Journal Mobile Options
Table of Contents
Vol. 48, No. 3, 2002
Issue release date: October 2002

Complications following Acute Ischemic Stroke

Weimar C. · Roth M.P. · Zillessen G. · Glahn J. · Wimmer M.L.J. · Busse O. · Haberl R.L. · Diener H.C. · on behalf of the German Stroke Data Bank Collaborators O.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

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.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Khaw KT: Epidemiology of stroke. J Neurol Neurosurg Psychiatry 1996;61:333–338.
  2. Weimar C, Ziegler A, König IR, Diener HC: Predicting functional outcome and survival after acute ischemic stroke. J Neurol 2002;249:888–895.

    External Resources

  3. van der Worp HB, Kappelle LJ: Complications of acute ischaemic stroke. Cerebrovasc Dis 1998;8:124–132.
  4. Johnston KC, Li JY, Lyden PD, Hanson SK, Feasby TE, Adams RJ, Faught RE Jr, Haley EC Jr: Medical and neurological complications of ischemic stroke: Experience from the RANTTAS trial. RANTTAS Investigators. Stroke 1998;29:447–453.
  5. Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C, Dick F, Taylor GS, Murray G: Medical complications after stroke: A multicenter study. Stroke 2000;31:1223–1229.
  6. Davenport RJ, Dennis MS, Wellwood I, Warlow CP: Complications after acute stroke. Stroke 1996;27:415–420.
  7. Adams HP Jr, Davis PH, Leira EC, Chang KC, Bendixen BH, Clarke WR, Woolson RF, Hansen MD: Baseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Neurology 1999;53:126–131.
  8. Grau AJ, Weimar C, Buggle F, Heinrich A, Goertler M, Neumaier S, Glahn J, Brandt T, Hacke W, Diener HC: Risk factors, outcome, and treatment in subtypes of ischemic stroke: The German stroke data bank. Stroke 2001;32:2559–2566.

    External Resources

  9. Hartmann A, Rundek T, Mast H, Paik MC, Boden-Albala B, Mohr JP, Sacco RL: Mortality and causes of death after first ischemic stroke: The Northern Manhattan Stroke Study. Neurology 2001;57:2000–2005.
  10. Dennis MS, Burn JP, Sandercock PA, Bamford JM, Wade DT, Warlow CP: Long-term survival after first-ever stroke: The Oxfordshire Community Stroke Project. Stroke 1993;24:796–800.
  11. Sarti C, Rastenyte D, Cepaitis Z, Tuomilehto J: International trends in mortality from stroke, 1968 to 1994. Stroke 2000;31:1588–1601.
  12. Schwab S, Steiner T, Aschoff A, Schwarz S, Steiner HH, Jansen O, Hacke W: Early hemicraniectomy in patients with complete middle cerebral artery infarction. Stroke 1998;29:1888–1893.
  13. 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. Lancet 1997;349:1569–1581.
  14. CAST: Randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group. Lancet 1997;349:1641–1649.
  15. Sandercock P: Is there still a role for intravenous heparin in acute stroke? No. Arch Neurol 1999;56:1160–1161.
  16. Hart RG, Sherman DG, Easton JD, Cairns JA: Prevention of stroke in patients with nonvalvular atrial fibrillation. Neurology 1998;51:674–681.
  17. Sacco RL, Foulkes MA, Mohr JP, Wolf PA, Hier DB, Price TR: Determinants of early recurrence of cerebral infarction. The Stroke Data Bank. Stroke 1989;20:983–989.
  18. Giroud M, Gras P, Fayolle H, Andre N, Soichot P, Dumas R: Early seizures after acute stroke: A study of 1,640 cases. Epilepsia 1994;35:959–964.
  19. So EL, Annegers JF, Hauser WA, O’Brien PC, Whisnant JP: Population-based study of seizure disorders after cerebral infarction. Neurology 1996;46:350–355.
  20. Reith J, Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS: Seizures in acute stroke: Predictors and prognostic significance. The Copenhagen Stroke Study. Stroke 1997;28:1585–1589.
  21. Arboix A, Comes E, Massons J, Garcia L, Oliveres M: Relevance of early seizures for in-hospital mortality in acute cerebrovascular disease. Neurology 1996;47:1429–1435.
  22. Kilpatrick CJ, Davis SM, Tress BM, Rossiter SC, Hopper JL, Vandendriesen ML: Epileptic seizures in acute stroke. Arch Neurol 1990;47:157–160.
  23. Reith J, Jorgensen HS, Pedersen PM, Nakayama H, Raaschou HO, Jeppesen LL, Olsen TS: Body temperature in acute stroke: Relation to stroke severity, infarct size, mortality, and outcome. Lancet 1996;347:422–425.
  24. Hajat C, Hajat S, Sharma P: Effects of poststroke pyrexia on stroke outcome: A meta-analysis of studies in patients. Stroke 2000;31:410–414.
  25. Chen H, Chopp M, Zhang ZG, Garcia JH: The effect of hypothermia on transient middle cerebral artery occlusion in the rat. J Cereb Blood Flow Metab 1992;12:621–628.
  26. Karibe H, Zarow GJ, Graham SH, Weinstein PR: 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. J Cereb Blood Flow Metab 1994;14:620–627.
  27. Schwab S, Spranger M, Aschoff A, Steiner T, Hacke W: Brain temperature monitoring and modulation in patients with severe MCA infarction. Neurology 1997;48:762–767.
  28. Blood pressure in Acute Stroke Collaboration (BASC). Blood pressure management in acute stroke. 1. Assessment of trials designed to alter blood pressure; in Warlow C, Van Gijn J, Sandercock P, Candelise L, Langhorne P (eds): Stroke Module of the Cochrane Database of Systematic Reviews. Oxford, Update Software, 1997.
  29. Sandercock PA, van den Belt AG, Lindley RI, Slattery J: Antithrombotic therapy in acute ischaemic stroke: An overview of the completed randomised trials. J Neurol Neurosurg Psychiatry 1993;56:17–25.
  30. Counsell C, Sandercock P: Low-molecular-weight heparins or heparinoids versus standard unfractionated heparin for acute ischaemic stroke. Cochrane Database Syst Rev 2000;2:CD000119.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50