J Korean Med Assoc.  2009 Apr;52(4):365-374. 10.5124/jkma.2009.52.4.365.

Management of Acute Stroke Complication

• Lee J

• KMID: 2137721
• DOI: http://doi.org/10.5124/jkma.2009.52.4.365

Abstract

Acute complications following stroke may increase mortality and impede functional recovery. Most of the complications are treatable and preventable. Close monitoring of the complications and proper management are necessary for the better outcome of the patients. Common complications include aspiration pneumonia, dysphagia, urinary tract infection, incontinence, malnutrition, deep vein thrombosis, pressure sore, fall, pain, seizure, and depression. Proper positioning and early mobilization are recommended to prevent major complications. Aspiration pneumonia is one of the frequent causes of death in acute stroke setting. Dysphagia screening should be done to evaluate the risk of aspiration. If oral feeding is not safe, nasogastric tube feeding should be considered. The majority of urinary tract infections in acute stroke are associated with the use of indwelling catheters, therefore prolonged indwelling catheterization should be avoided. Nutritional assessment and supplements are necessary in acute stroke patients. Low dose subcutaneous heparin or low molecular weight heparin should be considered for patients with high risk of deep vein thrombosis. If heparin is contraindicated, compressive stockings are an alternative. Regular assessment for skin breakdown and fall risk is recommended for all patients. Shoulder pain is also one of the frequent complications in stroke patients. Proper handling and mobilization in acute stage may prevent shoulder pain. Administration of anticonvulsants may prevent recurrent post-stroke seizures. Depression may limit functional outcome by inhibiting patient motivation and treatment with antidepressants should be considered. Proper management of acute complications needs multidisciplinary team approach that consists of physicians, nurses, therapists, and nutritionists. Adequate prevention and management of complications may improve functional outcome of acute stroke.

Keyword

Complications; Acute stroke; Management

MeSH Terms

Anticonvulsants
Antidepressive Agents
Catheters, Indwelling
Cause of Death
Deglutition Disorders
Depression
Early Ambulation
Enteral Nutrition
Handling (Psychology)
Heparin
Heparin, Low-Molecular-Weight
Humans
Malnutrition
Mass Screening
Motivation
Nutrition Assessment
Pneumonia, Aspiration
Pressure Ulcer
Seizures
Shoulder Pain
Skin
Stroke
Urinary Tract Infections
Venous Thrombosis
Anticonvulsants
Antidepressive Agents
Heparin
Heparin, Low-Molecular-Weight

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