Complications After Stroke

You are likely to experience some physical and neurological complications after a stroke. These complications may be minor or major, and the complications may be temporary or permanent depending on the size of the stroke and what part of the brain was affected.

Some things happen as a direct result of injury to the brain due to stroke. Others are because of a change in your abilities. For example, being unable to move freely can result in bedsores. 

Your doctor’s highest priorities after a stroke are to prevent complications and the occurrence of another stroke. Your doctor must ensure that you are healthy and able to resume some self-care activities. This means that all complications must be treated and under control.

Stroke Types and Their Impact on Complications

There are several different kinds of stroke and each has specific complications associated with it. The following is a list of stroke types and their common complications:

Hemorrhagic Stroke (Bleeding)

Complications of hemorrhagic stroke may include:

  • Blood clots (deep vein thrombosis or pulmonary embolism)
  • Brain swelling
  • Seizures
  • Memory loss
  • Vision and hearing problems
  • Muscle weakness 
  • Bed sores
  • Depression
  • Risk of pneumonia

Ischemic Stroke (Clots)

Complications of ischemic stroke may include:

  • Blood clots (deep vein thrombosis or pulmonary embolism)
  • Urinary tract infections, or UTI
  • Bowel and bladder problems
  • Risk of pneumonia
  • Muscle weakness
  • Bed sores
  • Mobility problems and falls

Transient Ischemic Attack (TIA)

Complications of TIA – also referred to as “mini-strokes” – may include:

  • Blood clots (deep vein thrombosis or pulmonary embolism)
  • Difficulty swallowing
  • Urinary tract infections, or UTI
  • Bed sores
  • Mobility problems and falls

Brain Stem Stroke

Complications of brain stem stroke may include:

  • Difficulty swallowing
  • Difficulty breathing
  • Loss of sensation
  • Vision problems
  • Motor control problems 
  • Coma
  • Locked-in syndrome, when the entire body is paralyzed except for the eyes

The Most Common Complications of Stroke

Brain Edema 

Brain edema is the swelling of the brain after a stroke. The swelling is caused by a build-up of fluid and pressure inside the skull that can affect the flow of oxygen and blood to the brain. Brain edema is a life-threatening condition that requires immediate treatment. The symptoms of brain edema may include: 

  • Headache
  • Nausea
  • Vomiting
  • Breathing difficulties
  • Vision changes
  • Difficulty speaking
  • Memory loss
  • Difficulty moving
  • Dizziness
  • Seizures
  • Neck stiffness or pain

Treatment options for brain edema may include medications, fluids given via IV oxygen therapy, surgery to relieve pressure, and ventriculostomy, which involves draining cerebral spinal fluid through a small hole in the skull.


Pneumonia is a common infection affecting the air sacs in one or both lungs. A complication of many major illnesses, pneumonia may include symptoms like a productive cough (produces phlegm), fever, chills, and breathing difficulties. Pneumonia is treated primarily with antibiotics.

Swallowing, respiratory therapy and deep breathing exercises call help decrease the risk of pneumonia in those recovering from a stroke.

Common Swallowing Problems

Dysphagia, or swallowing problems, are common after stroke and can sometimes result in things “going down the wrong pipe,” leading food, drinks, and saliva to be breathed into the lungs. Other symptoms of swallowing problems after a stroke may include coughing, feeling like food is stuck in your throat, bringing food back up after swallowing, chewing problems, and shortness of breath with swallowing.

The treatment for swallowing problems after stroke includes slowly taking small bites and sips, being sure to sit up straight while eating and drinking, and turning your head to one side while eating and drinking to protect your airway.

Urinary Tract Infection

A urinary tract infection, also called a UTI, may occur in the bladder, kidneys, urethra or ureters – all of which are part of the body’s urinary system. Bladder control problems are a common complication for those who are recovery from a stroke.

A UTI is most often caused by bacteria and may include the following symptoms:

  • Cloudy urine or blood in the urine
  • A feeling of pain or burning during urination
  • Pressure, pain or cramping in the lower abdomen
  • Fever

UTIs are frequently treated with antibiotics. Bladder training programs for incontinence are also a treatment approach for those who have UTIs or urination problems after stroke. 


Seizures occur when there is abnormal electrical activity in the cells of the brain. Seizures may cause convulsions, twitching, and changes in awareness, feelings and sensations.

Depending on the severity and frequency of seizures, treatments may include medication, dietary changes (for example, a ketogenic diet), surgery or electrical stimulation.

Clinical Depression

Clinical depression is a treatable mental health illness that often occurs with those recovering from a stroke. Depression causes unwanted emotional and physical reactions to changes and losses. 

Depression may include the following symptoms:

  • Feeling empty, sad or anxious for extended periods of time (more than 2 weeks)
  • Loss of interest in activities
  • Feelings of worthlessness and helplessness
  • Fatigue, feeling tired, having low energy
  • Changes to sleep habits (unable to sleep or sleeping excessively)
  • Weight changes
  • Appetite changes
  • Suicidal thoughts or thoughts about death

Psychological treatments for those recovering from stroke may include counseling or therapy for feelings that result from clinical depression. The types of treatment may include antidepressant medication, psychotherapy or both. You may also be referred to a local stroke support group.


Bedsores are pressure ulcers are injuries to the skin and underlying tissue from a decreased ability to move and increased pressure on areas of the body because of immobility. Bedsores may develop from lying in bed, sitting or otherwise being immobile. The sores develop quickly and are frequently found on the hips, tailbone, heels, shoulders, backs or sides of the knees and ankles.

Treatment approaches for bedsores includes frequent turning to relieve removing pressure from the affected areas, good nutrition, wound cleaning and medications. In more serious cases of bedsores, treatment may involve removing damaged or dead tissue or skin grafts.

Limb Contractures 

Limb contractures are shortened muscles in an arm or leg from reduced range of motion or lack of exercise. A contracture may occur in muscles, joints, tendons and other tissues and cause pain and a loss of movement. The treatment for limb contractures may include physical therapy and special range-of-motion exercises, supportive devices like splints and braces, medication, heat therapy and surgery.

Shoulder Pain

Shoulder pain stems from lack of support of an arm due to weakness or paralysis. This is usually caused when the affected arm hangs resulting in pulling of the arm on the shoulder. Shoulder pain is common among those who have had a stroke and is often attributed to weak rotator cuff muscles. Treatment typically involves range-of-motion exercises and physical therapy and may include supportive devices like slings.

Deep Venous Thrombosia

Deep venous thrombosis, or DVT, are blood clots that form in veins of the legs because of immobility from stroke. DVT is a serious condition that requires immediate attention to prevent clots from loosening and traveling to the lungs, creating a blockage. The symptoms of DVT may include:

  • Severe pain or cramping in the leg
  • Swelling
  • Areas of the skin that are feels warm
  • Skin redness 

DVT is typically treated with medication (like blood thinners) and compression socks. For those recovering from stroke, range-of-motion exercises and physical therapy may be part of the treatment plan for DVT.


Aphasia is an inability or reduced ability to communicate with others due to brain damage after a stroke. The condition causes difficulty in both understanding speech and expression. Speech therapy is the primary treatment approach for aphasia.  


A headache is pain in any area of the head that can vary in location and intensity. Treatment for headache usually involves the use of painkillers and an increase in fluid intake.

Involuntary Muscle Tightening 

Muscle tightening can occur after stroke and cause stiffness from muscles not being able to move in their full range of motion. The treatment for this complication includes physical therapy and special range-of-motion exercises, supportive devices like braces and medication.