Management of Acute Stroke Complication.
10.5124/jkma.2009.52.4.365
- Author:
Jongmin LEE
1
Author Information
1. Department of Rehabilitation Medicine, Konkuk University School of Medicine, Korea. leej@kku.ac.kr
- Publication Type:Original Article
- Keywords:
Complications;
Acute stroke;
Management
- MeSH:
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
- From:Journal of the Korean Medical Association
2009;52(4):365-374
- CountryRepublic of Korea
- Language:Korean
-
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.
