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Stroke. Causes, symptoms, diagnostics, modern diagnostics, effective treatment, rehabilitation and prevention of complications of the disease. Stroke: causes, symptoms, help, treatment

What it is? Stroke is an acute disorder of cerebral circulation, leading to persistent focal brain damage. It can be ischemic or hemorrhagic. Pathology is accompanied by acute disturbance of cerebral circulation, vascular and central nervous system damage. If the normal blood flow is disturbed, the nutrition of the nerve cells of the brain deteriorates, and this is very dangerous, since the organ works due to the constant supply of oxygen and glucose to it.

Let's look at what signs are characteristic of a stroke, why it is important to help a person in the first minutes of the onset of symptoms, and also what are the possible consequences of this condition.

What is a stroke?

A stroke is an acute disorder of blood circulation in the brain that causes damage and death of nerve cells.

During the period " therapeutic window"(Conventionally called the first 3-6 hours after a stroke), the irreversible consequences of ischemia and cell death can be prevented by therapeutic manipulations.

Strokes occur in individuals in a wide age range: from 20-25 years to old age.

  • Narrowing or blockage of blood vessels in the brain - ischemic stroke;
  • Hemorrhages in the brain or in its membranes - hemorrhagic stroke.

The frequency is quite high, it increases significantly with age. Mortality (mortality) from stroke remains very high. Treatment is aimed at restoring the functional activity of neurons, reducing the influence of causal factors and preventing the re-development of vascular catastrophe in the body. After a stroke, it is very important to rehabilitate a person.

Every person needs to know the signs of the disease in order to respond in time to a brain catastrophe and call an ambulance for himself or his loved ones. Knowing the underlying symptoms can save someone's life.

Views

There are 2 main types of stroke: ischemic and hemorrhagic. They have a fundamentally different mechanism of development and require radically different approaches to treatment. Ischemic and hemorrhagic strokes occupy 80% and 20% of the total population, respectively.

Ischemic stroke

Ischemic brain damage occurs in 8 cases out of 10. Mostly elderly people suffer from it, after 60 years, more often men. The main reason is a blockage of blood vessels or their prolonged spasm, which entails the cessation of blood supply and oxygen starvation. This leads to the death of brain cells.

This type of disease can develop more often at night or in the morning. There is also a connection with a previous increased emotional (stress factor) or physical activity, alcohol consumption, blood loss, or the progression of an infectious process or somatic illness.

Hemorrhagic stroke

What is it? Hemorrhagic stroke is the result of hemorrhage into the substance of the brain after damage to the walls of the vessel. Disruption of functional activity and death of neurocytes in this case mainly occurs due to their compression by a hematoma.

The occurrence of hemorrhagic stroke is mainly associated with diffuse or isolated cerebral vascular pathology, as a result of which the vascular wall loses its elasticity and becomes thinner.

More often accompanied by loss of consciousness, more rapid development of stroke symptoms, always significant neurological disorders. This is due to the fact that in this case the cerebral circulation is disturbed due to rupture of the vascular wall with the outflow of blood and the formation of a hematoma or as a result of the soaking of the nerve tissue with blood.

In 5% of cases of stroke it is not possible to find out the type and mechanism of development. Regardless of the type of stroke, its consequences are always the same - a sharp, rapidly developing dysfunction of a part of the brain due to the death of part of its neurocyte cells.

The first signs of a stroke in an adult

All people should be aware of the signs of a stroke, regardless of whether they have a medical education. These symptoms are primarily associated with a violation of the innervation of the muscles of the head and body, so if you suspect a stroke, ask the person to do three simple steps: smile, raise your hands, say any word or sentence.

In a person who suddenly feels "light-headed", vascular problems can be assumed by the following signs, which can be mistaken for the first signs of a stroke:

  • Numbness in areas of the body (face, limbs);
  • Headache;
  • Loss of control over the environment;
  • Double vision and other visual impairments;
  • Nausea, vomiting, dizziness;
  • Movement and sensory disorders.

It happens that a stroke occurs suddenly, but more often it occurs against the background of precursors. For example, in half of cases, ischemic stroke is preceded.

If in the last three months, once a week or more often at least two of the following symptoms recur, then an immediate visit to a doctor is required:

  • A headache that does not have a specific localization and arises from overwork or weather disasters.
  • Vertigo, on at rest, worse on motion.
  • The presence of tinnitus, both permanent and transient.
  • "Gaps" of memory for events of the current time period.
  • Change in the intensity of working capacity and sleep disturbance.

These symptoms should be viewed as harbingers of stroke.

How to recognize a stroke?

To recognize this disease, pay attention to the following points:

  1. Take a closer look, ask if the person needs help. A person can refuse, because he himself did not yet understand what was happening to him. A person with a stroke will have difficulty speaking.
  2. Ask to smile if the corners of the lips are located on a different line and the smile looks strange, this is a symptom of a stroke.
  3. Shake the man's hand, if there is a stroke, then the handshake will be weak. You can also ask to raise your hands up. One arm will drop spontaneously.

When detecting signs of a stroke in a person, urgently call an ambulance !!! The sooner qualified assistance is provided, the greater the chances of eliminating the consequences of this disease !!!

Causes of occurrence

Doctors identify two main causes of stroke. This is the occurrence of blood clots in the circulatory system and the presence of cholesterol plaques, which can block the vessels. An attack can occur in a healthy person, but this probability is extremely small.

