Neurological complications of acute ischaemic stroke

Balami, Joyce S.; Chen, Ruoli; Grunwald, Iris Q.; Buchan, Alastair M.

doi:10.1016/s1474-4422(10)70313-6

Cited by 197 publications

(191 citation statements)

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“…Post-stroke complication is a leading cause of death accounting for 23-50% of total deaths in patients with ischaemic stroke. These include both medical and neurological complications 15 . Neurological complications frequently account for the worsening seen during the acute phase 16 .…”

Section: Introductionmentioning

confidence: 99%

Stroke mortality and its predictors in a Nigerian teaching hospital

Ekeh¹,

Ogunniyi²,

Isamade³

et al. 2015

Afr H. Sci.

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Background: Stroke is the third leading cause of death worldwide. Stroke mortality has been noted to be higher in blacks in biracial studies. There have been few studies on stroke mortality and its predictors in Nigeria. This study examines mortality of stroke and its predictors in a Northern Nigerian teaching hospital. Methods: This was a prospective study that was carried out at Jos University Teaching Hospital in Nigeria. One hundred and twenty stroke patients admitted into the medical wards within one year were assessed. Demographic data was recorded. Patients were examined and ancillary investigations were carried out. The deaths and predictors were recorded. Multivariate logistic regression was used to identify independent predictors of mortality. Results: There were one hundred and twenty participants. Forty two (35%), patients died. Most (76.2%) deaths occurred within the first week. Predictors of mortality on univariate analysis were age ≥ 60 years, male sex, loss of consciousness, high NIHSS score (≥16), the presence of co-morbid conditions and presence of complications. On multivariate analysis, the predictors of mortality were the presence of co-morbid conditions, GCS<10 and high NIHSS score. Conclusion: Stroke mortality was quite high in this study. Predictors of mortality were the indices of severity and the presence of co-morbid conditions.

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Section: Introductionmentioning

confidence: 99%

Stroke mortality and its predictors in a Nigerian teaching hospital

Ekeh¹,

Ogunniyi²,

Isamade³

et al. 2015

Afr H. Sci.

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“…The prevalence varies between 13% and 38% 1. Previous studies have focused on neurological worsening within 48 h and up to the first week after stroke onset and showed that large‐vessel occlusion, insufficient collateralization, clot progression, haemorrhagic transformation, raised intracranial pressure, seizures, infection or pre‐existing comorbid conditions are potential factors associated with neurological worsening 2, 3, 4, 5, 6. Nocturnal cardiac modulation after acute ischaemic stroke may be responsible for sudden neurological worsening 7, and baroreflex sensitivity is a prospective marker for acute neurological worsening 5.…”

Section: Introductionmentioning

confidence: 99%

Early neurological worsening in acute ischaemic stroke patients

et al. 2015

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ObjectivesNeurological worsening in acute ischaemic stroke patients is common with significant morbidity and mortality.AimsTo determine the factors associated with early neurological worsening within the first 9 h after onset of acute ischaemic stroke.Materials & methodsThe National Institute of Health Stroke Scale (NIHSS) was used to assess stroke severity. Early neurological worsening was defined as NIHSS score increase ≥4 NIHSS points within 9 h of symptom onset compared to NIHSS score within 3 h of symptom onset. Patients with early neurological worsening were compared to patients with unchanged or improved NIHSS scores.ResultsOf the 2484 patients admitted with ischaemic stroke, 552 patients had NIHSS score within 3 h of symptom onset, and 44 (8.0%) experienced early neurological worsening. The median NIHSS on admission was 8.4 in both groups. Early neurological worsening was associated with low body temperature on admission (P = 0.01), proximal compared to distal MCA occlusion (P = 0.007) and with ipsilateral internal carotid artery stenosis >50% or occlusion (P = 0.04). Early neurological worsening was associated with higher NIHSS day 7 (P < 0.001) and higher mortality within 7 days of stroke onset (P = 0.005).ConclusionsEarly neurological worsening has serious consequences for the short‐term outcome for patients with acute ischaemic stroke and is associated with low body temperature on admission, and with extracranially and intracranially large‐vessel stenosis or occlusion.

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“…2 Frequent problems include epileptic seizures, depression, central pain, obstructive sleep apnea, cognitive dysfunction, and medical complications such as respiratory and urinary tract infections as well as cardiac arrhythmias. [2][3][4] An early diagnosis with subsequent adequate treatment of these complications was assumed to improve outcome after stroke. 4 Recent studies suggest in principle that prophylactic treatment (before its occurrence) of such poststroke complications might be even more beneficial than starting a treatment once a diagnosis of a specific complication is made.…”

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confidence: 99%

“…[2][3][4] An early diagnosis with subsequent adequate treatment of these complications was assumed to improve outcome after stroke. 4 Recent studies suggest in principle that prophylactic treatment (before its occurrence) of such poststroke complications might be even more beneficial than starting a treatment once a diagnosis of a specific complication is made. If true, such an acute prophylactic treatment of poststroke sequelae may have an enormous impact on the improvement of long-term neurological outcome and could become an important part in the care of patients with stroke besides acute treatment and secondary prevention.…”

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confidence: 99%