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  • Print publication year: 2014
  • Online publication date: September 2014

Chapter 20 - Management of acute ischemic stroke and its late complications

from Section 4: - Therapeutic strategies and neurorehabilitation


1. Wallace JD, Levy LL. Blood pressure after stroke. JAMA 1981; 246(19):2177–80.
2. Carlberg B, Asplund K, Hägg E. Factors influencing admission blood pressure levels in patients with acute stroke. Stroke 1991; 22:527–30.
3. Urrutia VC, Wityk RJ. Blood pressure management in acute stroke. Crit Care Clin 2006; 22(4):695–711.
4. Leonardi-Bee J, Bath PM, Phillips SJ, Sandercock PA; IST Collaborative Group. Blood pressure and clinical outcomes in the International Stroke Trial. Stroke 2002; 33:1315–20.
5. Vemmos KN, Tsivgoulis G, Spengos K, et al. U-shaped relationship between mortality and admission blood pressure in patients with acute stroke. J Intern Med 2004; 255:257–65.
6. Grabska K, Niewada M, Sarzyńska-Długosz I, Kamiński B, Członkowska A. Pulse pressure–independent predictor of poor early outcome and mortality following ischemic stroke. Cerebrovasc Dis 2009; 27:187–92.
7. Aslanyan S, Fazekas F, Weir CJ, Horner S, Lees KR; GAIN International Steering Committee and Investigators. Effect of blood pressure during the acute period of ischemic stroke on stroke outcome: a tertiary analysis of the GAIN International Trial. Stroke 2003; 34:2420–5.
8. Willmot M, Leonardi-Bee J, Bath PM. High blood pressure in acute stroke and subsequent outcome: a systematic review. Hypertension 2004; 43(1):18–24.
9. Brott T, Lu M, Kothari R, et al. Hypertension and its treatment in the NINDS rt-PA Stroke Trial. Stroke 1998; 29:1504–9.
10. Chamorro A, Vila N, Ascaso C, et al. Blood pressure and functional recovery in acute ischemic stroke. Stroke 1998; 29:1850–3.
11. Carlberg B, Asplund K, Hägg E. The prognostic value of admission blood pressure in patients with acute stroke. Stroke 1993; 24:1372–5.
12. Ahmed N, Wahlgren N, Brainin M, et al.; SITS Investigators. Relationship of blood pressure, antihypertensive therapy, and outcome in ischemic stroke treated with intravenous thrombolysis: retrospective analysis from Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR). Stroke 2009;40:2442–9.
13. Mattle HP, Kappeler L, Arnold M, et al. Blood pressure and vessel recanalization in the first hours after ischemic stroke. Stroke 2005; 36:264–8.
14. Shin HK, Nishimura M, Jones PB, et al. Mild induced hypertension improves blood flow and oxygen metabolism in transient focal cerebral ischemia. Stroke 2008; 39:1548–55.
15. Rordorf G, Koroshetz WJ, Ezzeddine MA, Segal AZ, Buonanno FS. A pilot study of drug-induced hypertension for treatment of acute stroke. Neurology 2001; 56:1210–13.
16. Marzan AS, Hungerbühler HJ, Studer A, Baumgartner RW, Georgiadis D. Feasibility and safety of norepinephrine-induced arterial hypertension in acute ischemic stroke. Neurology 2004; 62:1193–5.
17. Hillis AE, Ulatowski JA, Barker PB, et al. A pilot randomized trial of induced blood pressure elevation: effects on function and focal perfusion in acute and subacute stroke. Cerebrovasc Dis 2003; 16:236–46.
18. Olsen TS, Larsen B, Herning M, Skriver EB, Lassen NA. Blood flow and vascular reactivity in collaterally perfused brain tissue. Evidence of an ischemic penumbra in patients with acute stroke. Stroke 1983; 14:332–41.
19. Mistri AK, Robinson TG, Potter JF. Pressor therapy in acute ischemic stroke: systematic review. Stroke 2006; 37(6):1565–71.
20. Schrader J, Lüders S, Kulschewski A, et al.; Acute Candesartan Cilexetil Therapy in Stroke Survivors Study Group. The ACCESS Study: evaluation of Acute Candesartan Cilexetil Therapy in Stroke Survivors. Stroke 2003; 34:1699–703.
