Abstract
OBJETIVE:To describe general aspects related to acute ischemic stroke (AIS), as well as to know the main prognostic factors that have been related to the outcome and functional recovery after the AIS.
MATERIALS AND METHODS:A narrative review was performed using databases (PubMed, Science-Direct, MEDLINE), virtual platforms (National Institutes of Health) and publications of the Colombian Neurological Record.
RESULTS:Being female, advanced age, inattention (neglect), severity of cognitive and executive function impairment, malnutrition, and comorbidities such as pneumonia are associated with a worse prognosis in the 90 days after the event. Alterations in the mental sphere (delirium), altered consciousness, hemiplegia or paralysis of the conjugate gaze and the cardioembolic origin of the AIS are some of the factors that are associated with higher mortality. Hemispheric laterality is an important variable to consider in assessing the prognosis and residual functional disability post-event; however the current evidence is inconclusive and somewhat contradictory.
CONCLUSIONS:Early diagnosis and adequate intervention of patients with AIS and early control of modifiable factors of poor prognosis are important. Among the non-modifiable, hemispheric laterality may be more a selection criterion for a specific and personalized rehabilitation program, since there is undoubtedly a cognitive and language compromise that differs substantially in relation to the topographical location of the ischemic lesion.
References
M. J. O'Donnell, X. Denis, L. Liu, H. Zhang, S. L. Chin, P. Rao-Melacini, S. Rangarajan, S. Islam, P. Pais, M. J. McQueen, C. Mondo, A. Damasceno, P. Lopez-Jaramillo, G. J. Hankey, A. L. Dans, K. Yusoff, T. Truelsen, H. C. Diener, R. L. Sacco, D. Ryglewicz, A. Czlonkowska, C. Weimar, X. Wang, and S. Yusuf. Risk factors for ischaemic and intracerebral haemor-rhagic stroke in 22 countries (the INTERSTROKE study): A case-control study. Lancet. 2010;376(9735):112-23.
OMS. Enfermedades no transmisibles. Nota descriptiva OMS; 2015. [Online]. Disponible en http://www.who.int/mediacentre/factsheets/fs355/es/.
García JNR, Lozano JMR, Lugo DF, Yarelys E, Pérez R. Enfermedades Cerebrovasculares (Ecv) Ecv-1. Medisur. 2010;26(2):22-4.
Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman E. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010; 2012.
V. L. Feigin, R. V. Krishnamurthi, P. Parmar, B. Norrving, G. A. Mensah, D. A. Bennett, S. Barker-Collo, A. E. Moran, R. L. Sacco, T. Truelsen, S. Davis, J. D. Pandian, M. Naghavi, M. H. Forouzanfar, G. Nguyen, C. O. Johnson, T. Vos, A. Meretoja, C. J. L. Murray, and G. A. Roth. Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study. Neuroepidemiology. 2015;45(3): 161-76.
Suárez-Escudero JC, Restrepo Cano SC, Ramírez EP, Bedoya CL, Jiménez I. Descripción clínica, social, laboral y de la percepción funcional individual en pacientes con ataque cerebro-vascular. Acta Neurológica Colombiana. 2011;27(2): 97-105.
Instituto Nacional de Salud (INS). Boletín No. 1. Bogotá: INS; 2013.
Departamento Administrativo Nacional de Estadística (DANE). Defunciones no fetales 2015. Período 1° de junio-31 de agosto. [Online]. Disponible en: http://www.dane.gov.co/index.php/esp/poblacion-y-demografia/nacimientos-y-defunciones/118-demograficas/estadisticas-vitales/6234-.
Office of Communications and Public Liaison, National Institute of Neurological Disorders and Stroke, National Institutes of Health, and Bethesda. Accidente cerebrovascular: esperanza en la investigación. National Institute of Neurological Disorders and Stroke (NINDS); 2017. [Online]. Disponible en: Disponible en: https://espanol.ninds.nih.gov/trastornos/accidente_cere-brovascular.htm
. [Consultado: 19-Mar-2017].