Pathology develops as a complication of the underlying disease of the heart and blood vessels, as well as under the influence of unfavorable factors:

  • cerebral atherosclerosis;
  • thromboembolism;
  • hypertension (arterial);
  • rheumatic heart disease;
  • myocardial infarction;
  • heart surgery;
  • constant stress;
  • vascular tumors;
  • taking certain types of drugs;
  • alcoholism;
  • smoking;
  • cerebral artery aneurysm.

The development of complications is possible against the background of general well-being, however, often a breakdown of compensation mechanisms occurs in cases where the load on the vessels exceeds a certain critical level. Such situations can be associated with everyday life, with the presence of various diseases, with external circumstances:

  • a sharp transition from a lying position to a standing position (sometimes it is enough to switch to a sitting position);
  • dense food;
  • hot bath;
  • hot season;
  • increased physical and mental stress;
  • a sharp decrease in blood pressure (most often under the influence of drugs).

But the most common cause of stroke is considered to be high blood pressure, 7 out of 10 victims of hemorrhage are people with (blood pressure above 140 to 90), heart failure. Even harmless atrial fibrillation becomes the cause of the formation of blood clots, which lead to impaired blood flow.

Stroke symptoms

The clinical manifestations of a stroke depend on its type, location and size of the lesion.

Stroke symptoms in adults:

  • Signs of an impending stroke begin with headaches and dizziness that are not attributed to other causes. Loss of consciousness is possible.
  • Loss of the ability to clearly express one's thoughts in words is one of the characteristic symptoms. A person cannot say anything definite or even repeat a simple phrase.
  • The patient may begin vomiting, as well as with a concussion.
  • Noise in the head.
  • Forgetfulness appears, the person does not know or does not remember where he was going, why does he need the objects that he holds in his hands. Outwardly, this is manifested by distraction and confusion.
  • Visually, the symptoms of circulatory disorders in the brain are visible on the person's face. The patient cannot smile, the face is distorted, and perhaps cannot close the eyelid.

There are seven main symptoms before stroke. that accurately indicate this disease:

  • Skewed face (asymmetric smile, slanted eye).
  • Disjointed speech.
  • Sleepiness (apathy).
  • Focal sharp pains in the head and face.
  • Visual impairment.
  • Paralysis of the limbs.
  • Impaired coordination.

Signs of an impending stroke can be very diverse, so you should be extremely careful about what symptoms a person experiences before a stroke.

Symptoms in adults
Ischemic stroke The most pronounced symptoms of ischemic stroke are observed with embolism or thromboembolism of large cerebral arteries. It is characterized by:
  • sudden loss of consciousness
  • generalized seizures,
  • respiratory failure with focal symptoms and neurological disorders in the future (deterioration of speech, sensitivity, coordination of movement, epileptic seizures).

In addition, with an ischemic attack, a person's swallowing reflex and speech may deteriorate. Therefore, the patient may begin to stutter, not speak clearly. Due to the defeat of the spinal (spinal) column, the patient may develop a lack of coordination, so he will not be able to move independently or even sit.
Hemorrhagic stroke The first signs of a stroke (hemorrhagic type):
  • Loss of consciousness at the time of a jump in blood pressure (against the background of a crisis, stress - emotional or physical);
  • Vegetative symptoms (sweating, fever, facial flushing, less often pallor of the skin);
  • Breathing and heart rhythm disturbances;
  • The development of a coma is possible.

It is worth considering that if there are signs of a stroke, then the time of irreversible changes in the brain has already begun. Those 3-6 hours that are available to restore the impaired blood circulation and the struggle to reduce the affected area are decreasing with every minute.

If the symptoms of a stroke completely disappear within a period of up to 24 hours after the onset of its clinical manifestations, then we are not talking about a stroke, but about a transient violation of cerebral circulation (transient ischemic attack or hypertensive cerebral crisis).

First aid

With a stroke, cerebral hemorrhage requires an immediate reaction to its occurrence, therefore, after the onset of the first symptoms, the following steps must be taken:

  1. Position the patient so that their head is raised by about 30 °.
  2. If the patient faints and ends up on the floor, move him to a more comfortable position.
  3. If the patient has prerequisites for vomiting, turn his head to the side so that the vomit does not enter the respiratory system.
  4. It is necessary to understand how the pulse and blood pressure change in a sick person. If possible, you need to check these indicators and remember them.
  5. When the ambulance team arrives, doctors need to indicate how the problems began, how much worse they felt and looked sick, and also what pills he was taking.
  • move a person or put him on the bed (it is better to leave him where the attack occurred);
  • use ammonia to bring the patient to consciousness;
  • hold the limbs by force in the event of seizures;
  • give the patient medications in tablets or capsules that can get stuck in the airways (especially if he has a swallowing dysfunction).

Effects

The most typical problems that arise after a stroke include the following:

  • Weakened or paralyzed limbs. The most common paralysis is one half of the body. Immobilization can be complete or partial.
  • Muscle spasticity. The limb is held in one position, joints may gradually atrophy.
  • Speech problems: slurred and incoherent speech.
  • Dysphagia is a violation of swallowing functions.
  • Visual impairment: partial loss of vision, double vision, reduced field of vision.
  • Dysfunction of the intestines and bladder: urinary incontinence or, conversely, the inability to excrete it.
  • Mental pathologies: depression, fear, excessive emotionality.
  • Epilepsy.
Left-sided stroke Right-sided stroke
  • speech disorders;
  • the impossibility of a logical solution to the task;
  • inability to analyze the situation;
  • impaired ability to move the right arm and / or leg;
  • change in sensitivity on the same side (right) - numbness, paresthesia;
  • depressed mood and other mental changes.
  • poor memory, while speech, as a rule, remains normal;
  • paresis and paralysis on the left side of the body;
  • emotional poverty;
  • the emergence of pathological fantasies, etc.