21. Potter JF, Robinson TG, Ford GA, et al. Controlling hypertension and hypotension immediately post-stroke (CHHIPS): a randomised, placebo-controlled, double-blind pilot trial. Lancet Neurol 2009; 8:48–56.
22. Sandset EC, Bath PM, Boysen G, et al.; SCAST Study Group. The angiotensin-receptor blocker candesartan for treatment of acute stroke (SCAST): a randomised, placebo-controlled, double-blind trial. Lancet 2011;377:741–50
23. Robinson TG, Potter JF, Ford GA, et al.; COSSACS Investigators. Effects of antihypertensive treatment after acute stroke in the Continue or Stop Post-Stroke Antihypertensives Collaborative Study (COSSACS): a prospective, randomised, open, blinded-endpoint trial. Lancet Neurol 2010; 9:767–75.
24. Copen WA, Schaefer PW, Wu O. MR perfusion imaging in acute ischemic stroke. Neuroimaging Clin N Am 2011; 21:259–83.
25. The European Stroke Organisation (ESO) Executive Committee and the ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis 2008; 25:457–507.
26. Jauch EC, Saver JL, Adams HP Jr, et al.; American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Peripheral Vascular Disease, and Council on Clinical Cardiology. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013; 44:870–947.
27. Vázquez-Cruz J, Martí-Vilalta JL, Ferrer I, Pérez-Gallofré A, Folch J. Progressing cerebral infarction in relation to plasma glucose in gerbils. Stroke 1990; 21(11):1621–4.
28. Martín A, Rojas S, Chamorro A, et al. Why does acute hyperglycemia worsen the outcome of transient focal cerebral ischemia? Role of corticosteroids, inflammation, and protein O-glycosylation. Stroke 2006; 37(5):1288–95. Epub 2006/05/06.
29. Kiers L, Davis SM, Larkins R, et al. Stroke topography and outcome in relation to hyperglycaemia and diabetes. J Neurol Neurosurg Psychiatry 1992; 55:263–70.
30. Matz K, Keresztes K, Tatschl C, et al. Disorders of glucose metabolism in acute stroke patients: an underrecognized problem. Diabetes Care 2006; 29:792–7.
31. Capes SE, Hunt D, Malmberg K, Pathak P, Gerstein HC. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke 2001; 32:2426–32.
32. Alvarez-Sabín J, Molina CA, Montaner J, et al. Effects of admission hyperglycemia on stroke outcome in reperfused tissue plasminogen activator-treated patients. Stroke 2003; 34:1235–41.
33. Parsons MW, Barber PA, Desmond PM, et al. Acute hyperglycemia adversely affects stroke outcome: a magnetic resonance imaging and spectroscopy study. Ann Neurol 2002; 52(1):20–8.
34. Allport LE, Butcher KS, Baird TA, et al. Insular cortical ischemia is independently associated with acute stress hyperglycemia. Stroke 2004; 35:1886–91.
35. van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med 2001; 345(19):1359–67.
36. Malmberg K. Prospective randomized study of intensive insulin treatment on long term survival after acute myocardial infarction in patients with diabetes mellitus. DIGAMI (Diabetes Mellitus, Insulin Glucose Infusion in Acute Myocardial Infarction) Study Group. BMJ 1997; 314:1512–15.
37. Gray CS, Hildreth AJ, Sandercock PA, et al.; GIST Trialists Collaboration. Glucose-potassium-insulin infusions in the management of post-stroke hyperglycaemia: the UK Glucose Insulin in Stroke Trial (GIST-UK). Lancet Neurol 2007; 6:397–406.
38. McCormick MT, Muir KW, Gray C, Walters MR. Management of hyperglycemia in acute stroke: how, when, and for whom? Stroke 2008; 39(7):2177–85.
39. Glucose Regulation in Acute Stroke Patients Trial (GRASP). The Internet Stroke Center. American Stroke Association. 2008.
40. Bruno A, Kent TA, Coull BM, et al. Treatment of hyperglycemia in ischemic stroke (THIS): a randomized pilot trial. Stroke 2008; 39(2):384–9.
