Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Cerebrovascular Accident


Related Terms

  • Acute Cerebrovascular Disease
  • Brain Attack
  • Cerebral Infarction
  • Craniovascular Accident
  • CVA
  • Intracranial Hemorrhage
  • Stroke
  • Stroke Syndrome

Differential Diagnosis

Specialists

  • Cardiologist, Cardiovascular Physician
  • Internal Medicine Physician
  • Neurologist
  • Orthotist
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical or Occupational Therapist
  • Psychiatrist
  • Speech Therapist

Comorbid Conditions

Factors Influencing Duration

Delay in treatment of stroke negatively influences recovery. Age at onset also affects recovery, with older adults experiencing longer-lasting effects than those with onset before age 45. Disability varies with the part of the brain affected, the extent of brain damage, and response to treatment.

Medical Codes

ICD-9-CM:
434.01 - Cerebral Thrombosis; Thrombosis of Cerebral Arteries; with Cerebral Infarction
434.11 - Cerebral Embolism; with Cerebral Infarction
434.91 - Cerebral Artery Occlusion, Unspecified; with Cerebral Infarction
435.9 - Unspecified Transient Cerebral Ischemia; Impending Cerebrovascular Accident; Intermittent Cerebral Ischemia; Transient Ischemic Attack [TIA]
436 - Cerebrovascular Disease, Acute, But Ill-defined
437.1 - Cerebrovascular Disease, Other and Ill Defined; Other Generalized Ischemic Cerebrovascular Disease
997.02 - Iatrogenic Cerebrovascular Infarction or Hemorrhage; Postoperative Stroke

Overview

A cerebrovascular accident, commonly known as a stroke, is sudden, localized damage in the brain due to severe disturbance of the blood flow to a part of the organ that results in nervous system (neurologic) deficits. Stroke may result from either interrupted delivery of blood and oxygen to the brain (ischemic stroke) or bleeding in the brain (hemorrhagic stroke).

The cause of ischemic stroke is blockage (occlusion) of arteries that carry blood and oxygen to the brain or within the brain. Non-thrombotic occlusion of small arteries deep in the brain is the most common cause of ischemic stroke.

The source of the occlusion may also be a clot (thrombus) dislodged from the wall of a blood vessel, the heart, or the valves of the heart. Thrombi are most likely to form in the blood vessels when narrowing of the arteries caused by fatty deposits in the vessel walls (atherosclerosis) leads to turbulent blood flow. Thrombi form along the walls of the heart when portions of the heart muscle are damaged or not able to contract normally (e.g., heart attack [myocardial infarction], atrial fibrillation, severe congestive heart failure [CHF], cardiomyopathy). Thrombi form on valves when there is damage to the valve (endocarditis, mitral stenosis, artificial valves). Certain medical conditions can also cause platelets or red blood cells to become stickier or may cause increased blood viscosity, leading to formation of a thrombus; these conditions include polycythemia, multiple myeloma, sickle cell anemia, factor V Leiden, anti-thrombin III deficiency, prothrombin mutation, protein C deficiency, and protein S deficiency.

Occlusion can also be caused by material (embolus) traveling through the blood stream. Examples of an embolus include, besides a thrombus, a piece of atheromatous plaque, or a clump of bacteria.

Regardless of the cause of blockage, brain tissue and nerve cells (neurons) die when robbed of blood and oxygen supply. The size and location of the blockage and the extent of damage before blood flow is restored determines the effects of a stroke. Brief ischemic episodes (transient ischemic attacks [TIAs]) can occur as warning signs of an impending larger stroke. People with a history of TIAs have almost double the risk of strokes (Go). Symptoms of TIA usually pass quickly; a diagnosis of ischemic stroke is made when neurologic deficits persist for more than one hour.

Bleeding from a ruptured blood vessel causes hemorrhagic stroke. The blood vessel may rupture because of high blood pressure (hypertension), increased tendency toward bleeding, an abnormal circumscribed weakness in the wall of a blood vessel (aneurysm), or abnormal communication between arteries and veins (arteriovenous malformation). For specific information concerning hemorrhagic stroke, see the topic Cerebral Hemorrhage.

Conditions that predispose individuals to stroke are hypertension, diabetes mellitus, heart disease, CHF, and atrial fibrillation, particularly if these conditions are untreated or are poorly controlled. Risk also is increased in individuals who have a history of TIAs, cerebrovascular disease, or a family history of stroke.

