Hyperglycemia in Acute Stroke

Nyika D. Kruyt and Yvo W.B.M. Roos

Contents

Background:Stroke Stroke and Hyperglycemia Hyperglycemia After Stroke Etiology of Hyperglycemia in

Acute (Ischemic) Stroke Admission Hyperglycemia and

Clinical Outcome After Stroke Glucose Levels and Lesion Volume How Does Hyperglycemia Affect the Ischemic Brain? Treatment of Hyperglycemia Conclusions Recommendations References

Abstract

Hyperglycemia is frequently found (40-60%) after all kinds of stroke and it has been related to increased lesion size and poor clinical outcome. In this chapter, we will primarily focus on ischemic stroke; we will outline the incidence and natural course of post-stroke hyperglycemia and discuss the possible etiologies of post-stroke hyperglycemia. Subsequently, we will present an overview of various mechanisms that could explain how hyperglycemia is detrimental after ischemic stroke. Finally, we will address the question whether inhospital hyperglycemia should be treated in stroke patients, and if so decided, the glucose levels that should be targeted and the difficulties that arise in achieving this.

From: Contemporary Diabetes: Diabetes and the Brain Edited by: G. J. Biessels, J. A. Luchsinger (eds.), DOI 10.1007/978-1-60327-850-8_9 © Humana Press, a part of Springer Science+Business Media, LLC 2009

Keywords: Acute stroke; Ischemic stroke; Hyperglycemia; Stress response; Diabetes mellitus; Insulin resistance; Reperfusion injury; Glycemic control.

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