41. Rosso C, Corvol JC, Pires C, et al. Intensive versus subcutaneous insulin in patients with hyperacute stroke: results from the randomized INSULINFARCT trial. Stroke 2012; 43:2343–9.
42. Memezawa H, Zhao Q, Smith ML, Siesjö BK. Hyperthermia nullifies the ameliorating effect of dizocilpine maleate (MK-801) in focal cerebral ischemia. Brain Res 1995; 670(1):48–52.
43. Wass CT, Lanier WL, Hofer RE, Scheithauer BW, Andrews AG. Temperature changes of > or = 1 degree C alter functional neurologic outcome and histopathology in a canine model of complete cerebral ischemia. Anesthesiology 1995; 83:325–35.
44. Reith J, Jørgensen HS, Pedersen PM, et al. Body temperature in acute stroke: relation to stroke severity, infarct size, mortality, and outcome. Lancet 1996; 347:422–5.
45. Castillo J, Dávalos A, Marrugat J, Noya M. Timing for fever-related brain damage in acute ischemic stroke. Stroke 1998; 29(12):2455–60.
46. Varon J, Acosta P. Therapeutic hypothermia: past, present, and future. Chest 2008; 133:1267–74.
47. Hypothermia After Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurological outcome after cardiac arrest. N Engl J Med 2002; 346:549–56.
48. Clifton GL, Miller ER, Choi SC, et al. Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med 2001; 344:556–63.
49. Kasner SE, Wein T, Piriyawat P, et al. Acetaminophen for altering body temperature in acute stroke: a randomized clinical trial. Stroke 2002; 33:130–4.
50. Dippel DW, van Breda EJ, van Gemert HM, et al. Effect of paracetamol (acetaminophen) on body temperature in acute ischemic stroke: a double-blind, randomized phase II clinical trial. Stroke 2001; 32:1607–12.
51. Schwab S, Schwarz S, Spranger M, et al. Moderate hypothermia in the treatment of patients with severe middle cerebral artery infarction. Stroke 1998; 29:2461–6.
52. Guluma KZ, Oh H, Yu SW, et al. Effect of endovascular hypothermia on acute ischemic edema: morphometric analysis of the ICTuS trial. Neurocrit Care 2008; 8(1):42–7.
53. Olsen TS, Weber UJ, Kammersgaard LP, et al. Therapeutic hypothermia for acute stroke. Lancet Neurol 2003; 2:410–16.
54. De Georgia MA, Krieger DW, Abou-Chebl A, et al. Cooling for Acute Ischemic Brain Damage (COOL AID): a feasibility trial of endovascular cooling. Neurology 2004; 63(2):312–17.
55. Forsgren L, Bucht G, Eriksson S, Bergmark L. Incidence and clinical characterization of unprovoked seizures in adults: a prospective population-based study. Epilepsia 1996; 37:224–9.
56. Bladin CF, Alexandrov AV, Bellavance A, et al. Seizures after stroke: a prospective multicenter study. Arch Neurol 2000; 57:1617–22.
57. Lesser RP, Luders H, Dinner DS, Morris HH. Epileptic seizures due to thrombotic and embolic cerebrovascular disease in older patients. Epilepsia 1985; 26:622–30.
58. So EL, Annegers JF, Hauser WA, O’Brien PC, Whisnant JP. Population-based study of seizure disorders after cerebral infarction. Neurology 1996; 46:350–5.
59. Kilpatrick CJ, Davis SM, Tress BM, et al. Epileptic seizures in acute stroke. Arch Neurol 1990; 47:157–60.
60. Shinton RA, Gill JS, Melnick AK. The frequency, characteristics, and prognosis of epileptic seizures at the onset of stroke. J Neurol Neurosurg Psychiatry 1988; 51:273–6.
61. Arboix A, Garcia-Eroles L, Massons JB, Oliveres M, Comes E. Predictive factors of early seizures after acute cerebrovascular disease. Stroke 1997; 28:1590–4.
62. Reith J, Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS. Seizures in acute stroke: the Copenhagen Stroke Study. Stroke 1997; 28:1585–9.