Coma signs

Coma after an attack of a stroke develops quite quickly, acutely and has the following symptoms:

  • The man suddenly passed out
  • At the same time, his face turned crimson red
  • The breath became loud, wheezing
  • The pulse became tense, the blood pressure increased
  • Eyeballs deviated to the side
  • Pupils have narrowed or become uneven
  • Pupils' reaction to light became sluggish
  • Decreased muscle tone
  • Disorder of the pelvic organs occurs (urinary incontinence)

How many years do people live after a stroke?

There is no single answer to this question. Death can occur immediately after a stroke. However, a long, relatively full life for decades is also possible.

Meanwhile, it has been established that mortality after strokes is:

  • During the first month - 35%;
  • During the first year - about 50%.

The prognosis of stroke outcome depends on many factors, including:

  • The age of the patient;
  • Health conditions before stroke;
  • Quality of life before and after stroke;
  • Compliance with the regime of the rehabilitation period;
  • Completeness of eliminating the causes of stroke;
  • The presence of concomitant chronic diseases;
  • The presence of stress factors.

Diagnostics

Diagnostic measures include:

  • Inspection. SPD test. It is spelled out by the letters of the first three actions that the patient must perform: smile, speak and try to raise his hand.
  • Assessment of the general condition of the patient by the doctor.
  • An accurate and prompt examination of the patient is prescribed, magnetic resonance therapy or computed tomography will help.
  • A lumbar puncture will help distinguish cerebral hemorrhage from other brain pathologies.
  • Computed tomography and magnetic resonance imaging are used to identify the fact of a stroke, clarify its nature (ischemic or hemorrhagic), the affected area, and also to exclude other diseases with similar symptoms.

Treatment and rehabilitation after a stroke

The optimal terms of hospitalization and initiation of therapy are considered to be the first 3 hours from the onset of clinical manifestations. Treatment in the most acute period is carried out in the intensive care wards of specialized neurological departments, then the patient is transferred to the early rehabilitation unit. Before establishing the type of stroke, basic undifferentiated therapy is carried out, after an accurate diagnosis is made, specialized treatment, and then long-term rehabilitation.

Post-stroke treatment includes:

  • conducting a course of vascular therapy,
  • the use of drugs that improve brain metabolism,
  • oxygen therapy,
  • restorative treatment or rehabilitation (physiotherapy, physiotherapy, massage).

In case of a stroke, call an ambulance immediately! If you do not provide immediate assistance, this will lead to the death of the patient!

To prevent complications, therapy is carried out using the following drugs:

  • cerebroprotective agents restore the structure of damaged brain cells;
  • blood thinners (indicated exclusively for ischemic stroke);
  • hemostatics, or hemostatic agents (used with a clearly established stroke of hemorrhagic origin);
  • antioxidants, vitamins and drugs that improve metabolism and blood circulation in tissues.

Rehabilitation measures:

  • are carried out from the very beginning of the stroke and continue with the preservation of neurological deficit throughout life with the participation of the patient, a team of health workers and relatives;
  • proper care of the patient's body, the use of special devices;
  • breathing exercises (for the prevention of pneumonia);
  • as early as possible activation of the patient's motor regime, ranging from short sitting down in bed to full-fledged physiotherapy exercises;
  • the use of various physiotherapeutic and other methods: electrical procedures, massage, acupuncture, classes with a speech therapist.

Folk remedies for restoring the body after a stroke

Before using folk remedies, be sure to consult with your doctor, because contraindications are possible.

  1. Rosehip cinnamon... The fruits and roots of the plant are used to prepare a decoction, which is introduced into general baths in the treatment of paralysis and paresis. The course is 25 procedures, the broth is poured into water at a temperature of 37-38 ° C.
  2. Sage bath after a stroke. Pour 3 cups of sage herb with 2 liters of boiling water. Let the product stand for 1 hour, strain and pour into the bathroom with warm water. Take these baths every other day.
  3. This broth is also very useful: a teaspoon of crushed dry peony roots should be poured with a glass of boiling water. After that, insist for an hour and strain. Consume a tablespoon of the broth 5 times a day.
  4. Laurel oil. This tool is prepared as follows: 30 g of bay leaves need to be poured with a glass of vegetable oil. Insist 2 months, while shaking the jar every day. Strain the oil and then bring to a boil. It is recommended to rub the mixture into paralyzed places.

Prophylaxis

Stroke belongs to the category of those diseases that are easier to prevent than to cure. Stroke prevention consists of:

  1. It can be prevented with the help of a rational organization of work and rest, proper nutrition, regulation of sleep, a normal psychological climate, restriction of sodium salt in the diet, timely treatment of cardiovascular diseases: coronary heart disease, hypertension.
  2. The best way to avoid stroke is to prevent atherosclerosis and other cardiovascular diseases. Controlling blood pressure and checking for is important here.
  3. If necessary, take medications that improve the microcirculation of the vessels of the brain, and it is also possible to take medications that prevent the lack of oxygen (hypoxia) of the brain as prescribed by the doctor.