R. L. Sacco, S. E. Kasner, J. P. Broderick, L. R. Caplan, J. J. Connors, A. Culebras, M. S. V Elkind, M. G. George, A. D. Hamdan, R. T. Higashida, B. L. Hoh, L. S. Janis, C. S. Kase, D. O. Kleindorfer, J. M. Lee, M. E. Moseley, E. D. Peterson, T. N. Turan, A. L. Valderrama, and H. V. Vinters. An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American heart association/American stroke association. Stroke. 2013;44(7): 2064-89.
Ito H, Kano O, Ikeda K. Different Variables Between Patients with Left and Right Hemispheric Ischemic Stroke. J. Stroke Cerebrovasc Dis. 2008;17(1):35-8.
Foerch C, Misselwitz B, Sitzer M, Berger K, Steinmetz H, Neumann-Haefelin T. Difference in recognition of right and left hemispheric stroke. Lancet. 2005;366:392-3.
Portegies ML, Selwaness M, Hofman A, Koudstaal PJ, Vernooij MW, Ikram MA. Left-sided strokes are more often recognized the Rotterdam Study. Stroke. 2014;46(1):252-4.
Yew KS, Cheng E. Acute stroke diagnosis. Am Fam Physician. 2009;80(1):3-40.
Doyle KP, Simon RP, Stenzel-Poore MP. Mechanisms of ischemic brain damage. Neuropharmacology. 2008;55(3):310-8.
González R, Hirsch G, Joshua A, Koroshetz WJ, Lev MH, Schaefer PW. Acute Ischemic Stroke. Spring; 2006.
Dirnagl U, Iadecola C, Moskowitz MA. Pathobiology of ischaemic stroke: an integrated view. 4441. Trends Neurosci. 1999;22(9): 391-7.
Adams H, Bendixen B, Kappelle L, Biller J, Love B, Gordon D, Marsh E. Classification of Subtype of Acute Ischemic Stroke. Stroke. 1993;23(1):35-41.
C.-J. Yang, W-I. Liao, J.-C. Wang, C.-L. Tsai, J.-T. Lee, G.-S. Peng, C.-H. Lee, C.-W. Hsu, and S.-H. Tsai. Usefulness of glycated hemoglobin A1c-based adjusted glycemic variables in diabetic patients presenting with acute ischemic stroke. Am J Emerg Med. 2017;35(9):1240-6.
J.-Y. Sung, C.-I. Chen, Y.-C. Hsieh, Y.-R. Chen, H.-C. Wu, L. Chan, C.-J. Hu, H.-H. Hu, H.-Y Chiou, and N.-F. Chi. Comparison of admission random glucose, fasting glucose, and glycated hemoglobin in predicting the neurological outcome of acute ischemic stroke: a retrospective study. PeerJ. 2017;5:e2948.
S. Wu, Y Shi, Y Pan, J. Li, Q. Jia, N. Zhang, X. Zhao, G. Liu, Y Wang, Y. Wang, and C. Wang. Glycated hemoglobin independently or in combination with fasting plasma glucose versus oral glucose tolerance test to detect abnormal glycometabolism in acute ischemic stroke: a Chinese cross-sectional study. BMC Neurol. 2014;14(1):177.
American Stroke Association. Treatments. 2016. [Online]. Disponible en: http://www.strokeassociation.org/STROKE-ORG/AboutStroke/Treatment/Stroke-Treatments.
R. G. Holloway, P. S. Chan, H. H. Ting, A. R. Chappel, and E. D. Peterson, "Association Between Stroke Center Hospitalization for Acute Ischemic Stroke and Mortality," 2015; 305(4): 373-380.
Craig LE, Bernhardt J, Langhorne P, Wu O. Early mobilization after stroke: An example of an individual patient data meta-analysis of a complex intervention. Stroke. 2010;41(11):2632-6.
Sundseth A, Thommessen B, Ronning OM. Outcome After Mobilization Within 24 Hours of Acute Stroke: A Randomized Controlled Trial. Stroke. 2012;43(9):2389-94.
Sato S, Uehara T, Ohara T, Suzuki R, Toyoda T, Minematsu K. Factors associated with unfavorable outcome in minor ischemic stroke. Neurology. 2014;83(2):174-81.
Shi Q, Presutti R, Selchen D, Saposnik G. Delirium in acute stroke: a systematic review and meta-analysis. Stroke. 2012;43(3):645-9.
