Hopp til hovedinnhold

Hjerneslag

Et hjerneslag inntrer når blodtilførselen til en del av hjernen blokkeres og hjernevev får for lite blod. Det kan skyldes blodpropp som kommer fra for eksempel hjertet eller blodpropp som dannes på stedet eller sjeldnere blødning.

Sist revidert:

QR
Del pasientinformasjon

Den ligger åpent tilgjengelig på NHI.no sammen annen relevant informasjon

https://nhi.no/forstehjelp/hode-og-rygg/hjerneslag/ 

Fakta

Hjerneslag, hva er det?

Alarmsignaler

Førstehjelp

Vil du vite mer?

Animasjoner

Kilder

Referanser

Dette dokumentet er basert på det profesjonelle dokumentet Hjerneslag og TIA. Referanselisten for dette dokumentet vises nedenfor.

  1. Folkehelseinstituttet. Hjerte- og karregisteret. Forekomst av hjerte- og karsykdom i 2021. Siden lest 13.12.2022 www.fhi.no 
  2. Rafay MF, Pontigon A-M, Chiang J, et al. Delay to diagnosis in acute pediatric arterial ischemic stroke. Stroke 2009; 40: 58-64. Stroke 
  3. Wyller TB, Bautz-Holter E, Holmen J. Prevalence of stroke and stroke-related disability in North Trøndelag county, Norway. Cerebrovasc Dis 1994; 4: 421-427. PubMed 
  4. The GBD 2016 Lifetime Risk of Stroke Collaborators. Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016. N Engl J Med 2018; 379: 2429-37. doi:10.1056/NEJMoa1804492 DOI 
  5. Folkehelseinstituttet. Dødsfall etter hjerteinfarkt og hjerneslag er dramatisk redusert. Dødsårsaksregisteret. Publisert 04.12.2019 www.fhi.no 
  6. Sposato LA, Cipriano LE, Saposnik G, Ruíz Vargas E, Riccio PM, Hachinski V. Diagnosis of atrial fibrillation after stroke and transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol. 2015 Apr;14(4):377-87 . pmid:25748102 PubMed 
  7. Gladstone DJ, Spring M, Dorian P, et al. Atrial fibrillation in patients with cryptogenic stroke. N Engl J Med. 2014; 370: 2467-77. doi: 10.1056/NEJMoa1311376 DOI 
  8. Ratajczak-Tretel B, Lambert AT, NOR-FIB study Group. Atrial fibrillation in cryptogenic stroke and TIA patients in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study: Main results. Eur Stroke J 2019; 4: 172-180. pmid:31259265 PubMed 
  9. Connolly ES Jr, Rabinstein AA, Carhuapoma JR, et al.; American Heart Assoication Stroke Council; Council on Cardiovascular Radiology and Intervention; Couincil on Cardiovascular Nursing; Council on Cardiovascular Surgery and Anesthesia; Council on Clinical Cardiology. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43(6):1711–1737.
  10. Solbakken T, Moen G, Tysnes O-B. Kraniocervikal arteriedisseksjon. Tidsskr Nor Lægeforen 2002; 122: 2355-7. PubMed 
  11. Sandvik L, Erikssen J, Thaulow E, Erikssen G, Mundal R, Rodahl K. Physical fitness as a predictor of mortality among healthy, middle-aged Norwegian men. N Engl J Med 1993; 328: 533 - 7. New England Journal of Medicine 
  12. Helsedirektoratet. Nasjonal faglig retningslinje for behandling og rehabilitering ved hjerneslag. Oslo, Helsedirektoratet. Sist oppdatert 27.04.2020. helsedirektoratet.no 
  13. Easton JD, Albers GW, Caplan LR, et al. Discussion: Reconsideration of TIA terminology and definitions. Neurology. 2004; 62: 29-34. PubMed 
  14. O'Donnell MJ, Xavier D, Liu L, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case control study. Lancet 2010; 376: 112-23. PubMed 
  15. Schmidt M, Hováth-Puhó E, Christiansen CF, et al. Preadmission use of non-aspirin nonsteroidal anti-inflammatory drugs and 30-day stroke mortality. Neurology 2014; 83: 2013-22. doi:10.1212/WNL.0000000000001024 DOI 
  16. Bénard-Laribière A, Hucyeau E, Debette S, et al. Risk of first ischaemic stroke and use of antidopaminergic antiemetics: nationwide case-time-control study. BMJ 2022; 376: e066192. pmid:35321876 PubMed 