Stroke, or cerebral vascular catastrophe, is a disease in which early diagnosis and the provision of qualified medical care are the most important factors affecting the prognosis.

After a stroke, under the influence of hypoxia, changes in nerve cells begin to occur. Around the brain cells affected by necrosis, there is an "ischemic penumbra" - a zone, the outcome of which depends on the restoration of blood flow. During the period of the "therapeutic window" (conventionally called the first 3-6 hours after a stroke), the irreversible consequences of ischemia and cell death can be prevented by therapeutic manipulations.

In this regard, any person needs to know about the first signs of a stroke. It is important to be able to suspect the disease in time and organize the delivery of the victim to the hospital as quickly as possible.

On the one hand, there are no clear pathognomonic (that is, inherent only to this disease) signs of a stroke. Even the most specific focal symptomatology requires differential diagnosis, since this is not always a consequence of a stroke.

On the other hand, risk factors should be taken into account: if symptoms arise against their background, then the degree of likelihood of a stroke increases sharply. Their list is called the "fatal quintet", because even in the presence of 2-3 factors, the risk of death from a stroke increases significantly. These include:

  1. Arterial hypertension. With high blood pressure, the risk of stroke increases 5 times.
  1. Left ventricular hypertrophy. Almost always, "experienced hypertension" is accompanied by changes in the left heart, since the heart muscle has to push the blood into the vessels with a vengeance.
  1. Increased blood cholesterol. Blood cholesterol can be called an "indicator" of the presence of atherosclerotic plaques in the vessels. As you know, most often the negative consequences of their presence are felt in the coronary and cerebral vessels.
  1. Diabetes. With elevated blood sugar levels, the likelihood of developing a stroke increases by 2-4 times, since the glucose molecule damages the blood vessel wall.
  1. Smoking. It has been proven that regular use of nicotine increases the incidence of cardiovascular diseases by 2-4 times, in old age it is higher.


Harbingers of stroke

It happens that a stroke occurs suddenly, but more often it occurs against the background of precursors. For example, in half of cases, ischemic stroke is preceded by (TIA). They should be regarded as the first signs of cerebrovascular accidents requiring immediate diagnosis and treatment. Hypertensive crises can provoke their appearance or be independent precursors of the disease.

Treatment of these conditions can be considered as prevention of the clinical form of stroke.

Also, the imminent development of a stroke can be judged by signs of cerebrovascular accident, identified by special tests. One of these questionnaires is the Manvelov test.

If in the last three months, once a week or more often at least two of the following symptoms recur, then an immediate visit to a doctor is required:

  1. A headache that does not have a specific localization and arises from overwork or weather disasters.
  2. Vertigo, on at rest, worse on motion.
  3. The presence of tinnitus, both permanent and transient.
  4. "Gaps" of memory for events of the current time period.
  5. Change in the intensity of working capacity and sleep disturbance.

These symptoms should be viewed as harbingers of stroke.


Clinical features of types of stroke

Despite the specific area of ​​damage and the clinical picture, the severity of the first symptoms is so different that diagnosis is difficult. With minor manifestations, many do not go to the doctor at all, and sometimes hospitalization occurs too late.

It is not possible to talk about the differences between the first signs of the disease in men and women, since they proceed in the same way.

At a young age, the signs of a stroke are usually not pronounced; only one or two symptoms of neurological deficit can be identified. In the elderly, the clinical picture of stroke is more often not in doubt, and the disease is more severe.

Navigation

Stroke is a violation of cerebral circulation, occurs as a result of blockage or violation of the integrity of the cerebral vessel. This condition threatens the patient's health and life. A favorable outcome is possible only on condition of early detection of pathology and prompt provision of professional assistance. The prerequisites for a critical state are often obvious and can be noticed even by a person without specialized education. The symptoms of stroke in women and men are similar, so there is no gender division here. The disease is one of the most common causes of disability and mortality among the population, so everyone should know its symptoms.

The specifics of the course and signs of stroke in men and women

Despite the similarity of the clinical picture, in women and men, acute cerebrovascular accident (ACVA) can develop and proceed with nuances. They must be taken into account when there is a suspicion of pathology, this will facilitate the diagnosis process.

The main gender differences in an emergency are:

  • Age factor. Strokes in women more often appear at the age of 18-40 and after 60 years. In the case of men, the increased risk occurs after age 40.
  • The degree of manifestation of symptoms. Atypical first signs of stroke in men are less pronounced than in women, and therefore are often ignored by patients. If you know them and pay attention to them in time, there is a chance to prevent acute damage to brain tissue.
  • The severity of the consequences. The disease is more severe in older women than in younger women. Regardless of the cause of the brain damage, the fairer sex suffer a stroke worse than men. Their mortality rate is higher, and the chances of recovery are lower.

The reasons for the development of a stroke in women are more numerous. Eliminating them minimizes the likelihood of developing pathology at a young age and reduces potential risks for the elderly.

Stroke Causes and Risk Factors

The characteristic specific causes of stroke have not yet been identified by specialists. There is only a list of factors, the presence of which contributes to the disruption of important processes in the tissues of the whole body, including the organs of the central nervous system.

