- 1 Causes of disease
- 2 Features of each type
- 3 Symptoms of pathology
- 4 How to detect strokes
- 5 First aid
- 6 Treatment methods
- 7 Rehabilitation period
- 8 Complications of the disease and prognosis
- 9 Preventive measures
Stroke – a sudden disturbance of blood flow in the brain structures, which leads to tissue necrosis. As a result of cell death, the functioning of certain areas of the brain is lost: speech is disturbed, limbs are paralyzed. The irreversibility of the effects depends on the extent of damage to the nerve cells. The disease does not appear on its own, it is a consequence of vascular pathologies.
Causes of disease
The causes of a stroke are the development of an acute blood supply to the brain. Brain stroke types are differentiated based on how a stroke occurs. Ischemic and hemorrhagic stroke is distinguished.
When an anomaly develops due to an artery blockage or narrowing of the vascular lumen, a stroke of the brain of the ischemic type is detected. When the artery ruptures and blood is poured into the medulla, a hemorrhagic type of pathology is diagnosed.
A curious fact! At the time of Hippocrates, pathology was called an apoplexic stroke.
Causes of ischemic brain damage can be modified and unmodified. Among the modified causes of cerebral stroke are:
- high blood pressure;
- myocardial infarction;
- vascular disease;
- damage to the carotid artery.
Unmodified factors include age, genetic predisposition, obesity, alcohol and tobacco abuse, drug addiction, and emotional overstrain.
Hemorrhagic type is caused by leukemia, tumor processes, septic phenomena, uremia, arterial hypertension.
The risk of blockade increases in the presence of bad habits, diseases of the cardiovascular system. Other risk factors include unhealthy diet, dominated by fatty and salty foods, a sedentary lifestyle.
Features of each type
Types of stroke are differentiated depending on what causes the blockade. Brain stroke can be ischemic and hemorrhagic.
The ischemic form of a stroke also has another name – cerebral infarction, which appears after a blockage of a vessel with a plaque or thrombus. The affected part of the brain does not receive the required amount of oxygen, ischemia develops. Vascular obstruction can last for a long time, leading to an increase in pathological signs: vomiting, headache, inability to move.
Based on the causes of stroke, these types of diseases are distinguished:
- Atherothrombotic. Formed due to atherosclerosis of the arteries. Signs are increasing gradually. This type usually appears at night. Thrombus leads to cerebral ischemia.
- Cardibolic It develops against the background of cardiovascular diseases – arrhythmias, heart diseases, and heart attacks. Accompanied by embolism of the vascular lumen. The neurological picture is particularly pronounced.
- Hemodynamic. It is recorded as a result of impaired blood circulation – with a decrease in arterial values, a decrease in cardiac volume. Causes of blockade are vascular anomalies, stenosis.
- Lacunar It is diagnosed in hypertensive patients, diabetics.
- Rheological. Detected in healthy vascular condition.
Usually, the cerebral blood flow is normalized by the arrival of medical care, a person begins to feel better and refuses to be hospitalized. But cell destruction continues. In the absence of therapy, relapses that provoke paralysis and death develop. Ischemic cerebral infarction requires treatment aimed at rehabilitation and prevention of relapse.
This type of stroke develops after a rupture of the vessel and hemorrhage, which is absent in the ischemic type. Cerebral bleeding is difficult to stop, because traditional hemostatic drugs do not penetrate to the capillaries of the brain. Pathology is difficult, often leads to death.
The blood enters the brain structure, there is puffiness and hematoma, which squeezes the organ. Edema is formed due to violations of the outflow of cerebrospinal fluid and venous blood. Increased intracranial pressure, compressed brain stem. This causes a breakdown in the functioning of the cardiovascular system.
Hypertensive crisis, emotional and physical strain, traumatic brain injury – from which there is a stroke. This type of aneurysm also results when the victim feels intense pain in the head, nausea, and loses consciousness. Stroke is accompanied by hemorrhage in the brain stem, which is associated with the spinal cord. Structures control the functions of respiration, heartbeat, blood supply.
Hemorrhagic stroke is characterized by a higher percentage of mortality compared with cerebral infarction. During the first year after the blockade, most of the victims die, the rest remain disabled.
Symptoms of pathology
Sometimes people confuse the manifestations of a small and extensive stroke, since some of the symptoms are similar. But diseases have different consequences. A microstroke is accompanied by temporary dysfunctions lasting for several minutes. But the normal state does not mean recovery, the victim must be hospitalized, since the mini-stroke often precedes an extensive blockade.
