Progression of stroke after arrival at hospital

In order to investigate the frequency, extent and importance of progression of stroke symptoms after arrival at hospital, 402 consecutive patients were studied. Speech ability, extremity and facial pareses were evaluated and graded on four occasions during hospitalization. Deterioration was noted in 43% of the patients; it was fairly marked in 25%. The frequency among the few patients with cerebral haemorrhage was much the same as in those with infarction. Limb motor function was affected in most cases. Half of the progressions occurred within the first 24 h after admission. Patients with progression stayed longer in hospital, were more disabled at discharge and more often needed further institutional care than those without progression, although the initial dysfunction was similar in the two groups. No characteristics were found that would help to identify a risk of deterioration. Thus, progression of stroke symptoms after arrival at hospital is a common and serious problem, whose solution calls for vigorous research.