Brain stroke provocateurs:

  • hypertension;
  • hypertrophy of the tissues of the left ventricle of the heart;
  • excess of normal blood cholesterol levels;
  • diabetes mellitus is accompanied by irritation of blood vessels with glucose molecules, which can lead to stroke;
  • smoking causes structural changes in the vascular walls, narrowing their lumen and reducing tissue strength;
  • stroke in women can develop while taking contraceptives, migraines and abnormal pregnancy.

People at risk and their loved ones are encouraged to examine the signs of cerebral hemorrhage. Perhaps it help save their lives if an emergency develops.

Harbingers of stroke

Acute cerebrovascular accident can occur unexpectedly, but most often it develops against a characteristic background. There are a few early signs and symptoms of a stroke. If at least two manifestations from the above list are identified, you must immediately seek medical help.

Here are the main signs of an impending stroke:

  • a strong and persistent headache without a clear localization, which is not relieved by painkillers or goes away under their influence only for a while;
  • dizziness, which begins at rest and intensifies with movement;
  • persistent or transient tinnitus;
  • memory problems in relation to information related to the present time;
  • lack of coordination against the background of numbness of the extremities is another harbinger of a stroke;
  • decreased sleep quality, fatigue, deterioration in performance.

Studies have identified atypical signs of an impending stroke. They are more often determined in adult women, but they are also typical for men. Patients may experience increased heartbeat, shortness of breath, dry mouth, or soreness in one side of the body. This also includes mental disorders in the form of disorientation and disorders of consciousness.

Stroke test

If you have symptoms characteristic of a stroke, a few simple tests should be done. It only takes a couple of minutes, and the results are more likely to provide a correct initial diagnosis.

Here are four tips on how to recognize a stroke:

  • Let the person smile. If the brain is damaged, one half of the face will remain motionless.
  • Let the person raise his hands forward. In the event of a stroke, only one arm will rise, while in the other, muscle weakness will be evident.
  • Let the person say a simple phrase. Difficulties with articulation indicate impaired cerebral circulation.
  • Let the man stick out his tongue. With pathology, its tip will deviate to the side - towards the focus of tissue damage in the brain.

If at least one of the tests fails, the chances are high that the person has a stroke. From the moment the first obvious symptoms appear, there are 3-4 hours in which the patient must receive emergency assistance. This increases the likelihood that it will be possible to avoid permanent pathological changes as a result of hemorrhage in the brain or disruption of blood flow in its tissues.

Types of brain damage and their features

The main signs of a stroke can vary depending on the type of brain damage and the localization of the pathological process. Age affects the degree of manifestation of the clinical picture. In young people, stroke is often indicated by only a couple of symptoms of a neurological type. The development of stroke in the elderly is bright and difficult.

Ischemic stroke or hemorrhagic stroke - how to distinguish?

Cerebral ventricles

The defeat of the cerebral ventricles is manifested in the form of loss of consciousness and coma. Mortality against the background of the condition is very high. Very often, doctors do not have time to take the necessary action even if the patient is already in the hospital at that moment.

Cerebellum

The formation of a focus in the zone is accompanied by severe pain in the occiput, vomiting and dizziness. Speech and coordination disorders may occur. A characteristic point is that the victim is not able to take an upright position.

Each lobe of the brain is responsible for its own set of functions. Violation of the usual course of processes in these areas is accompanied by specific manifestations. According to some characteristic symptoms, one can not only determine a stroke in a person, but also assume what problems will have to be faced during the period.

Lobes of the brain and symptoms of their defeat:

  • Frontal. The set of manifestations of the disease is called "frontal psyche". The patient's behavior during the formation of a focus on the site changes dramatically. He becomes disinhibited or apathetic, aggressive. Convulsive seizures and return of primitive reflexes are possible.
  • Parietal. Tactile sensitivity is impaired. The victim does not recognize familiar objects, is poorly oriented in space. He may lose the acquired skills: counting, writing, reading.
  • Temporal. The ability to understand the native language and any familiar sounds (music, laughter, birdsong) is lost. Hearing impairment due to severe tinnitus is not uncommon. Hallucinations sometimes appear.

The listed symptoms are accompanied by other manifestations characteristic of stroke. If the border zone is affected or the lesion is too extensive, the signs can be combined.

Suspected stroke is an indication for immediate medical attention. Even in the case of the development of a blurred clinical picture and its independent disappearance, it is necessary to undergo a specialized examination. Ignoring the problem increases the risk of developing a severe stroke According to statistics, 50% of people who have had a minor or coming stroke, within five years after that, go to the hospital with severe stroke.

Drawing conclusions

Strokes are the cause of almost 70% of all deaths in the world. Seven out of ten people die due to blockages in the arteries in the brain. And the very first and main sign of vascular blockage is a headache!

Blockage of blood vessels results in a disease under the well-known name "hypertension", here are just some of its symptoms:

  • Headache
  • Heart palpitations
  • Blackheads in front of the eyes (flies)
  • Apathy, irritability, drowsiness
  • Blurry vision
  • Sweating
  • Chronic fatigue
  • Swelling of the face
  • Numbness and chills in the fingers
  • Pressure surges
Attention! If you notice at least 2 symptoms in yourself - this is a serious reason to think!

The only remedy that gave a significant result ...

Among all neurological diseases, stroke is the most important problem. 1/3 of people who have had a stroke die in the first months. Only 10% of patients return to normal life. The rest of the patients need regular care. Long months of adaptation and treatment give positive results: a person re-learns to speak, walk and perform basic everyday activities.

