Incidence of secondary vascular complications after stroke.
Stroke is a clinical syndrome characterized by the sudden occurrence of a permanent focal neurological deficit. The most common causes of death are transtentorial herniation, pneumonia, pulmonary embolism and heart disease. According to literature data, pulmonary embolism (PE) is responsible for 5% of deaths after stroke.


OBJECTIVE
The aim of this article is to determine the incidence of patients who had secondary vascular complications in the form of PE and deep venous thrombosis (DVT) after stroke and indicate the need for creating and promoting the algorithm for these complications in patients after stroke.


METHODS
The study included 86 patients hospitalized at the Clinic of Physical Medicine and Rehabilitation in the period from October 2008 to October 2009 who have had rehabilitation as a continuation of the treatment immediately after the stroke.


RESULTS
Hemorrhagic type was present in 13% of patients, and ischemic in 87%. As a secondary complication after stroke, five patients had pulmonary embolism. Neurological deficit in these patients was in the form of hemiplegia and were with ischemic type. Time from stroke until the appearance of symptoms of pulmonary embolism was in average 25.4 days. Suggested thrombi prophylaxis therapy (which they received before rehabilitation) in patients who have developed PE was Aspirin Protect, while no patient had recommended low molecular heparin. Physical therapy was performed for all patients, and mechanical methods of prophylaxis were used.


CONCLUSIONS
Different attitudes about prophylaxis effects for these patients should be regulated by a unique algorithm that would reduce the possibility of discrepancy in therapeutic sense. That is why for patients with acute stroke and limited mobility it is recommended to use heparin or low molecular heparin (LMH) in preventive doses, if there are no contraindications for anticoagulants, with physical therapy and mechanical methods of prophylaxis.
Hadziahmetovic
Narcisa Vavra
NV
Clinic of Physical Medicine and Rehabilitation, Clinical Center of Sarajevo University, Bosnia and Herzegovina.
Hadziahmetovic
Zoran
Z
D002545:Brain Ischemia / Q000150:complications; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology*; D020521:Stroke / Q000150:complications* / Q000209:etiology; D020246:Venous Thrombosis / Q000209:etiology*