Incidence and Prevalence: Ischemic strokes account for 87% of all strokes (Go). Each year about 130,000 Americans experience a stroke (CDC). Stroke is the fourth leading cause of death and the tenth leading cause of disability in the US (CDC).

Blacks have a higher prevalence of hypertension, diabetes, obesity, smoking, and sickle cell anemia leading to a prevalence of stroke almost twice that in Caucasian populations, with 3.9% of blacks and 2.4% of Caucasians affected (Go). The incidence of stroke in black males aged 45 to 54 is 9.7 per 1,000 and 7.2 per 1,000 black females; the incidence of stroke in Caucasian males and females aged 45 to 54 is 2.4 per 1,000 (Go). By age 65, the incidence of stroke in black males and females increases to 13.1 per 1,000 and 10.0 per 1,000 respectively, and stroke incidence in Caucasian males is 6.1 per 1,000 and in Caucasian females 4.8 per 1,000 (Go).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Most strokes occur in adults over the age of 55 and the risk of stroke increases with each decade of age. Lifestyle risk factors for stroke are high cholesterol, obesity, cigarette smoking, cocaine use (the most common cause of stroke in people under age 55), and heavy use of alcohol (Go; Treadwill).

Men have a higher risk for stroke than women. The stroke risk for young women who smoke and also take birth control pills (high-estrogen oral contraceptives) is more than 20 times higher than for women who do not smoke and also do not use oral contraceptives.

Source: Medical Disability Advisor



Diagnosis

History: Ischemic stroke may occur suddenly, or symptoms may develop gradually over minutes to hours. The individual also may report symptoms that occurred a day or two before the stroke, such as neck pain or tingling in the arm. Stroke may occur during sleep so that the individual awakens with what appears to be a sudden deficit, such as restricted movement on one side of the body or inability to speak.

Symptoms vary depending on which blood vessel in the brain has been blocked and what part of the brain is affected by the blockage. The pattern of symptoms can help determine whether the stroke involves the front of the brain (anterior circulation) or back of the brain (posterior circulation), including the cerebellum or brain stem. Symptoms may include numbness (paresthesia) or weakness (paresis) in the face, arm, or leg, usually on one side of the body (hemianesthesia or hemiparesis); difficulty in speaking (expressive aphasia) or understanding speech (receptive aphasia); vision loss affecting one or both eyes (visual field cut); double vision (diplopia); slurred speech (dysarthria); difficulty swallowing (dysphagia); difficulty walking (gait ataxia and / or dyspraxia); dizziness; vertigo; or loss of balance or coordination. These symptoms may occur alone or in combination and may be accompanied by a change in the level of consciousness.

Physical exam: Physical findings vary depending on the part of the brain that has been affected by the stroke. In addition to observation of the symptoms described above, other findings may include increased or decreased muscle tone (hypertonia or hypotonia) or changes in reflexes. If the stroke affects blood circulation in the brain stem, the regulation of temperature, blood pressure, and breathing may be affected since the brainstem controls these functions.

The physical examination should localize the site of the damage (lesion), document the neurologic deficits, rule out conditions that can be confused with stroke, and determine potential cardiovascular causes of stroke. The National Institutes of Health Stroke Scale (NIHSS) is a 42-point scale that allows quantification of an individual's neurologic deficits. This scale can be used to follow changes throughout an individual's course.

Tests: The following tests are usually ordered: a complete blood count (CBC), blood chemistries for electrolyte levels (sodium, potassium, and chloride), blood glucose level, and lipid levels (high density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol, triglycerides). Cardiac enzymes are evaluated because of the association between cardiovascular disease and cerebrovascular disease and to rule out a simultaneous myocardial infarction. Coagulation studies (prothrombin time [PT], partial thromboplastin time [PTT]) reveal clotting or bleeding tendencies. Brain computed tomography (CT) and magnetic resonance imaging (MRI) are performed to rule out hemorrhage and confirm an ischemic stroke, localize the affected area, and determine the extent of damage. Electrocardiogram (ECG) and heart rate monitoring are done to evaluate heart function. Oxygen levels may be monitored. Tests to determine the source of thrombi may include carotid Doppler ultrasound to examine the carotid arteries in the neck, and echocardiography to examine the heart valves. Angiography is most important in the preoperative evaluation of carotid disease and in defining the cerebrovascular anatomy in certain individuals.

