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Medical complications of stroke

Koto Ishida, MD
Section Editor
Scott E Kasner, MD
Deputy Editor
John F Dashe, MD, PhD


Medical complications of acute ischemic stroke are common. They increase the risk of poor clinical outcomes. Preventative strategies and treatments are available and should be used when appropriate.

The major medical complications associated with stroke will be reviewed here; cardiac and pulmonary complications of stroke are discussed in greater detail separately. (See "Cardiac complications of stroke" and "Stroke-related pulmonary complications and abnormal respiratory patterns".)

Poststroke epilepsy is reviewed elsewhere. (See "Overview of the management of epilepsy in adults", section on 'Poststroke seizures'.)


The rates of reported medical complications of stroke are high (table 1) [1-4]. In a prospective study that analyzed the placebo group of the Randomized Trial of Tirilazad Mesylate in Acute Stroke (RANTTAS) database (n = 279), at least one medical complication occurred in 95 percent of patients, and at least one serious medical complication (defined as prolonged, immediately life threatening, or resulting in hospitalization or death) occurred in 24 percent [2]. The most common serious medical complications were pneumonia (5 percent), gastrointestinal bleeding (3 percent), congestive heart failure (3 percent), and cardiac arrest (2 percent) (table 2).

In another report of 489 patients with acute stroke, most patients (64 percent) experienced one or more complications within the first week after stroke [3]. Incidence rates vary across studies but improving care may be reducing complication rates. In one prospective longitudinal study, the frequency of one or more medical complications within the first week after stroke declined from 2003 to 2013 by 36 percent [5].

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Literature review current through: Nov 2017. | This topic last updated: May 18, 2017.
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