Symptoms after a stroke are differentiated into focal and cerebral.
By cerebral manifestations include:
- intense pain in the head, which is accompanied by vomiting;
- a person becomes lethargic;
- blurred consciousness;
- excessive sweating;
- disorientation in space.
The severity of focal signs depends on which part of the brain is affected – each of them is responsible for a specific activity. The victim may lose his sight, speech skills, lose his balance.
The most dangerous type of stroke is ischemic, since initially it has no specific symptoms. This type of stroke is a pain in the head, dizziness, then the signs disappear. With hemorrhagic blockade, a person immediately feels a painful headache, the condition is accompanied by loss of consciousness.
First signs of an attack
A brain injury in stroke usually occurs at night or in the morning as a result of physical or emotional overstrain. You can notice the asymmetry of a smile, the omission of the corners of the mouth, speech disorders. The victim can not simultaneously raise both hands.
The blockade is often preceded by a ischemic attack, which is expressed in sudden dizziness, excruciating pain in the head, impaired motor function, fainting. The patient notes the numbness of the muscles on one side of the body, vision deteriorates, problems with movement.
The nature of the painful manifestations depends on the cause and location of the lesion. With the blockade in the left hemisphere, malfunctions in mental processes appear, some parts of the body become numb, a wrong idea about the parameters of objects develops. If the occipital region is affected, blindness may occur.
How to detect strokes
To make a correct diagnosis, it is necessary to determine the exact zone of the blockade, the scale of the lesion, to identify the cause of the attack. This information is necessary to select the correct tactics of treatment and prevention of relapse.
As a diagnostic method, an examination of the vessels and the heart using magnetic resonance imaging is used. During the procedure, a three-dimensional picture of brain tissue is visualized. The doctor sees all the changes and the focus of the affected brain structures.
Also used computed tomography for stroke, which is advisable to carry out at the first suspicion of the development of brain dysfunction. The procedure reveals bleeding in the brain tissues, assesses the extent of organ damage.
Diagnostics of stroke includes ultrasound scanning of the carotid artery, which is the main vessel that carries blood to the brain. The study assesses the state of the blood vessels, reveals the presence of atherosclerotic plaques. A transcranial study of the cerebral arteries. The doctor receives information about blood circulation in the vessels, the presence of plaques.
Magnetic resonance angiography reveals the localization of a blood clot in the arteries of the brain. For cerebral angiography, a contrast chemical is injected into the affected vessels, which visualizes the capillaries during X-ray radiation.
The patient makes an electrocardiogram, echocardiogram. These studies evaluate the work of the heart muscle, reveal possible abnormalities in the structure of the organ, and rhythm malfunctions. Such deviations often lead to stroke.
To examine the brain for its activity, an electroencephalogram is used. The specialist attaches special electrodes to the patient’s head. Electrodes can detect the electrical activity of the brain.
Blood is taken to determine the concentration of glucose, lipoproteins, and coagulogram. The last study assesses the rate of thickening of the blood during thrombosis or bleeding.
You can minimize the consequences of a stroke, knowing how to provide first aid to the victim. Initially, you need to call an ambulance. It is recommended to describe the patient’s condition by telephone so that a neurological team is sent to the person.
The patient needs to be laid, having placed a pillow under the head, to provide inflow of fresh air, to get rid of belts and fasteners. When an emetic reflex appears, one should turn the head to the right side and clean the oral cavity and airways from the released masses. If possible, you need to measure the pressure.
You can not panic, you should create a calm atmosphere and wait for medical help. If a person has difficulty breathing, he has lost consciousness, then an indirect heart massage is required along with artificial respiration.
The consequence of a stroke is the development of atrophic and necrotic processes in the brain tissue. Treatment of ischemic and hemorrhagic stroke is different. The goal of therapy for hemorrhagic type of stroke is to prevent irreversible brain dysfunctions, to prevent relapse. Treatment of ischemic stroke of the brain is aimed at restoring the affected areas, which speeds up the recovery of the person.
Ischemic Stroke Therapy
The patient is prescribed treatment to prevent relapse. To eliminate a blood clot that clogs an artery, drugs are injected that dissolve the formation (fibrinolytics). Conducting the drug by using a catheter. To minimize the extent of damage and reduce the severity of neurological disorders, reperfusion treatment is carried out – the introduction of the necessary drug substance.
