Complications

Complication
Timeframe
Likelihood
short term
medium

Preventable infections include aspiration pneumonia, urinary tract infection, and cellulitis from infected pressure ulcers.

short term
medium

Consider either anticoagulation or use of a vena caval filter in patients who develop symptomatic deep venous thrombosis or pulmonary embolism to prevent the development of further pulmonary emboli.[55] Use your clinical judgement to individually assess the risk-benefit balance of using (or avoiding) anticoagulant treatment in a patient with intracerebral haemorrhage and pulmonary embolism. There is no evidence to guide the management of these patients.[30]​​

long term
medium

New-onset seizures in the context of spontaneous ICH are relatively common (affecting between 2.8% and 28% of patients); most of these seizures occur within the first 24 hours of the haemorrhage.[23]​ Seizures may develop into epilepsy.[113]

The risk is higher with cortical bleeds.

Generalised seizures

variable
high

A period of delirium is common following intracerebral haemorrhage.

Assessment of delirium

variable
high

At least half of all stroke survivors experience fatigue.[114]​ Post-stroke fatigue affects quality of life and exerts a negative impact on a patient's daily activities, such as decreased participation in physical activities and rehabilitation.[114]​ People with stroke should be assessed and periodically reviewed for post-stroke fatigue, including for factors that might precipitate or exacerbate fatigue (e.g., depression and anxiety, sleep disorders, pain) and these factors should be addressed accordingly. Appropriate time points for review are at discharge from hospital and then at regular intervals, including at 6 months and annually thereafter.[30]

variable
medium

Stroke-related dysphagia results in aspiration and subsequent pneumonia.[64]

A dysphagia screen is recommended in stroke patients before oral intake.

When aspiration pneumonia occurs, treatment is with antibiotics with consideration of enteral feeding.

Aspiration pneumonia

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