Prognosis

In 2019, there were 3.29 million deaths worldwide as a result of ischemic stroke. Stroke is a leading cause of serious long-term disability in the US and worldwide.[9][11]​​ Prognosis of functional outcome can be reliably assessed using well-validated prognostic scores like the ASTRAL score or the iScore.[255]

Intravenous thrombolysis and mechanical thrombectomy, both together and separately, have been shown to improve stroke outcome. Treating patients in dedicated stroke units is effective.[119][223][224]​​ [ Cochrane Clinical Answers logo ]

Overall, patients with cerebral venous thrombosis have a favorable outcome.[8]​ Most patients with CVT achieve functional independence and survive without physical disability.[8]​ However, residual symptoms related to cognition, mood, fatigue, and headache, which negatively affect quality of life, are not uncommon.[8][203]​[256][257][258]​​​ Factors associated with poor prognosis include advanced age, active cancer, decreased level of consciousness, and intracerebral hemorrhage.[7][8]​​​[259]​​​​​​​

Common medical complications related to stroke include aspiration pneumonia, urinary tract infection, depression, malnutrition, and deep vein thrombosis.

A meta-analysis on the efficacy of physical therapy following stroke found that a variety of interventions improved functional outcomes, even when they were applied late after stroke.[260]

Patients receiving intravenous recombinant tissue plasminogen activator (r-tPA)

These patients are more likely to have a better outcome than patients not treated with r-tPA, despite a 6% risk of symptomatic intracranial hemorrhage.[155]

Estimates of the number needed to treat (NNT) to prevent one additional case of stroke-related disability within 4.5 hours of symptom onset are:[154]

  • 3 (following administration of r-tPA)

  • 2-4 (following administration of r-tPA plus thrombectomy).

Estimate of NNT to prevent one additional case of stroke-related disability within 4.5 to 9.0 hours of symptom onset is:

  • 25 (following administration of r-tPA).

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