neurologic disorders
Ischemic Stroke
Prognosis for Ischemic Stroke
Stroke severity and progression are often assessed using standardized measures such as the National Institutes of Health (NIH) Stroke Scale (see table); the score on this scale correlates with extent of functional impairment and prognosis. During the first days, progression and outcome can be difficult to predict. Older age, impaired consciousness, aphasia, and brain stem signs suggest a poor prognosis. Early improvement and younger age suggest a favorable prognosis. About 50% of patients with moderate or severe hemiplegia and most with milder deficits have a clear sensorium and eventually can take care of their basic needs and walk adequately. Complete neurologic recovery occurs in about 10%. Use of the affected limb is usually limited, and most deficits that remain after 12 months are permanent. Patients who have had a stroke are at high risk of subsequent strokes and each tends to worsen neurologic function. About 25% of patients who recover from a first stroke have another stroke within 5 years. After an ischemic stroke, about 20% of patients die in the hospital; mortality rate increases with age. 