Early changes in physiological variables after stroke

Wong, Andrew A. and Read, Stephen J. (2008) Early changes in physiological variables after stroke. Annals of Indian Academy of Neurology, 11 4: 207-220. doi:10.4103/0972-2327.44555


Author Wong, Andrew A.
Read, Stephen J.
Title Early changes in physiological variables after stroke
Journal name Annals of Indian Academy of Neurology   Check publisher's open access policy
ISSN 0972-2327
1998-3549
Publication date 2008-10-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.4103/0972-2327.44555
Open Access Status DOI
Volume 11
Issue 4
Start page 207
End page 220
Total pages 14
Place of publication Ghatkopar (E), Mumbai, Maharastra, India
Publisher Medknow Publications and Media
Language eng
Subject 2728 Clinical Neurology
Formatted abstract
Several aspects of physiology, notably blood pressure, body temperature, blood glucose, and blood oxygen saturation, may be altered after an ischemic stroke and intracerebral hemorrhage. Generally, blood pressure and temperature rise acutely after a stroke, before returning to normal. Blood glucose and oxygen levels may be abnormal in individuals, but they do not follow a set pattern. Several aspects of these physiological alterations remain unclear, including their principal determinants - whether they genuinely affect prognosis (as opposed to merely representing underlying processes such as inflammation or a stress response), whether these effects are adaptive or maladaptive, whether the effects are specific to certain subgroups (e.g. lacunar stroke) and whether modifying physiology also modifies its prognostic effect. Hypertension and hyperglycemia may be helpful or harmful, depending on the perfusion status after an ischemic stroke; the therapeutic response to their lowering may be correspondingly variable. Hypothermia may provide benefits, in addition to preventing harm through protection from hyperthermia. Hypoxia is harmful, but normobaric hyperoxia is unhelpful or even harmful in normoxic patients. Hyperbaric hyperoxia, however, may be beneficial, though this remains unproven. The above-mentioned uncertainties necessitate generally conservative measures for physiology management, although there are notably specific recommendations for thrombolysis-eligible patients. Stroke unit care is associated with better outcome, possibly through better management of poststroke physiology. Stroke units can also facilitate research to clarify the relationship between physiology and prognosis, and to subsequently clarify management guidelines.
Keyword Blood glucose
Blood pressure
Body temperature
Cerebrovascular disorders
Oxygen
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
 
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