(HealthDay News) — Bed positioning in the first 24 hours after an ischemic stroke is a critical but complicated decision, according to a report published in MedLink Neurology.

“The period immediately following an acute ischemic stroke is a time of significant risk,” neurologists from the Loyola University Medical Center in Maywood, Ill., said in a university news release. “Meticulous attention to the care of the stroke patient during this time can prevent further neurologic injury and minimize common complications, optimizing the chance of functional recovery.”

Sitting upright can harm ischemic stroke patients because it decreases blood flow to the brain when it needs more blood, the researchers explained. This would suggest that it’s best to keep these patients lying as flat as possible, but strokes can also cause brain swelling. Keeping patients sitting upright helps improve blood drainage and reduces swelling. 

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“There are few data to guide decision making in this difficult situation,” wrote Murray Flaster, MD, PhD, and colleagues in the news release. Another complicating factor is that some stroke patients have difficulty breathing while lying flat. In such cases, the head of the bed should be at the lowest elevation the patient can tolerate.

The report also examines many other issues in stroke care, such as: glycemic control; blood pressure management; use of statin drugs; complications such as pneumonia and sepsis; heart attack and other heart problems; deep vein thrombosis; infection; seizures; further strokes; brain swelling and bleeding; and malnutrition and aspiration. Research has shown that patients treated at hospital units that specialize in stroke care are less likely to die, more likely to be able to return home, and have better functioning and quality of life, the report said.


  1. Available at: http://loyolamedicine.org/newswire/news/stroke-patients-hospital-bed-position-delicate-balancing-act. Accessed November 10, 2014.