Lin HJ, Wolf PA, Kelly-Hayes M, Beiser AS, Kase CS, Benjamin EJ, D'Agostino RB. Stroke severity in atrial fibrillation. The Framingham Study. Stroke. 1996;27(10):1760-4.
Katzan IL, Cebul RD, Husak HS, Dawson NV, Baker DW The effect of pneumonia on mortality among patients hospitalized for acute stroke. Neurology. 2003;60(4):620-5.
VK. Vemmos, G. Ntaios, K. Spengos, P. Savvari, A. Vemmou, T. Pappa, E. Manios, G. Georgiopoulos, and M. Alevizaki. Association between obesity and mortality after acute first-ever stroke: the obesity-stroke paradox. Stroke. 2011;42(1):30-6.
Yoo SH, Kim JS, Kwon SU, Yun SC, Koh JY. Undernutrition as a Predictor of Poor Clinical Outcomes in Acute Ischemic Stroke Patients. Arch Neurol. 2008;65(1):39-43.
Y. H. Park, J.-W. Jang, S. Y. Park, M. J. Wang, J.-S. Lim, M. J. Baek, B. J. Kim, M.-K. Han, H.-J. Bae, S. Ahn, and S. Kim. Executive function as a strong predictor of recovery from disability in patients with acute stroke: a preliminary study. J Stroke Cerebrovasc Dis. 2015;24(3):554-61.
Geurts M, Scheijmans FEV, van Seeters T, Biessels GJ, Kappelle LJ, Velthuis BK, van der Worp HB, and on behalf of the D. DUST investigators. Temporal profile of body temperature in acute ischemic stroke: relation to infarct size and outcome. BMC Neurol. 2016;16(1):233.
Jones PS, Pomeroy VM, Wang J, Schlaug G, Tulasi Marrapu S, Geva S, Baron JC. Does stroke location predict walk speed response to gait rehabilitation? Hum Brain Mapp. 2016;(37) (2):689-703.
B. Cheng, N. D. Forkert, M. Zavaglia, C. C. Hilgetag, A. Golsari, S. Siemonsen, J. Fiehler, S. Pedraza, J. Puig, T. H. Cho, J. Alawneh, J. C. Baron, L. Ostergaard, C. Gerloff, and G. Thomalla. Influence of stroke infarct location on functional outcome measured by the modified rankin scale. Stroke. 2014;45(6):1695-1702.
N. Yassi, L. Churilov, B. C. V Campbell, G. Sharma, R. Bammer, P. M. Desmond, M. W. Parsons, G. W. Albers, G. A. Donnan, and S. M. Davis. The association between lesion location and functional outcome after ischemic stroke. Int J Stroke. 2015;10(8):1270-6.
O. Wu, L. Cloonan, S. J. T. Mocking, M. J. R. J. Bouts, W. A. Copen, P. T. Cougo-Pinto, K. Fitzpatrick, A. Kanakis, P. W. Schaefer, J. Rosand, K. L. Furie, and N. S. Rost. Role of Acute Lesion Topography in Initial Ischemic Stroke Severity and Long-Term Functional Outcomes. Stroke. 2015;46(9):2438-44.
Etherton MR, Rost NS, Wu O. Infarct topography and functional outcomes. J Cereb Blood Flow Metab. 2017; enero: 0271678X1770066.
Ween JE, Alexander MP, D'Esposito M, Roberts M. Factors predictive of stroke outcome in a rehabilitation setting. Neurology. 1996;47(2):388-92.
Macciocchi SN, Diamond PT, Alves WM, Mertz T. Ischemic stroke: Relation of age, lesion location, and initial neurologic deficit to functional outcome. Arch Phys Med Rehabil. 1998;79(10):1255-7.
N. Patricia Bonilla, H. Oliveros, J. Proaños, B. Espinel, J. C. Alvarez, C. Duran, C. Sánchez, L. Castillo, D. García, and J. Restrepo. Estudio de frecuencia de los factores de riesgo asociados al desarrollo de enfermedad cerebrovascular isquémica no embólica en un hospital de tercer nivel. Acta Neurológica Colombiana. 2014;30(3):149-55.