  17. Demel SL, Kittner S, Ley SH, et al. Stroke Risk Factors Unique to Women. Stroke 2018; 49: 518-23. pmid:29438077 PubMed 
  18. Lidegaard Ø, Løkkegaard E, Jensen A, Skovlund CW, Keiding N. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med 2012; 366: 2257-66. New England Journal of Medicine 
  19. Smeeth L, Thomas SL, Hall AJ et al. Risk of myocardial infarction and stroke after acute infection and vaccination. N Engl J Med 2004; 351: 2611-8. New England Journal of Medicine 
  20. Minassian C, D'Aiuto F, Hingorani AD, Smeeth L. Invasive dental treatment and risk for vascular events: a self-controlled case series. Ann Intern Med 2010; 153: 499-506. PubMed 
  21. Strazzulo P, D'Elia L, Kandala N-B, Cappuccio FP. Salt intake, stroke, and cardiovascular disease: a meta-analysis of prospective studies. BMJ 2009; 339: b4567. BMJ (DOI) 
  22. Haynes MJ, Vincent K, Fischhoff C, et al. Assessing the risk of stroke from neck manipulation: a systematic review. Int J Clin Pract 2012; 66: 940-7. PubMed 
  23. Hov MR, Larsen K, Bakke I, Sandset EC. Hjerneslag hos kvinner gir andre symptomer enn hos menn. Tidsskriftet 2022; 16; 142: 1375-6. doi:10.4045/tidsskr.22.0576 DOI 
  24. Shajahan S, Sun L, Harris K, et al. Sex differences in the symptom presentation of stroke: A systematic review and meta-analysis. Int J Stroke. 2022 Apr 12:17474930221090133. Epub ahead of print. PMID: 35411828 PubMed 
  25. Ali M, van Os HJA, van der Weerd N et al. Sex Differences in Presentation of Stroke: A Systematic Review and Meta-Analysis. Stroke 2022; 53: 345–54. PMID: 34903037 PubMed 
  26. Kerkhoff G. Neurovisual rehabilitation: recent developments and future directions. J Neurol Neurosurg Psychiatry 2000; 68: 691-706. PubMed 
  27. National Institutes og Health, National Institute of Neurological Disorders and Stroke. NIH Stroke Scale. Siden lest 11.11.2022. www.stroke.nih.gov 
  28. Zeltzer L, Korner-Bitensky N, Sitcoff E. Stroke engine. National Institutes of Health Stroke Scale (NIHSS). Evidence Reviewed as of before: 19-08-2008. Siden lest 11.11.2022. strokengine.ca 
  29. Shahjouei S, Li J, Koza E, et al. Risk of Subsequent Stroke Among Patients Receiving Outpatient vs Inpatient Care for Transient Ischemic Attack A Systematic Review and Meta-analysis. JAMA Netw Open 2022. doi:10.1001/jamanetworkopen.2021.36644 DOI 
  30. Kiyohara T, Kamouchi M, Kumai Y, et al. ABCD3 and ABCD3-I scores are superior to ABCD2 score in the prediction of short- and long-term risks of stroke after transient ischemic attack. Stroke 2014; 45: 418-25. pmid:24335223 PubMed 
  31. Perry JJ, Sivilotti MLA, Émond M, et al. CCBYNC Open access Research Prospective validation of Canadian TIA Score and comparison with ABCD2 and ABCD2i for subsequent stroke risk after transient ischaemic attack: multicentre prospective cohort study. BMJ 2021; 372: n49. pmid:33541890 PubMed 
  32. Langhorne P, Ramachandra S. Organised inpatient (stroke unit) care for stroke: network meta‐analysis. Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No.: CD000197. DOI: 10.1002/14651858.CD000197.pub4. Accessed 13 December 2022 The Cochrane Library 
  33. Siemieniuk RAC, Chu DK, Kim LH, et al. Oxygen therapy for acutely ill medical patients: a clinical practice guideline. BMJ 2018; 363: k4169. pmid:30355567 PubMed 
  34. Prabhakaran S, Ruff I, Bernstein RA. Acute stroke intervention: a systematic review. JAMA. 2015; 313:1451-62. doi: 10.1001/jama.2015.3058 DOI 
  35. Wardlaw JM, Murray V, Berge E, del Zoppo GJ. Thrombolysis for acute ischaemic stroke. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No.: CD000213. DOI: 10.1002/14651858.CD000213.pub3. Accessed 13 December 2022 The Cochrane Library 