63. Giroud M, Gras P, Fayolle H, et al. Early seizures after stroke: a study of 1,640 cases. Epilepsia 1994; 35:959–64.
64. Olsen TS. Post-stroke epilepsy. Curr Atheroscler Rep 2001; 3(4):340–4. Review.
65. Benbir G, Ince B, Bozluolcay M. The epidemiology of post-stroke epilepsy according to stroke sub-types. Acta Neurol Scand 2006; 114:8–12.
66. Myint PK, Staufenberg EF, Sabanathan K. Post-stroke seizure and post-stroke epilepsy. Postgrad Med J 2006; 82:568–72.
67. Conrad J, Pawlowski M, Dogan M, et al. Seizures after cerebrovascular events: risk factors and clinical features. Seizure 2013; 22(4):275–82
68. Cordonnier C, Hénon H, Derambure P, Pasquier F, Leys D. Influence of pre-existing dementia on the risk of post-stroke epileptic seizures. J Neurol Neurosurg Psychiatry 2005; 76:1649–53.
69. De Reuck J, Proot P, Van Maele G. Chronic obstructive pulmonary disease as a risk factor for stroke-related seizures. Eur J Neurol 2007; 14:989–92.
70. Sun DA, Sombati S, DeLorenzo RJ. Glutamate injury-induced epileptogenesis in hippocampal neurons: an in vitro model of stroke-induced “epilepsy”. Stroke 2001; 32:2344–50.
71. Stroemer RP, Kent TA, Hulsebosch CE. Neocortical neural sprouting, synaptogenesis, and behavioral recovery after neocortical infarction in rats. Stroke 1995; 26:2135–44.
72. Gilad R, Lampl Y, Eschel Y, Sadeh M. Antiepileptic treatment in patients with early postischemic stroke seizures: a retrospective study. Cerebrovas Dis 2001; 12:39–43.
73. Ryvlin P, Montavont A, Nighoghossian N. Optimizing therapy of seizures in stroke patients. Neurology 2006; 67(12 Suppl 4):S3–9.
74. Gilad R. Management of seizures following a stroke: what are the options? Drugs Aging 2012; 29:533–8.
75. Alvarez-Sabín J, Montaner J, Padró L, et al. Gabapentin in late-onset poststroke seizures. Neurology 2002; 59(12):1991–3.
76. Gilad R, Sadeh M, Rapoport A, et al. Monotherapy of lamotrigine versus carbamazepine in patients with poststroke seizure. Clin Neuropharmacol 2007; 30:189–95.
77. Hackett ML, Yapa C, Parag V, Anderson CS. Frequency of depression after stroke: a systematic review of observational studies. Stroke 2005; 36:1330–4.
78. Paolucci S, Gandolfo C, Provinciali L, Torta R, Toso V; DESTRO Study Group. The Italian multicenter observational study on post-stroke depression (DESTRO). J Neurol 2006; 253:556–62.
79. Morris PL, Robinson RG, Samuels J. Depression, introversion and mortality following stroke. Aust N Z J Psychiatry 1993; 27:443–9.
80. Yuan HW, Wang CX, Zhang N, et al. Poststroke depression and risk of recurrent stroke at 1 year in a Chinese cohort study. PLoS One 2012; 7:e46906.
81. Gainotti G, Marra C. Determinants and consequences of post-stroke depression. Curr Opin Neurol 2002; 15(1):85–9.
82. Narushima K, Kosier JT, Robinson RG. A reappraisal of poststroke depression, intra- and inter-hemispheric lesion location using meta-analysis. J Neuropsychiatry Clin Neurosci 2003; 15:422–30.
83. Bhogal SK, Teasell R, Foley N, Speechley M. Lesion location and poststroke depression: systematic review of the methodological limitations in the literature. Stroke 2004; 35:794–802.
84. Gaete JM, Bogousslavsky J. Post-stroke depression. Expert Rev Neurother 2008; 8:75–92.
85. Brodaty H, Withball A, Sachdev PS. Rates of depression at 3 and 15 months poststroke and their relationship with cognitive decline: the Sydney Stroke Study. Am J Geriatr Psychiatry 2007; 15:477–86.
