Journal Mobile Options
Table of Contents
Vol. 16, No. 4, 2003
Issue release date: September 2003
Cerebrovasc Dis 2003;16:383–388
(DOI:10.1159/000072561)

Consequences of Mild Stroke in Persons <75 Years – A 1-Year Follow-Up

Carlsson G.E. · Möller A. · Blomstrand C.
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

Background and Purpose: Mild strokes can be neglected regarding subtle sequels as fatigue, and cognitive and emotional changes. We have addressed this topic by exploring late consequences of an initially mild stroke (Barthel score ≧50). Accordingly, we assayed impairment, disability and handicap data 1 year after the first-ever stroke in persons <75 years, focusing on symptoms as fatigue, concentration difficulties, memory disturbances, emotional lability, stress resistance, anxiety and uneasiness, symptoms comprised in the astheno-emotional disorder (AED), and its relation to life satisfaction. Results: The mean value of the Barthel Index was 99.5 (SD 0.5) and 25% scored 0–1 on the Oxford Handicap Scale. AED was diagnosed in 71% of the patients, and fatigue was experienced by 72%. AED correlated significantly with life satisfaction, handicap and depression. Life satisfaction was significantly below that of norm values according to satisfaction with life as a whole, sex life and ability to manage selfcare. Conclusions: Our findings emphasize that ‘hidden dysfunctions’ not so easily discovered within the hospital context are common consequences of mild stroke. The concept of mild stroke as principally founded in motor function or ability in P-ADL therefore seems to be insufficient with respect to the patient long-term perspective.



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. Stegmayr B, Asplund K, Wester PO: Trends in incidence, case-fatality rate, and severity of stroke in northern Sweden, 1985–1991. Stroke 1994;25:1738–1745.
  2. Numminen H, Kaste M, Aho K, Waltimo O, Kotila M: Decreased severity of brain infarct can in part explain the decreasing case fatality rate of stroke. Stroke 2000;31:651–655.
  3. Carota A, Staub F, Bogousslavsky J: Emotions, behaviours and mood changes in stroke. Curr Opin Neurol 2002;15:57–69.
  4. Robinson RG: Neuropsychiatric consequences of stroke. Annu Rev Med 1997;48:217–229.
  5. Ingles JL, Eskes GA, Phillips SJ: Fatigue after stroke. Arch Phys Med Rehabil 1999;80:173–178.
  6. Van Zandvoort MJ, Kappelle LJ, Algra A, De Haan EH: Decreased capacity for mental effort after single supratentorial lacunar infarct may affect performance in everyday life. J Neurol Neurosurg Psychiatry 1998;65:697–702.
  7. van der Werf SP, van den Broek HL, Anten HW, Bleijenberg G: Experience of severe fatigue long after stroke and its relation to depressive symptoms and disease characteristics. Eur Neurol 2001;45:28–33.
  8. Staub F, Bogousslavsky J: Fatigue after stroke: A major but neglected issue. Cerebrovasc Dis 2001;12:75–81.
  9. Stroke Unit Trialists’ Collaboration: Organised Inpatient (Stroke Unit) Care for Stroke (Cochrane Review on CD-ROM). Oxford, Cochrane Library, Internet Update 1999.
  10. Wade DT, Hewer RL: Functional abilities after stroke: Measurement, natural history and prognosis. J Neurol Neurosurg Psychiatry 1987;50:177–182.
  11. Forsberg-Warleby G, Moller A, Blomstrand C: Spouses of first-ever stroke patients: Their view of the future during the first phase after stroke. Clin Rehabil 2002;16:506–514.

    External Resources

  12. Scandinavian Stroke Study Group: Multicenter trial of hemodilution in ischemic stroke – Background and study protocol. Stroke 1985;16:885–890.
  13. Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  14. Friedman PJ: The Star Cancellation Test in acute stroke. Clin Rehabil 1992;6:23–30.
  15. Mahoney FI, Barthel DW: Functional evaluation: The Barthel Index. Md State Medical J 1965:61–65.
  16. Bamford JM, Sandercock PA, Warlow CP, Slattery J: Interobserver agreement for the assessment of handicap in stroke patients. Stroke 1989;20:828.
  17. Lindqvist G, Malmgren H: Organic mental disorders as hypothetical pathogenetic processes. Acta Psychiatr Scand Suppl 1993;373:5–17.
  18. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 1994.
  19. Tullberg M, Mansson JE, Fredman P, Lekman A, Blennow K, Ekman R, Rosengren LE, Tisell M, Wikkelso C: CSF sulfatide distinguishes between normal pressure hydrocephalus and subcortical arteriosclerotic encephalopathy. J Neurol Neurosurg Psychiatry 2000;69:74–81.
  20. Rodholm M, Starmark JE, Svensson E, Von Essen C: Astheno-emotional disorder after aneurysmal SAH: Reliability, symptomatology and relation to outcome. Acta Neurol Scand 2001;103:379–385.
  21. Rodholm M, Hellstrom P, Bilting M, Starmark JE: Diagnostic classification of organic psychiatric disorders after aneurysmal subarachnoid hemorrhage: A comparison between ICD 10, DSM-IV and the Lindqvist & Malmgren classification system. Acta Psychiatr Scand, in press.
  22. Fugl-Meyer AR, Bränholm IB, Fugl-Meyer K: Happiness and domain specific life satisfaction in adult northern Swedes. Clin Rehabil 1991;5:25–33.
  23. Fugl-Meyer K: Health, sexual ability and quality of life; in Levin B (ed): Sex in Sweden. Stockholm, National Institute of Public Health, 1998, pp 217–234.
  24. Bamford J, Sandercock P, Dennis M, Burn J, Warlow C: Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet 1991;337:1521–1526.
  25. Staub F, Bogousslavsky J: Post-stroke depression or fatigue. Eur Neurol 2001;45:3–5.
  26. The Board of Directors of the National Stroke Register: Analysed report from the National Stroke Register for the years 1999 and 2000. www.riks-stroke.org/files/contents.html.
  27. Peltonen M, Stegmayr B, Asplund K: Time trends in long-term survival after stroke: The Northern Sweden Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study, 1985–1994. Stroke 1998;29:1358–1365.


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