. Olsen,et al.  Seizures in acute stroke: predictors and prognostic significance. The Copenhagen Stroke Study. , 1997, Stroke.

[17]  R. Adams,et al.  Medical and neurological complications of ischemic stroke: experience from the RANTTAS trial. RANTTAS Investigators. , 1998, Stroke.

[18]  M. Giroud,et al.  Early Seizures After Acute Stroke: A Study of 1,640 Cases , 1994, Epilepsia.

[19]  P. Sandercock.  Is there still a role for intravenous heparin in acute stroke? No. , 1999 .

[20]  L. Kappelle,et al.  Complications of Acute Ischaemic Stroke , 1998, Cerebrovascular Diseases.

[21]  Zheng-Ming Chen,et al.  CAST: randomised placebo-controlled trial of early aspirin use in 20 000 patients with acute ischaemic stroke , 1997, The Lancet.

[22]  W Hacke,et al.  Early hemicraniectomy in patients with complete middle cerebral artery infarction. , 1998, Stroke.

[23]  T. Olsen,et al.  Body temperature in acute stroke: relation to stroke severity, infarct size, mortality, and outcome , 1996, The Lancet.

[24]  M Chopp,et al.  The Effect of Hypothermia on Transient Middle Cerebral Artery Occlusion in the Rat , 1992, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[25]  Peter Sandercock,et al.  The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19 435 patients with acute ischaemic stroke , 1997, The Lancet.

[26]  The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group. , 1997, Lancet.

[27]  S. Hajat,et al.  Effects of poststroke pyrexia on stroke outcome : a meta-analysis of studies in patients. , 2000, Stroke.

[28]  A. Arboix,et al.  Relevance of early seizures for in-hospital mortality in acute cerebrovascular disease , 1996, Neurology.

[29]  Daniel B Hier,et al.  Determinants of early recurrence of cerebral infarction. The Stroke Data Bank. , 1989, Stroke.

[30]  J Tuomilehto,et al.  International trends in mortality from stroke, 1968 to 1994. , 2000, Stroke.

[31]  H. Diener,et al.  Risk Factors, Outcome, and Treatment in Subtypes of Ischemic Stroke: The German Stroke Data Bank , 2001, Stroke.

[32]  M. O. Dayhoff,et al.  Data bank , 1981, Nature.