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Stroke Impairments and Complications

Cerebral Vascular Accidents (Strokes) are common and most physicians are trained aggressively to recognize symptoms and aggressively treat them. Two thirds of stroke patients are over the age of 65. Strokes remain in the top 5 leading cause of death in the United States. However, despite aggressive treatment in time or due to late discovery, many patients suffer stroke impairments and complications. The purpose of this article is to provide information on the post stroke sequelae and not on treatment.

Implementation of an Effective Post-Stroke Rehabilitation Program Can Greatly Reduce Morbidity and Mortality Associated With The Stroke And Should Be Aggressively Pursued In Most Cases.

90% of all strokes are ischemic in nature (either embolic or thrombotic). 10% are hemorrhagic, either presenting as either as subarachnoid or intracerebral bleeds. Underlying etiology for most strokes are atherosclerotic in nature in larger vessels, smaller vessels ischemic disease or cardioembolic conditions (atrial fibrillation). Underlying comorbidities which cause progression of damage to blood vessels include hypertension, diabetes, dyslipidemia and life style choices (smoking, illicit drug use, etc.).

ImpairmentPatients With Acute Impairment:Patients With Chronic Impairment
Motor Weakness:90%50%
Sensory Deficits:50%25%
Aphasia (Difficulty Understanding or Expressing Speech):35%20%
Dysarthria (Difficulty Speaking):50%20%
Cognitive Deficits:35%30%
Dysphagia (Trouble Swallowing):30%10%
Complications Seen In Acute Strokes:Frequency %:
Aspiration Pneumonia:40%
Urinary Tract Infection:40%
Pain Syndrome (Regional):30%
Pressure Ulcers:3%
Metabolic Encephalopathy (Confusion):10%

Most patients show signs of recovery in a few days (1-3 days). Most meaningful recovery will occur in the first 3 months, including cognitive function losses. Language function recovery can still occur up to 12 months from the acute stroke. Recovery is possible beyond these time frames, but usually does not result in a return of meaningful return of function.

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