  36. Smedslund G, Myrhaug HT, Hov L, Kirkehei I. Effekt av trombolytisk behandling i intervallet 3 til 4,5 timer etter hjerneslag. Rapport fra Folkehelseinstituttet – 2016. ISBN 978-82-8082-746-3 www.kunnskapssenteret.no 
  37. Roaldsen MB, Jusufovic M, Berge E, Lindekleiv H. Endovascular thrombectomy and intra‐arterial interventions for acute ischaemic stroke. Cochrane Database of Systematic Reviews 2021, Issue 6. Art. No.: CD007574. DOI: 10.1002/14651858.CD007574.pub3. Accessed 13 December 2022. The Cochrane Library 
  38. Jovin TG, Nogueira RG, Lansberg MG, et al. Thrombectomy for anterior circulation stroke beyond 6 h from time last known well (AURORA): a systematic review and individual patient data meta-analysis. Lancet 2022; 399: 249-58. pmid:34774198 PubMed 
  39. Oldgren J, Åsberg S, Hijazi Z, et al. Early Versus Delayed Non–Vitamin K Antagonist Oral Anticoagulant Therapy After Acute Ischemic Stroke in Atrial Fibrillation (TIMING): A Registry-Based Randomized Controlled Noninferiority Study. Circulation 2022. pmid:36065821 PubMed 
  40. Gibson E, Koh C-L, Eames S, Bennett S, Scott AM, Hoffmann TC. Occupational therapy for cognitive impairment in stroke patients. Cochrane Database of Systematic Reviews 2022, Issue 3. Art. No.: CD006430. DOI: 10.1002/14651858.CD006430.pub3. Accessed 13 December 2022. The Cochrane Library 
  41. Næss H, Waje-Andreassen U, Thomassen L. Overvåking ved akutt hjerneinfarkt. Tidsskr Nor Lægeforen 2006; 126: 444-6. PubMed 
  42. Ryu W-S, Schellingerhout D, Hong K-S, et al. Relation of Pre-Stroke Aspirin Use With Cerebral Infarct Volume and Functional Outcomes. Ann Neurol 2021; 90: 763-76. pmid:34536234 PubMed 
  43. Adams H jr, Adams RJ, Brott T, et al. Guidelines for the early management of patients with ischemic stroke. a scientific statement from the Stroke Council of The American Stroke Association. Stroke 2003; 34: 1056-83. PubMed 
  44. Vandvik PO, Kristiansen A, Brandt L, Berge E, Dahm AE, Halvorsen S, Sandset PM. Retningslinje for antitrombotisk behandling og tromboseprofylakse, 2013. http://www.magicapp.org/guideline/1
  45. Hobbs FD, Roalfe AK, Lip GY, et al. Performance of stroke risk scores in older people with atrial fibrillation not taking warfarin: comparative cohort study from BAFTA trial. BMJ 2011; 342: d3653. BMJ (DOI) 
  46. Turan TN, Nizam A, Lynn MJ, et al. Relationship between risk factor control and vascular events in the SAMMPRIS trial. Neurology 2016. pmid:28003500 PubMed 
  47. Friberg L, Skeppholm M, Terènt M. Benefit of anticoagulation unlikely in patients with atrial fibrillation and a CHA2DS2-VASc score of 1. J Am Coll Cardiol 2015: 27; 65:225. PMID: 25614418 PubMed 
  48. Gynnild MN, Hageman SHJ, Dorrestreijn JAN, Spigset O, et al. Risk Stratification in Patients with Ischemic Stroke and Residual Cardiovascular Risk with Current Secondary Prevention. Clin Epidemiol 2021; 13: 813-23. pmid:34566434 PubMed 
  49. Kwok CS, Shoamanesh A, Copley HC, et al. Efficacy of antiplatelet therapy in secondary prevention following lacunar stroke: pooled analysis of randomized trials. Stroke 2015; 46: 1014-23. doi:10.1161/STROKEAHA.114.008422 DOI 
  50. Greving JP, Diener HC, Reitsma JB, et al. Antiplatelet Therapy After Noncardioembolic Stroke. Stroke. 2019 Jul;50(7):1812-18. PMID: 31177983 PubMed 
  51. Diener HC, Sacco RL, Easton JD, et al. Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source. N Engl J Med. 2019 May 16;380(20):1906-1917. doi: 10.1056/NEJMoa1813959 DOI 
  52. Hart RG, Sharma M, Mundl H, et al. Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source. N Engl J Med 2018; 378: 2191-201. pmid:29766772 PubMed 
  53. RESTART Collaboration. Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial. Lancet 2019. doi:10.1016/S0140-6736(19)30840-2 DOI 