The dominant drugs are thrombolytics that dissolve the blood clot: Alteplaza, Streptokinase, Anistrplaza. Drugs have a therapeutic effect only in the first hours after the blockade, so they are allowed to use under certain conditions:
- if the painful clinical picture appears at the time of admission to the clinic;
- the diagnosis was confirmed using magnetic resonance imaging or computed tomography;
- less than 3 hours after the attack;
- if it is a primary stroke;
- in the absence of recent surgical interventions;
- in the absence of arterial hypertension;
- with a healthy sugar concentration.
In case of non-compliance with the conditions, other medicines are used: anticoagulants, antiplatelet agents.
Sometimes a thrombus is removed on its own before the arrival of an ambulance – a microstroke is diagnosed. But even with a small form of the victim must be hospitalized, since in the coming days the risk of relapse increases.
Hemorrhagic Stroke Therapy
This type of cerebral vascular stroke is accompanied by rupture of the artery and hemorrhage. Therefore, the primary task is to stop the bleeding. It is necessary to reduce blood pressure and temperature values, the patient is given Enalapril and Paracetamol. To prevent arrhythmias, beta-blockers are prescribed.
To maintain the salt balance, salt solutions are infused. To saturate the tissues with oxygen and restore the damaged areas of the brain, special blood proteins are introduced – albumin. As a symptomatic treatment, anticonvulsant, sedative and antiemetic drugs can be used.
Surgical intervention is used for extensive hemorrhage, which is accompanied by hypoxia and swelling of the brain. The patient loses a lot of blood with an intense increase in intracranial pressure. Such a stroke is characterized by the development of a number of irreversible complications. An emergency operation is performed to save the patient’s life.
After a stroke and a course of therapy, the recovery period begins, the initial stage of which is most significant. Usually bed rest is limited to a week, then the victim is sent to physical therapy, massage, acupuncture, gymnastics. Exercises and procedures gradually restore lost motor activity, preventing muscle atrophy.
Note! Regular breathing exercises can prevent the occurrence of congestive processes in the lungs.
Under the condition of hard work after a month of rehabilitation, the patient begins to learn how to walk, develop fine motor skills. Sessions with a speech therapist correct the lost speech skills. The patient requires professional support from a psychotherapist, as many despair and lose faith in recovery.
In the recovery phase, the patient is taught to eat right. Salt and cholesterol must be eliminated from the diet, this will help prevent the formation of plaques and blood clots. It should daily drink more than 1.5 liters of water or fruit drinks, fruit drinks. It is forbidden to drink carbonated drinks, coffee, alcohol. It is necessary to enrich the menu with vegetables, fruits, sea fish, products containing potassium.
Complications of the disease and prognosis
For any type of brain stroke, the structures lack oxygen as a result of impaired blood circulation — tissue necrosis begins. The consequences of a brain stroke depend on the site of the lesion and the duration of the attack:
- disorientation in space;
- deterioration of intellectual abilities;
- speech disorders;
- visual dysfunction;
- inability to swallow;
- partial memory loss;
- muscle weakness, paralysis;
- behavior change.
The defeat of a particular hemisphere provokes the development of certain disorders. With right-sided blockade, a person experiences difficulties with movement, orientation in time, irrational fear, deep depression develops. With circulatory dysfunction on the left side, the patient’s intellectual capacity decreases, he becomes slow, indecisive.
The most common complication after the blockade is aphasia – problems with the use of words. Aphasia is accompanied by the inability to properly express thoughts, difficulties in understanding the speech of other people. The patient writes poorly, reads, cannot communicate.
Note! Every year in the world about 6 million strokes are revealed, the third part of which ends in death.
According to statistics, 30% of victims die during the first month, 50% by the end of 12 months. The most dangerous recurrent seizures: in most patients, relapse is diagnosed within 5 years after the blockade.
Impaired blood supply to the brain does not occur independently. Stroke often develops as a result of hypertension in people with overweight, heart disease, and systemic stress. You should monitor the painful symptoms and consult a doctor in time.
After recovery, it is necessary to provide preventive measures to reduce the risk of recurrence and the development of irreversible effects after various types of stroke. If the patient had a hemorrhagic type of the disease on the background of elevated blood pressure values, he should be prescribed Dibazol, Papaverine. If an ischemic type occurs, antiplatelet agents and anticoagulants are prescribed to prevent recurrence: Aspirin, Heparin.
Taking drugs after a stroke does not guarantee complete rehabilitation and the absence of repeated attacks. A person must begin to eat properly, change lifestyle, give up bad habits. Responsible attitude to health will help to adapt to new conditions of life and return to society.