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Chapter 7 - Neurological Deterioration in Acute Ischemic Stroke

Published online by Cambridge University Press:  28 October 2019

Mary Carter Denny ,
Ahmad Riad Ramadan ,
Sean I. Savitz  and
James Grotta
Mary Carter Denny
Affiliation:
Georgetown University Hospital
Ahmad Riad Ramadan
Affiliation:
Henry Ford Hospital, Detroit
Sean I. Savitz
Affiliation:
University of Texas Health Science Center, Houston
James Grotta
Affiliation:
Memorial Hermann Texas Medical School
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Summary

Although, classically, stroke symptoms are maximal at onset and patients gradually recover over days, weeks, and months, patients sometimes deteriorate. People have termed the phenomenon stroke progression, stroke in evolution, stroke deterioration, and symptom fluctuation. There is no consistent terminology. The phenomenon occurs from different causes and is incompletely understood. Although the typical definition of a significant neurological deterioration in trials has been a gain of ≥ 1 point on item 1a (level of consciousness) or ≥ 4 points in the motor items of the NIHSS, any detectable deterioration should prompt careful assessment and a tailored work-up.

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Chapter
Information
Acute Stroke Care , pp. 101 - 118
Publisher: Cambridge University Press
Print publication year: 2019

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