Stroke: Life-Threatening Complications

Topic Overview

Complications that threaten a person's life may develop soon after stroke symptoms occur. Preventing these complications is a major focus of initial stroke treatment.

Life-threatening complications include:

• Increased pressure on the brain, which develops when the brain swells after a large stroke. Such swelling occurs quickly, becomes most severe within 3 to 5 days after the stroke, and can cause death. Pressure on the brain is more likely in people who have had a stroke caused by a bleeding blood vessel (hemorrhagic stroke).
• Fever. This may make a person's chance of recovery worse if the fever occurs at the same time as a stroke. Fever may be a sign of an infection, such as pneumonia or a urinary tract infection. Drugs that reduce fever (acetaminophen or aspirin) are often used. But if these do not work, a special blanket that circulates cool air or water may be needed.
• High blood sugar (glucose). This often occurs in people who have diabetes. Very high or low blood sugar immediately after a stroke interferes with proper brain cell function, increasing the risk of damage.
• Blood pressure changes. People who have a stroke usually will have higher blood pressure for at least 1 to 3 days after the stroke. This may represent an attempt by the body to increase blood flow to the part of the brain that is being affected by the stroke. Only very high blood pressure is treated. If it occurs, very high blood pressure usually is brought down slowly. A rapid drop in blood pressure can lead to more brain damage.
• Buildup of spinal fluid within the brain (hydrocephalus). Fluid on the brain is more likely to occur if the stroke was caused by bleeding (hemorrhagic stroke).
• Spasms of blood vessels (vasospasm). Vasospasm may occur if the stroke was caused by a subarachnoid hemorrhage from an aneurysm.
• A blood clot in the legs (deep vein thrombosis) that may travel to the lungs (pulmonary embolism).
• Seizures.
• Another stroke.
• Coma.