Management of Stroke in Patients With Chronic Liver Disease: A Practical Review

Stroke. 2023 Sep;54(9):2461-2471. doi: 10.1161/STROKEAHA.123.043011. Epub 2023 Jul 7.

Abstract

Chronic liver disease (CLD) is a highly prevalent condition. There is burgeoning recognition that there are many people with subclinical liver disease that may nonetheless be clinically significant. CLD has a variety of systemic aberrations relevant to stroke, including thrombocytopenia, coagulopathy, elevated liver enzymes, and altered drug metabolism. There is a growing body of literature on the intersection of CLD and stroke. Despite this, there have been few efforts to synthesize these data, and stroke guidelines provide scant guidance on this topic. To fill this gap, this multidisciplinary review provides a contemporary overview of CLD for the vascular neurologist while appraising data regarding the impact of CLD on stroke risk, mechanisms, and outcomes. Finally, the review addresses acute and chronic treatment considerations for patients with stroke-ischemic and hemorrhagic-and CLD.

Keywords: cerebrovascular disorders; liver diseases; stroke.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Blood Coagulation Disorders*
  • Chronic Disease
  • Hemorrhage
  • Humans
  • Liver Diseases* / complications
  • Liver Diseases* / epidemiology
  • Liver Diseases* / therapy
  • Stroke* / epidemiology
  • Stroke* / therapy
  • Thrombocytopenia*