Source: Medical Disability Advisor



Treatment

Immediate transport to the hospital is critical for all individuals with suspected stroke. Prompt restoration of blood flow to the area of blockage can prevent further damage from occurring and reduce or reverse injury. Reperfusion agents (thrombolytics) are drugs that can help restore blood flow in ischemic strokes by dissolving clots; however, these drugs are most effective when given within 3 hours of symptom onset. Thrombolytic agents are contraindicated when brain CT or MRI reveals a hemorrhagic stroke. Tissue plasminogen activator (tPA) may be given according to protocol if the individual meets strict criteria. Individuals who do not meet criteria for tPA may be given antiplatelet medications (e.g., aspirin) and / or anticoagulants (e.g., heparin and / or warfarin) to prevent additional clot formation that could result in another stroke, a myocardial infarction, or complications of the current stroke. Heparin dosage must be carefully regulated when used for ischemic stroke because it can overcorrect the coagulation problem, resulting in bleeding. Coagulation levels are carefully monitored with use of any anticoagulant. The use of other medications may be indicated to control hypertension, fever, brain swelling, or to treat complications such as concomitant myocardial infarction.

Individuals are hospitalized for monitoring of vital signs (blood pressure and heart rate), coagulation times (PT and PTT), oxygen levels, electrolyte balance, and other blood chemistries. These parameters must be closely regulated to minimize the amount of brain damage resulting from the stroke and to normalize the individual’s body chemistry to prevent another stroke.

Source: Medical Disability Advisor



Prognosis

Recovery rates vary depending on age and the part of the brain affected and the extent of the stroke. Function will be restored in more than half of individuals with moderate to severe paralysis on one side of the body (hemiplegia) (Kwakkel). Stroke (all types) has an overall mortality rate of 39.1 per 100,000 individuals; higher mortality occurs in older individuals, and in those with brain stem stroke, or hemorrhagic stroke with alterations of consciousness (Go; Zia). About 5% to 10% of stroke survivors have a second stroke within a year. Control of risk factors such as hypertension, atrial fibrillation, atherosclerosis, obesity, and high lipid levels is important to prevent additional strokes (Go). Rehabilitation is a significant factor in stroke outcomes.

Source: Medical Disability Advisor



Rehabilitation

Individuals who experience a stroke may require a variety of rehabilitation services including physical therapy, occupational therapy, speech therapy, and orthotic management. Therapy should begin as soon as the individual is medically stable, usually within 72 hours. Acute inpatient rehabilitation should continue daily until the individual is discharged from the hospital. Individuals discharged to a rehabilitation hospital or skilled nursing unit should have several hours of therapy daily. Individuals discharged to home should have the appropriate home care services several times a week for about 6 to 9 weeks. Additional outpatient therapy may be indicated.

The focus of occupational therapy is to regain as much as possible the individual's ability to perform activities of daily living. Occupational therapists help individuals learn new ways to perform activities such as washing dishes and doing the laundry. Individuals may learn either to perform such tasks while sitting down on a kitchen stool or by using adaptive equipment to make tasks easier. Individuals also learn bathing, toileting, and dressing techniques. Occupational therapists may order equipment such as a tub transfer bench to assist individuals in using the bathtub or elastic shoelaces to promote ease of dressing.

Occupational therapists promote the return of upper extremity and hand function through a variety of activities. Often the upper arm separates (subluxes) from the shoulder girdle due to the loss of muscle tone; neuromuscular electrical stimulation (NMES) uses electrodes that provide external stimulation to the muscles to counteract this problem. More frequently, individuals use a hemi-sling that helps support the arm to prevent subluxation. Occupational therapists may stretch the upper extremity and teach self-stretching techniques and strengthening exercises so the arm can regain maximum potential function.

Individuals perform tasks requiring weight bearing on the affected extremity to provide nerve impulses to the brain to try to promote the healing of damaged neural paths. An example of a weight-bearing activity is placing the hands on the bed while seated to help maintain an upright posture. Individuals engage in tasks using both hands, such as holding a cup with the weak hand while pouring a drink with the unaffected hand. As function returns, individuals may engage in fine motor tasks such as handwriting.

Physical therapy focuses on stretching and strengthening any tight or weak musculature. Therapists may passively stretch any affected joints and instruct individuals and their family members on how to perform a stretching and strengthening program. Physical therapy also focuses on transfer training. The physical therapist teaches individuals to roll in bed, transfer from lying to sitting, and from sitting to standing. Physical therapy teaches the individual to roll to both sides and bear weight evenly when sitting and standing. Individuals also learn mobility techniques such as walking and climbing stairs using a pyramid cane, four-pronged cane, or a walker. A wheelchair is ordered for those individuals unable to walk. Individuals learn to propel the wheelchair outside over curbs and ramps.