With a stroke, it is important to send the person to a medical facility as early as possible for help.

Stroke is a pathology of the vessels of the brain. The blood vessels feeding the brain, under the influence of factors, are destroyed, clogged, thinned, damaged. When a rupture or blockage occurs, blood does not flow to the brain cells, as a result of which they die.

A person's life depends on the speed of medical care. The prognosis for those with hemorrhagic stroke is worse than for those with ischemic stroke. Patients with hemorrhage often die before hospitalization. Timely examination of blood vessels using CT and MRI can identify existing problems and take measures that will reduce complications.

Stages of ischemic stroke

The development and course of ischemic stroke resembles a cascade - the beginning of one process leads to the emergence and development of another. The stage of tissue hypoxia leads to glutamate-calcium excitotoxicity. The release of glutamate and aspartate into the extracellular space leads to oxidative stress, against the background of which neurons die.

Stages of the "ischemic cascade":

  1. Reduced blood flow.
  2. There is a release of glutamate and aspartate, which entails the phenomenon of excitotoxicity.
  3. Calcium accumulates inside the cells.
  4. Intracellular enzymes are activated, oxidative stress develops, local inflammation reactions appear.
  5. Neuron death occurs.

The process is inevitably accompanied by cerebral edema - fluid enters the neurons (the cell membrane becomes permeable), the cells swell. The volume of the brain increases, intracranial pressure increases.

As a result, individual parts of the brain are displaced (dislocation syndrome):


Therapeutic assistance should be provided within the first 3 hours after the onset of symptoms of ischemic stroke. The longer a person is not provided with qualified medical care, the less chances of saving a life.

Signs that should alert:

  • dizziness;
  • loss of sensitivity, numbness of half (or a separate area) of the body;
  • headache;
  • weakness, impaired coordination of movements;
  • speech disorder;
  • loss of consciousness;
  • sometimes decreased or loss of vision.

Most often, people with a stroke cannot help themselves on their own, their lives depend on the attentiveness of others."Drunken gait", unrelated speech of a passer-by does not always indicate the state that a person is in a state of alcoholic intoxication. Unconscious, a person is doomed to death if indifferent people are nearby. If an ischemic stroke is suspected, the person should be hospitalized immediately.

There are several options for identifying the periods of ischemic stroke of the brain. It is necessary to take into account the epidemiological indicators, the use of thrombolytics in treatment. The current classification contains the following periods of stroke:

  • the most acute period;
  • acute period;
  • early recovery period;
  • late recovery period;
  • stage of residual effects.

The most acute period (up to 4-5 hours)

It is assumed that during the first 3 hours of ischemic cerebral stroke, the use of thrombolytics will help restore blood flow and reduce or eliminate massive neuronal death. In some cases, it is possible to inject drugs directly into the stroke zone, which can reduce the amount of drugs used and prevent the development of complications.

The first 3 hours are also called the "therapeutic window".

Further, measures are taken to stabilize the pressure, rehydration (during an attack, dehydration is possible due to impaired swallowing, vomiting) or dehydration (if CT showed cerebral edema), oxygen therapy (oxygen inhalation).

During this period, the patient is in the hospital under the supervision of medical personnel. Ultrasound examinations, MRI, CT, ECG, blood tests are performed. In the most acute period, it is especially important for the patient to ensure peace, remove physical and emotional stress.

Acute period (up to 14 days)

In the acute period of ischemic stroke of the brain, the patient is still in a specialized department, where, under the supervision of doctors, the patient is treated with medication. The activities of the medical staff are aimed at:


At this stage, neurology specialists begin to restore the activity of brain cells that have died during an ischemic stroke. Many stroke patients during this period are limited in movement, cannot speak, and do not remember recent events well. Therefore, the presence of close loving people is necessary. Getting positive emotions during treatment helps a person recover faster.

Early recovery period (2-3 to 6 months)

In the early recovery period (from 2-3 to 6 months), specialists continue to carry out the previously selected course of treatment: a combination of a drug and non-drug method:


The patient's relatives and close people are actively involved in the process. While it is difficult for the patient to perform elementary actions on his own, the care falls on the shoulders of the family.

During this period, recovery is much more productive - the body has already adapted to the changes that have occurred, and the muscles have not yet had time to atrophy.

The sooner the patient starts the rehabilitation treatment, the faster the results are obtained. On average, strength in the muscles of the arm is restored in 2-3 months of regular exercise, and coordination of movements, fine motor skills - up to a year. Recovery principle - from simple to complex:


It is necessary to strengthen muscles every day, restore physical activity, strengthen ligaments and joints. Persons who have had an ischemic stroke, including those of the brain stem, like small children, learn to sit down again, walk, and perform bends. Attention is also paid to the development of fine motor skills, which is needed to perform elementary tasks (holding a spoon, buttoning a button, putting a signature, etc.).

Late recovery period

The time when more than 6 months have passed since the ischemic stroke. The skills that were developed in the early recovery period are visible. By the age of one year, fine motor skills and sensitivity in the fingers are partially restored.

During a stroke, some of the fibers that transmit a signal from neurons to a nerve and then to muscles die off. For the first few months, a replacement and redistribution of functions occurs, the body uses reserves that have not been previously used. That is why it takes a long time to rehab.

