Early control of the factors of poor prognosis in the approach of patients with ischemic cerebrovascular events

OBJETIVE:To describe general aspects related to acute ischemic stroke (AIS), as well as to know the main prognostic factors that have been related to the outcome and functional recovery after the AIS.MATERIALS AND METHODS:A narrative review was performed using databases (PubMed, Science-Direct, MEDLINE), virtual platforms (National Institutes of Health) and publications of the Colombian Neurological Record.RESULTS:Being female, advanced age, inattention (neglect), severity of cognitive and executive function impairment, malnutrition, and comorbidities such as pneumonia are associated with a worse prognosis in the 90 days after the event. Alterations in the mental sphere (delirium), altered consciousness, hemiplegia or paralysis of the conjugate gaze and the cardioembolic origin of the AIS are some of the factors that are associated with higher mortality. Hemispheric laterality is an important variable to consider in assessing the prognosis and residual functional disability post-event; however the current evidence is inconclusive and somewhat contradictory.CONCLUSIONS:Early diagnosis and adequate intervention of patients with AIS and early control of modifiable factors of poor prognosis are important. Among the non-modifiable, hemispheric laterality may be more a selection criterion for a specific and personalized rehabilitation program, since there is undoubtedly a cognitive and language compromise that differs substantially in relation to the topographical location of the ischemic lesion.