Complications after stroke : Clinical challenges in stroke aftercare

Abstract

Besides the treatment of cardiovascular risk factors, the prevention and treatment of secondary complications is the main focus of outpatient poststroke care. The spectrum of noteworthy complications after astroke changes during the course of the treatment and constitutes aspecific challenge of outpatient poststroke care. This article provides references to the importance, management, diagnosis and treatment of the wide spectrum of nonvascular complications after stroke in the context of outpatient stroke aftercare. Poststroke depression (PSD), anxiety disorders and post-stroke fatigue are common complications after stroke, which require a timely diagnosis and treatment. Furthermore, the incidence of newly diagnosed dementia is 20% within the first 6 months after astroke. Here too, therapeutic and preventive strategies especially in the early stage can delay the subsequent burden of the disease and the dependency on care. About half of every newly diagnosed epilepsy in patients older than 60years is the result of astroke. Falls and subsequent injuries are another important complication and a common reason for rehospitalization after astroke. Although nearly 50% of patients suffer from chronic pain after astroke this is often not sufficiently recognized. The wide spectrum of secondary complications after astroke constitutes acomplex, sustained and multidisciplinary challenge, which requires across-sectoral interaction of various and numerous actors in outpatient poststroke care.