Rehabilitation begins with prevention of stroke recurrence and other medical complications. The risk of stroke recurrence may be reduced with many of the same measures used to prevent stroke, including quitting smoking and controlling blood pressure.
One of the most common medical complications following stroke is deep venous thrombosis, in which a clot forms within a limb immobilized by paralysis. Clots that break free can often become lodged in an artery feeding the lungs. This type of pulmonary embolism is a common cause of death in the weeks following a stroke. Resuming activity within a day or two after the stroke is an important preventive measure, along with use of elastic stockings on the lower limbs. Drugs that prevent clotting may be given, including intravenous heparin and oral warfarin.
Weakness and loss of coordination of the swallowing muscles may impair swallowing (dysphagia), and allow food to enter the lower airway. This may lead to aspiration pneumonia, another common cause of death shortly after a stroke. Dysphagia may be treated with retraining exercises and temporary use of pureed foods.
Depression occurs in 30–60% of stroke patients. Antidepressants and psychotherapy may be used in combination.
Other medical complications include urinary tract infections, pressure ulcers, falls, and seizures.
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