Arturo Silva FS, García Goméz RG, Adolfo Díaz GS, Guillermo Zarruk JS, Federico Rueda-Clausen C, Alberto Restrepo J, Córdoba Porras A. Ausencia de asociación entre obesidad y sobrepeso con enfermedad cerebrovascular isquémica aguda en una muestra de población colombiana. Acta Neurol Colombiana. 2010;26(2):65-74.
Sposato LA, Cohen G, Wardlaw JM, Sandercock P, Lindley RI, Hachinski V, IST-3 Expert Reading Panel, IST-3 Collaborative Group. Effect of Right Insular Involvement on Death and Functional Outcome After Acute Ischemic Stroke in the IST-3 Trial (Third International Stroke Trial). Stroke. 2016;47(12):2959-65.
E. C. Jauch, J. L. Saver, H. P. Adams, A. Bruno, J. J. Connors, B. M. Demaerschalk, P. Khatri, P. W. McMullan, A. I. Qureshi, K. Rosenfield, P. A. Scott, D. R. Summers, D. Z. Wang, M. Wintermark, H. Yonas. 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(3):870-947.
NIH. National Institutes of Health Stroke Scale. [Online]. Disponible en: Disponible en: http://www.ninds.nih.gov/doctors/NIHStroke_Scale.pdf
. [Consultado 11-Oct-2016].
R0nning OM, Guldvog B. Should stroke victims routinely receive supplemental oxygen? A quasi-randomized controlledtrial. Stroke. 1999;30(10):2033-7.
Azzimondi G, Bassein L, Nonino F, Fiorani L, Vignatelli L, Re G, D'Alessandro R. Fever in acute stroke worsens prognosis. A prospective study. Stroke. 1995;26(11):2040-3.
T. Lokeskrawee, S. Muengtaweepongsa, J. Patumanond, S. Tiamkao, T. Thamangraksat, P. Phankhian, P. Pleumpanupatand, P. Sribussara, T. Kitjavijit, A. Supap, W. Rattanaphibool, and J. Prisiri. Prognostic parameters for symptomatic intracranial hemorrhage after intravenous thrombolysis in acute ischemic stroke in an Asian population. Curr Neurovasc Res. 2017;14(999):1-1.
Al-Khaled M, Matthis C, Eggers J. Predictors of In-hospital Mortality and the Risk of Symptomatic Intracerebral Hemorrhage after Thrombolytic Therapy with Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke. J Stroke Cerebrovasc. Dis. 2014;23(1):7-11.
Tong X, George MG, Yang Q, Gillespie C. Predictors of inHospital Death and Symptomatic Intracranial Hemorrhage in Patients with Acute Ischemic Stroke Treated with Thrombo-lytic Therapy: Paul Coverdell Acute Stroke Registry 2008-2012. Int J Stroke. 2014;9(6):728-34.
Scottish Intercollegiate Guidelines Network. Management of patients with stroke: Rehabilitation, prevention and management of complications, and discharge planning. A national clinical guideline. Edinburgh: Scottish Intercollegiate Guidelines Network; 2010. Available in: http://www.sign.ac.uk/assets/sign118.pdf
Luker J, Murray C, Lynch E, Bernhardsson S, Shannon M, Bernhardt J. Carers' experiences, needs and preferences during inpatient stroke rehabilitation: a systematic review of qualitative studies. Arch Phys Med Rehabil. 2017;4:108.
S. Alladi, T. H. Bak, S. Mekala, A. Rajan, J. R. Chaudhuri, E. Mioshi, R. Krovvidi, B. Surampudi, V. Duggirala, and S. Kaul. Impact of bilingualism on cognitive outcome after stroke. Stroke. 2016;47(1):258-61.
Anderson KR, Woodbury ML, Phillips K, Gauthier LV. Virtual reality video games to promote movement recovery in stroke rehabilitation: a guide for clinicians. Arch Phys Med Rehabil. 2015;96(5):973-6.
The Management of Stroke Rehabilitation Working Group. Department of Veterans Affairs / The American Heart Association / American Stroke Association. VA/DoD Clinical Practice Guideline For The Management Of Stroke Rehabilitation. 2010. Available in: https://www.healthquality.va.gov.
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