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CDHB

Neurological Complications following Stroke

• Brain oedema and raised intracranial pressure.
  • Young patients with large infarcts are at risk of brain oedema causing raised intracranial pressure. This usually presents as progressive neurological deterioration 24-72 hours after stroke onset.

  Refer to management of raised intracranial pressure. However:

  • Corticosteroids are not helpful for post-infarction brain oedema.
  • Surgical decompression can be life-saving, particularly for cerebellar infarcts, but also may be considered for some young patients with large hemispheric strokes (hemicraniectomy). Neurological and neurosurgical consultations are recommended.
• Seizures.
  • Seizures occur in 6-8% of strokes. If a seizure has occurred, anticonvulsants should be commenced. Neurological follow-up is also recommended to determine the length of anticonvulsant treatment required for the individual patient.
• Other complications.
  • E.g., DVT, pressure areas, shoulder pain, dehydration, aspiration, malnutrition.
  • Refer to "Maintain patient ‘homeostasis'" under Acute Management.

Topic Code: 1508