In the late period, it is important to continue working on the development of sensitivity in the limbs, to do gymnastics every day.

The period of residual effects of a stroke is 12-24 months: at this stage it is important to maintain and improve the results achieved, follow the doctor's recommendations, and take preventive measures to prevent a new attack.

One of the serious diseases that often arise as a result of hypertension, as well as atherosclerosis of the vessels of the brain, is a stroke. Treatment of this disease, provided it is successful, can prolong a person's vital activity. The danger of a stroke is the high probability of negative consequences, because quite often the consequence is the disability of a person.

Among the elderly, stroke is the most frequently reported cause of death.

A stroke is characterized by an acute disturbance of blood circulation in the cerebral cortex, which results in damage and death of nerve cells.

Stroke is a number of other pathological conditions, including:

  • Cerebral hemorrhage;
  • Cerebral infarction;
  • Subarachnoid hemorrhage.

There are two types of strokes:

  • Ischemic;
  • Hemorrhagic.

They not only differ in origin, but each of them is treated according to a different scheme.

Peculiarity ischemic a stroke is a violation of the blood supply to certain areas in the cerebral cortex due to blockage of an artery by a blood clot or atherosclerotic plaque.

Hemorrhagic a stroke occurs when an artery ruptures and then bleeds. The cause of this type of disease is a rupture in the enlarged part of the artery due to a congenital pathology of the vessel, called an aneurysm, or a ruptured artery, the background for which may be high blood pressure.


 Types of strokes

Stroke of any kind requires urgent action, medical attention and treatment. The clinical picture with hemorrhage develops so rapidly that the ability to cure the disease is limited by time. Only with the timely provision of qualified assistance, brain damage can be minimized, preventing the manifestation of complications in the future.

Treatment stages

In order to know how to treat a stroke, it is necessary to imagine the sequence of the main stages of this process, consisting of:

  • Emergency care;
  • Inpatient treatment;
  • Rehabilitation or spa therapy.

Signs of a stroke

In order to recognize in time the symptoms of a dangerous ailment in a person, they must be firmly remembered.

The signs of a stroke are:

  • Sudden weakness;
  • Paralysis or partial numbness of the muscles of the face or limbs (most often only on one side);
  • Speech disorders;
  • Deterioration of vision;
  • The appearance of a strong and sharp headache;
  • Dizziness;
  • Loss of balance and coordination, gait disturbances.

A stroke often takes a person by surprise, and at this moment it is very important that the people around them pay attention and provide first aid.

If you notice a passer-by on the street behaving unnaturally, you should not think that he is drunk before a stroke check is performed according to the following plan:

Actions before the ambulance arrives

If there is a suspicion of a stroke that a person can find at any time - at home or on the street, do the following as soon as possible:

  • Put the patient on your back, try not to touch his head;
  • Provide free access to fresh air which could be from an open window or a fan. For the same purpose, it is necessary to exclude any squeezing of the body from a tight tie or collar, belt;
  • If the patient shows signs of vomiting, you need turn his head in any direction in order to avoid the ingress of vomit into the bronchial region;
  • Whenever possible a cold compress will help placed on your head or a hot water bottle with ice;
  • The patient, if he is conscious, can ask about his hypertension and give him a pill under the tongue (often hypertensive patients hold the necessary medications in the pocket);
  • Preliminary blood pressure measurement- one of the useful actions that can be performed with a special apparatus at hand;
  • A distracting procedure that can be done at home is placement of mustard plasters in the calf area on the legs.

Help and first actions of medical workers

In the first minutes after arriving at the location of the injured person from the stroke, the specialists of the ambulance team assess the severity of the patient's condition. Their main task is to transport the patient to a hospital equipped with an intensive care unit.

During transportation, the following are produced:

  • Blood pressure measurements;
  • The introduction of drugs that correct the work of the cardiac and respiratory systems.

Transportation of patients who:

  • Have been found in a coma;
  • When they have circulatory disorders in the brain in terminal states of various pathologies of internal organs or tumors.

Patients with such deviations are provided with symptomatic assistance, after which the call is transferred to the clinic.

Which department is put in with a stroke?

After hospitalization of the victim, treatment of a brain stroke in the hospital begins with its placement in the intensive care unit or intensive care unit. This requires the presence of an appropriate unit in the clinic, equipped with special equipment and qualified personnel.

Patients are examined by a neurologist. Consultation with a neurosurgeon may be required. The treatment regimen, as well as in which department the patient will be located, is determined by the doctor depending on the type and severity of the disease. The main tasks of the hospital depend on the type of the given disease.

Inpatient treatment. Preparations.

Treatment for hemorrhagic stroke.

For the treatment of the brain with the development of hemorrhagic stroke, therapy should include a number of specific tasks, these are:

  • Elimination of puffiness in the brain tissues;
  • Decrease in intracranial and blood pressure;
  • Treatment aimed at increasing blood clotting and the density of the vascular walls.

For all actions of the medical staff, a certain position of the patient on the bed is observed. For this, a functional bed with a raised headboard is used. Ice is placed on the patient's head, and heating pads are placed on the legs. Relaxing the muscles will help to ensure the hamstring curve is created. For the same purpose, you can put a roller under your knees.

Drug treatment includes the following drugs for intravenous drip use:

  • Sulphate magnesia;
  • Dibazol;
  • Aminazine;
  • Pentamin.

