Chapter 24 Medical complications of stroke

Abstract

Stroke patients are prone to develop complications as a result of the stroke and the disability caused by it. Complications after stroke may be caused by preexisting medical conditions, such as atherosclerosis, prolonged bed rest and immobility, iatrogenic interventions, stroke-related therapeutics, or they may be a direct consequence of the stroke itself. The occurrence of complications after stroke is facilitated by several factors, such as advanced age, pre-stroke disability, pre-existing medical conditions, low serum albumin level, and increasing length of hospital stay. However, the severity of neurological deficits resulting from the stroke plays a dominant role. The likelihood and number of complications often correlate with stroke severity, and patients with the most severe neurological impairments tend to experience the most serious complications. The chapter discusses various medical complications of stroke, such as venous thromboembolism; deep venous thrombosis; pulmonary embolism; cardiovascular complications such as arrhythmias, elevated cardiac enzymes, and myocardial infarction; pulmonary complications such as oxygen desaturation and obstructive sleep apnea, dysphagia and aspiration, pneumonia, and pulmonary edema; genitourinary complications such as voiding dysfunction, urinary tract infections, and sexual dysfunction; psychological complications such as depression and fatigue; gastrointestinal complications such as gastrointestinal hemorrhage and constipation; endocrine and metabolic complications such as hyperglycemia and malnutrition; electrolyte disturbances; and musculoskeletal complications such as arthritis, nerve injury, decubitus ulcers, hip fractures, and limb or shoulder pain. The chapter also describes various neurological complications.