Ischemic stroke natural history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Ischemic stroke is a medical emergency requiring urgent diagnosis and treatment. Neurological tissue is highly time sensitive when there is decreased or absent blood supply to the brain.[1] If left untreated, brain tissue may irreversibly be damaged causing permanent neurological deficit and in certain cases death. The extent of damage and complications which may result highly depends on the site of infarction, the blood vessels involved and the presence of other risk factors.[2][3][4] Complications of ischemic stroke may include cerebral edema, cerebral herniation, hemorrhagic transformation of ischemic stroke, deep venous thrombosis, pulmonary embolism, aspiration pneumonia, seizures, pressure sores, depression and anxiety.[5][6][7][8][9][10][11][12][13][14][15][16] [17] [18][19] Prognosis of ischemic stroke depends on volume and size of infarct, degree of neurological deficit, presence of co morbid conditions and complications such as fever, hyperglycemia and cerebral edema.[20][21][22][23][24][25][26][27]

Natural History

Ischemic stroke is a medical emergency requiring urgent diagnosis and treatment. Neurological tissue is highly time sensitive when there is decreased or absent blood supply to the brain.[1] If left untreated, brain tissue may irreversibly be damaged causing permanent neurological deficit and in certain cases death. The extent of damage and complications which may result highly depends on the site of infarction, the blood vessels involved and the presence of other risk factors.[2][3][4]

Complications

Common complications of ischemic stroke may include:[5][6][7][8][9][10][11][12][13][14][15][16] [17] [18][19]

Duration Complications
Early complications

( <7 days )

Late complications

( >7 days )

Prognosis

Prognosis of stroke depends on factors such as:[20][21][22][23][24][25][26][27]

Good prognostic factors Bad Prognostic factors
Small size of infarct Large size and volume of infarct[28]
Mild neurological defect Severe neurological deficit[21][23][29][30][31][27]
NIHSS score >16 NIHSS score <16[32][33][34]
Lacunar infarcts Location of the infarct[25][29][35][36][37][38]
Absence of fever, cerebral edema and hyperglycemia Presence of fever, cerebral edema, hyperglycemia[25][29][42][43]
No co morbid conditions Presence of co morbid conditions[25][44]
Younger age group Advanced age[23][50]
Early diagnosis and treatment Delay in seeking treatment
Good nutritional status Poor nutritional status [51]

References

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