Due to the increased risk of reducing blood clotting, medications can be administered that activate thrombosis in the vessels. This type of therapy should be carried out under the control of a laboratory blood test for a coagulogram.

In the first 2-3 days, the following are prescribed:

  • Calcium chloride;
  • Vikasol;
  • Aminocaproic acid.

In cases where, on the third day after a stroke, there are pronounced signs of atherosclerosis and subarachnoid hemorrhage, proteolytic enzymes can be prescribed:

  • Gordox;
  • Contrikal.

Etamsilat is one of the most effective modern agents used in the treatment of cerebral stroke. It allows you to stop blood loss, improve microcirculation in damaged areas of the brain, and normalize vascular permeability. It also serves as an excellent antioxidant.

If cerebral edema has severe meningeal symptoms, a spinal tap should be performed with caution, in which small amounts of cerebrospinal fluid are extracted.

Treatment for ischemic stroke

In the second type of brain stroke, the actions of specialists will be aimed at solving the following tasks:

  • Improving blood supply to tissues;
  • Formation of increased resistance to oxygen deficiency;
  • The introduction of drugs to improve the metabolism in the surviving cells.

The position of the patient in bed should be comfortable, but his head should not be raised as high as it should be done in a hemorrhagic stroke.

With ischemic stroke, treatment must necessarily include means that dilate the blood vessels. To a greater extent, collaterals are used, which are auxiliary capillaries that can partially replace natural ones.

For this purpose, the following agents are used in the form of solutions for intravenous drip injection:

  • Euphyllin;
  • No-shpa;
  • Papaverine;
  • A nicotinic acid;
  • Complaint.

Used by medicine to improve hemodilution - Rheopolyglucin, which improves blood supply by reducing blood clotting.

Medical supervision and treatment includes careful measurement of the volume of injected fluid, which in excessive amounts can pose a risk of increased tissue edema. The use of diuretics also requires caution, especially if there is hypertension.

Anticoagulants are used simultaneously with fibrinolytic agents. The important term "golden hour" is used in stroke therapy. It serves as an indicator of the maximum effectiveness of drug administration to reduce blood clotting, as well as to predict the disease.

Due to the too long transportation to the clinic, it becomes difficult to establish the difference between different types of stroke and provide the correct assistance in treatment, and its optimal time is lost.

On the first day, ischemic stroke is treated by injecting a solution of Fibrinolysin with Heparin.

After this, the therapy regimen includes:

  • Intramuscular injection of Heparin;
  • After 3-5 days, it is recommended to switch to Fenilin and Dikumarin.

In the treatment of young patients and middle-aged people, Pentoxifylline is used, which helps to improve blood density.

Elderly patients are prescribed for treatment:

  • Parmidin;
  • Xanthinol nicotinate;
  • Anaprilin (with existing tachycardia);
  • Cavinton, Cinnarizine (can improve vascular tone).

Medicine has found that in ischemic stroke, the combined intake of Curantil and Aspirin will help reduce the risk of re-development of pathology.

Arousal syndrome in a patient can be cured by prescribing barbiturates. Metabolic failure should be treated with drugs of the class of metabolites (Piracetam, Aminalon, Cerebrolysin), which also help to increase the resistance of cells to a lack of oxygen.

Surgical methods


Sometimes a stroke can be overcome with surgery. If a patient has a hemorrhagic stroke, then surgical methods of treatment can be used only if they are young or middle-aged, and also if lateral hematomas and hemorrhages in the cerebellar region have been diagnosed.

The indications for the operation are:

  • The inability to relieve cerebral edema by other means;
  • The appearance of signs of compression by a hematoma;
  • Suspicions of the possibility of repeated hemorrhage in the brain stem or hemispheres.

The best time for surgery is 1-2 days. An autopsy and removal of the hematoma is performed. If ruptures of an aneurysm of the brain were found, the vessel is ligated.

Surgical treatments for ischemia are rarely used. Indications for surgery are diagnostics of narrowing of the carotid, vertebral or subclavian arteries, causing pathology.

Patient care

In order to recover from a stroke, it is very important to provide proper patient care.

Care measures during inpatient treatment include:

  • A specific diet that includes juices, liquid high-calorie meals;
  • In a comatose state, nutrition is carried out using a probe;
  • Prevention of congestion in the lungs and bedsores, for which the patient is turned over every 2-3 hours, a rubber circle is placed in the sacrum area, and dense rings under the heels;
  • They monitor the cleanliness of bed linen, do not allow high humidity;
  • The skin should be treated with a weak solution of manganese, camphor alcohol or solcoseryl ointment;
  • The oral cavity is treated with boric acid;
  • A catheter is used to drain urine, laxatives are given and an enema is given for constipation.

Rehabilitation

It is possible to safely eliminate the consequences of a stroke with well-organized rehabilitation.

Care for the brain stroke survivor should include the following measures and actions:

  • Gentle massage of the limbs from the second week of illness;
  • Physiotherapy exercises, contributing to the restoration of motor functions with a gradual increase in intensity.
  • Kinesiotherapy, which develops small hand movements, helping the patient to self-care in new conditions;
  • Water treatments aimed at stretching the muscles, oxygen baths, hydromassage.

With correctly taken treatment measures for stroke, as well as competently organized rehabilitation, up to 70% of people who have suffered a cerebral stroke return to independent life.

The best period for rehabilitation measures and assistance is the first three years, during which you need to be patient and have faith in success.

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