Orthotic management may also be required for individuals to regain function. A night splint may be made that places the hand in a more functional position. An orthotist may make a leg splint (ankle-foot orthosis) to promote better control of the ankle and knee while walking.

Speech therapy may be required to strengthen the muscles of the face for improved speech and swallowing. Individuals learn to move the facial muscles in a balanced manner both by manual assistance and visual cueing using a mirror. Individuals perform tongue exercises that allow improved speech and easier eating. Individuals learn to speak with greater clarity through activities such as sustained vocal expressions (e.g., saying "ah"). To assist in the swallowing reflex, individuals begin eating semi-moist, pureed food that is easier to swallow and then progress to food that is rich in taste, smell, and texture. Individuals also learn to achieve sucking control and saliva production first by sucking on small ice chips and progressing to sucking thick liquids through a straw.

Individuals may need counseling by a psychologist or psychiatrist to help adjust to their altered functional abilities and body image.

Source: Medical Disability Advisor



Complications

Complications vary with the severity of the stroke, the part of the brain affected, and the amount of time between the onset of stroke and treatment. Individuals who have had an ischemic stroke are at increased risk for having another stroke or myocardial infarction. Heart monitors should be used following stroke, as individuals often will have abnormal or irregular heart rhythms (cardiac arrhythmia), especially atrial fibrillation, which can contribute to thrombus and / or embolus formation and another stroke. Decreased muscle activity following stroke may increase risk of blood clot formation in veins (deep vein thrombosis [DVT]). These blood clots can travel to the lungs (pulmonary embolism) and cause serious respiratory problems or death. Deep vein thrombosis can be prevented by walking for individuals who are ambulatory, compression stockings for individuals who are confined to bed, and / or by medications.

Cognitive dysfunction may affect memory, level of attention and alertness, ability to communicate clearly, and motor skills. Instructions may be misunderstood or forgotten and the individual may not be able to process information and respond appropriately. The individual may become a threat to his or her own safety, and unable to function responsibly, complete tasks, or operate equipment. Depression affects at least one-third of individuals with stroke (Lokk).

Difficulty swallowing and decreased alertness can allow food or saliva to enter the lungs (aspiration) and cause sudden death due to choking or lung infection (aspiration pneumonia). Seizures occur in approximately 10% of individuals with ischemic stroke (NSA). Urinary incontinence and poor bladder function may result in urinary tract infection (UTI) or kidney problems. Individuals who have had a stroke are at increased risk of falls due to factors such as impaired judgment, poor balance and coordination, and muscle weakness. Uncontrolled muscle spasm can lead to joint stiffness and immobility (contractures). Shoulder injury can result due to decreased muscle tone. Pressure sores (decubitus ulcers) may occur if the individual is immobile and unable to make frequent position changes or is not moved frequently by caretakers. Poor healing of pressure sores and related bacterial contamination may become a source of systemic infection (sepsis).

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

An individual who has experienced a stroke will have varying needs when returning to the workplace. If a cane, walker, or wheelchair is necessary, the work environment should be free of barriers that limit mobility. Individuals may need a quiet work environment to aid concentration if cognition was affected by the stroke. Individuals may need adaptive equipment such as pens and pencils with thicker shafts that allow better gripping. Individuals may need to change job positions if the original job required heavy lifting, prolonged standing, or cognitive skills that have been lost.

Risk: Generally, there are no occupations that place an individual at increased risk of a stroke.

Capacity: Capacity may be affected in individuals who sustained a stroke with permanent damage. Depending on the area of the brain affected, testing for disability is needed.

Tolerance: Tolerance may be affected in individuals who experience a permanent deficit from their stroke. Rehabilitation is often an important mechanism to encourage use of an affected body part and re-integration into the work environment. Worksite accommodations and Americans with Disabilities Act (ADA) considerations may become pertinent in the discussion.