  54. Amarenco P, Kim JS, Labreuche J, et al. A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke. N Engl J Med 2019. pmid:31738483 PubMed 
  55. Giugliano RP, Pedersen TR, Saver JL, et al; FOURIER Investigators. Stroke Prevention With the PCSK9 (Proprotein Convertase Subtilisin-Kexin Type 9) Inhibitor Evolocumab Added to Statin in High-Risk Patients With Stable Atherosclerosis. Stroke. 2020 May;51(5):1546-1554. doi: 10.1161/STROKEAHA.119.027759. Epub 2020 Apr 21. PMID: 32312223.
  56. FOCUS Trial Collaboration. Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial.. Lancet 2018. doi:10.1016/S0140-6736(18)32823-X DOI 
  57. Legg LA, Tilney R, Hsieh CF, et al. Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery. Cochrane Database Syst Rev. 2019 Nov 26;2019(11). doi: 10.1002/14651858.CD009286.pub3 DOI 
  58. Snaphaan L, de Leeuw FE. Poststroke memory function in nondemented patients: a systematic review on frequency and neuroimaging correlates. Stroke 2007; 38: 198-203. PubMed 
  59. Pettersen R. Inkontinens etter hjerneslag. Tidsskr Nor Lægeforen 2007; 127: 1383-6. PubMed 
  60. The CLOTS Trials Collaboration. Effectivness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomised controlled trial. Lancet 2009; 373: 1958-65. PubMed 
  61. Fure B. Depresjon, angst og andre emosjonelle symptomer ved hjerneslag. Tidsskr Nor Lægeforen 2007; 127: 1387-9. PubMed 
  62. Robinson RG, Jorge RE, Moser DJ et al. Escitalopram and Problem-Solving Therapy for Prevention of Poststroke Depression. JAMA 2008; 299: 2391-2400. PubMed 
  63. Jones JS, Kimata R, Almeida OP, et al. Risk of Fractures in Stroke Patients Treated With a Selective Serotonin Reuptake Inhibitor: A Systematic Review and Meta-Analysis. Stroke 2021. PMID: 34167325 PubMed 
  64. Oldenbeuving AW, de Kort PL, Jansen BP, et al. Delirium in the acute phase after stroke: Incidence, risk factors, and outcome. Neurology 2011; 76: 993-9. Neurology 
  65. Pendlebury ST, Rothwell PM, Oxford Vascular Study. Incidence and prevalence of dementia associated with transient ischaemic attack and stroke: analysis of the population-based Oxford Vascular Study. Lancet Neurol 2019; 18: 248-58. pmid:30784556 PubMed 
  66. Levine DA, Galecki AT, Langa KM, et al. Trajectory of cognitive decline after incident stroke. JAMA 2015; 314: 41-51. doi:10.1001/jama.2015.6968 DOI 
  67. Toyoda K, Yoshimura S, Nakai M, et al. Twenty-Year Change in Severity and Outcome of Ischemic and Hemorrhagic Strokes. JAMA Neurol 2022; 79: 61-69. pmid:34870689 PubMed 
  68. Fjærtoft H, Indredavik B. Kostnadsvurderinger ved hjerneslag Tidsskr Nor Lægeforen 2007; 127: 744 - 7. PubMed 
  69. Folkehelseinstituttet. Kvalitet i helsetjenesten. 30 dagers overlevelse og reinnleggelse etter sykehusinnleggelse. Resultater for 2019. FHI 2020. www.fhi.no 
  70. Skajaa N, Adelborg K, Horváth-Puhó E, et al. Labour market participation and retirement after stroke in Denmark: registry based cohort study. BMJ 2023; 380: e072308. pmid:36596583 PubMed 
  71. Skajaa N, Adelborg K, Horváth-Puhó E, et al. Risks of Stroke Recurrence and Mortality After First and Recurrent Strokes in Denmark: A Nationwide Registry Study. Neurology 2021. pmid:34845054 PubMed 
  72. Indredavik B, Fjærtoft H, Ekeberg G, Løge A, Mørch B. Benefit of an extended stroke unit service with early supported discharge. A randomized controlled trial. Stroke 2000; 31: 2989-94. PubMed 
  73. Drummond AE, Pearson B, Lincoln NB, Berman P. Ten year follow-up of a randomised controlled trial of care in a stroke rehabilitation unit. BMJ 2005; 331: 491-2. PubMed 
  74. Helsedirektoratet. Pakkeforløp for hjerneslag. Sist faglig oppdatert 23.12.2020. Siden lest 28.10.2021 www.helsedirektoratet.no