86. Robinson RG, Jorge RE, Moser DJ, et al. Escitalopram and problem-solving therapy for prevention of poststroke depression: a randomized controlled trial. JAMA 2008; 299:2391–400.
87. Ried LD, Jia H, Feng H, et al. Selective serotonin reuptake inhibitor treatment and depression are associated with poststroke mortality. Ann Pharmacother 2011; 45:888–97.
88. Román GC, Tatemichi TK, Erkinjuntti T, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993; 43(2):250–60.
89. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-4), 4th edn. Washington DC: American Psychiatric Association; 1994.
90. Wetterling T, Kanitz RD, Borgis KJ. Comparison of different diagnostic criteria for vascular dementia (ADDTC, DSM-IV, ICD-10, NINDS-AIREN). Stroke 1996; 27:30–6.
91. Dubois MF, Hébert R. The incidence of vascular dementia in Canada: a comparison with Europe and East Asia. Neuroepidemiology 2001; 20(3):179–87.
92. Hénon H, Durieu I, Guerouaou D, et al. Poststroke dementia: incidence and relationship to prestroke cognitive decline. Neurology 2001; 57:1216–22.
93. Ince PG, Fernando MS. Neuropathology of vascular cognitive impairment and vascular dementia. Int Psychogeriatr 2003; 15(Suppl1):71–5.
94. Jellinger KA. Pathology and pathophysiology of vascular cognitive impairment. A critical update. Panminerva Med 2004; 46(4):217–21.
95. Skoog I. Status of risk factors for vascular dementia. Neuroepidemiology 1998; 17(1):2–9.
96. Bornstein NM, Gur AY, Treves TA, et al. Do silent brain infarctions predict the development of dementia after first ischemic stroke? Stroke 1996; 27:904–5.
97. Longstreth WT Jr, Manolio TA, Arnold A, et al. Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. Stroke 1996; 27:1274–82.
98. Gur AY, Neufeld MY, Treves TA, et al. EEG as predictor of dementia following first ischemic stroke. Acta Neurol Scand 1994; 90(4):263–5.
99. Snowdon DA, Greiner LH, Mortimer JA, et al. Brain infarction and the clinical expression of Alzheimer disease. The Nun Study. JAMA 1997; 277:813–17.
100. Kavirajan H, Schneider LS. Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials. Lancet Neurol 2007; 6:782–92.
101. Ingles JL, Eskes GA, Phillips SJ. Fatigue after stroke. Arch Phys Med Rehabil 1999; 80(2):173–8.
102. Staub F, Bogousslavsky J. Fatigue after stroke: a major but neglected issue. Cerebrovasc Dis 2001; 12:75–81.
103. Fisk JD, Pontefract A, Ritvo PG, Archibald CJ, Murray TJ. The impact of fatigue on patients with multiple sclerosis. Can J Neurol Sci 1994; 21:9–14.
104. Rose L, Pugh LC, Lears K, Gordon DL. The fatigue experience: persons with HIV infection. J Adv Nurs 1998; 28:295–304.
105. Riemsma RP, Rasker JJ, Taal E, et al. Fatigue in rheumatoid arthritis: the role of self-efficacy and problematic social support. Br J Rheumatol 1998; 37:1042–6.
106. Zwarts MJ, Bleijenberg G, van Engelen BG. Clinical neurophysiology of fatigue. Clin Neurophysiol 2008; 119:2–10.
107. van der Werf SP, van den Broek HL, Anten HW, Bleijenberg G. Experience of severe fatigue long after stroke and its relation to depressive symptoms and disease characteristics. Eur Neurol 2001; 45:28–33.
108. Kutlubaev MA, Duncan FH, Mead GE. Biological correlates of post-stroke fatigue: a systematic review. Acta Neurol Scand 2012; 125:219–27.
109. Glader EL, Stegmayr B, Asplund K. Poststroke fatigue: a 2-year follow-up study of stroke patients in Sweden. Stroke 2002; 33:1327–33.
110. Naess H, Lunde L, Brogger J, Waje-Andreassen U. Fatigue among stroke patients on long-term follow-up. The Bergen Stroke Study. J Neurol Sci 2012; 312:138–41.