Source: Medical Disability Advisor



Maximum Medical Improvement

360 days.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual have hypertension, blood clotting disorder, diabetes mellitus, history of TIAs or stroke, heart disease, or CHF? Does individual smoke, use cocaine, or abuse alcohol? Does individual have high cholesterol, or is individual obese?
  • What is individual's age? Sex? Family history?
  • Did individual experience a sudden, severe headache and / or loss of consciousness?
  • Has paresthesia, paresis, or paralysis occurred in the face, arm, or leg? Was expressive or receptive aphasia, visual field cut, diplopia, dysarthria, dysphagia, gait ataxia, vertigo, or loss of balance or coordination reported?
  • On physical exam, were increased or decreased muscle tone or changes in reflexes observed?
  • Does individual have difficulty with regulation of temperature, blood pressure, and / or breathing?
  • Was a brain CT or MRI done? ECG and cardiac enzymes measurement performed? Doppler, echocardiogram, or angiography done?
  • Were tests done to rule out conditions with similar symptoms?

Regarding treatment:

  • Was individual taken to the hospital immediately?
  • If individual met criteria, was the tPA protocol administered?
  • Is individual being treated with heparin, aspirin, or warfarin?
  • Is it necessary to administer other medications to control hypertension, high blood lipids, severe muscle spasms, or complications such as myocardial infarction?

Regarding prognosis:

  • Has individual addressed modifiable risk factors?
  • Is individual active in rehabilitation? Is a home exercise program in place?
  • Does individual have any complications such as another stroke, myocardial infarction, cardiac arrhythmia, DVT, pulmonary embolism, or aspiration pneumonia?
  • Does individual have seizures, urinary tract infection or kidney problems, other injuries from falls, contractures, bedsores, or sepsis?
  • Is individual depressed?

Source: Medical Disability Advisor



References

Cited

""47.5 Million U.S. Adults Report a Disability; Arthritis Remains Most Common Cause." CDC. 21 Jun. 2011. Centers for Disease Control and Prevention. 8 May 2014 <http://www.cdc.gov/features/dsadultdisabilitycauses/>.

"Leading Causes of Death." CDC. 30 Dec. 2013. Centers for Disease Control and Prevention. 8 May 2014 <http://www.cdc.gov/nchs/fastats/lcod.htm>.

"Seizures and Epilepsy." National Stroke Association. Aug. 2012. National Stroke Association. 8 May 2014 <http://www.stroke.org/site/PageServer?pagename=seizures>.

Go, A. S. , et al. "Heart Disease and Stroke Statistics--2013 Update: A Report from the American Heart Association." Circulation 127 (2013): e6-e245.

Jauch, Edward C. "Acute Management of Stroke." eMedicine. Eds. Helmi L. Lutsep, et al. 29 Oct. 2012. Medscape. 8 May 2014 <http://emedicine.medscape.com/article/1159752-overview>.

Jauch, Edward C. "Ischemic Stroke." eMedicine. Eds. Helmi L. Lutsep, et al. 2 May. 2014. Medscape. 8 May 2014 <http://emedicine.com/emerg/topic558.htm>.

Kwakkel, G. , and B. J. Kollen. "Predicting Activities after Stroke: What Is Clinically Relevant." International Journal of Stroke 88 (2013): 25-32.

Lokk, J. , and A. Delbari. "Management of Depression in Elderly Stroke Patients." Neuropsychiatric Disease and Treatment 6 (2010): 539-549.

Porter, Robert S., ed. "Ischemic Stroke." The Merck Manual of Diagnosis and Therapy. 19th ed. Whitehouse Station, NJ: Merck Laboratories, 2011.

Sacco, R. L. "Newer Risk Factors for Stroke." Neurology 57 5 (2001): 31-34. MD Consult. Jan. 2001. Elsevier, Inc. 8 May 2014 <http://home.mdconsult.com/das/journal/view/39434791-2/N/12029915?sid=286878571&source=MI>.

Singh, Niten, et al. "Atherosclerotic Disease of the Carotid Artery." eMedicine. Eds. Vincent Lopez Rowe, et al. 27 Mar. 2014. Medscape. 8 May 2014 <http://emedicine.medscape.com/article/463147-overview>.

Sultan, Sally. "Genetic and Inflammatory Mechanisms in Stroke." eMedicine. Eds. Helmi L. Lutsep, et al. 21 Oct. 2013. Medscape. 8 May 2014 <http://emedicine.medscape.com/article/1163331-overview>.

Treadwell, S. D. , and T. G. Robinson. "Cocaine Use and Stroke." Postgraduate Medical Journal 83 (2007): 389-394.

Zia, E. , et al. "Three-Year Survival and Stroke Recurrence Rates in Patients with Primary Intracerebral Hemorrhage." Stroke 40 (2009): 3567-3573.

Source: Medical Disability Advisor






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