Stroke

Do not miss the first signs of a stroke

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A stroke is called an acute violation of cerebral circulation. It can happen as a result of blockage of one or several vessels that feed the brain (ischemic stroke) or rupture of the cerebral vessel and cerebral hemorrhage (hemorrhagic stroke).

Ischemic stroke can be relatively mild if there is a short-term blockage of a small artery by a tiny clot of blood, or spasm of a large artery. Sometimes people who have had a mild stroke do not even know about it. Temporary difficulties with speech or numbness of a limb, dizziness, or a short-term decrease in vision may not attract attention, but meanwhile they are typical symptoms of a stroke.

Seek medical attention immediately if you experience the following symptoms:

  • Sudden weakness and loss of sensation in the arm, leg, face, especially on one side of the body,
  • short-term difficulty in speaking,
  • confusion,
  • sudden visual impairment
  • unexplained severe headache
  • dizziness, impaired coordination, double vision
  • difficulty swallowing.

Even if all this did not last long and has already passed, you may have suffered a minor stroke, which is dangerous not in itself, but with the possibility of recurrence. The next stroke can be severe, extensive and fatal. Stroke is a very dangerous disease, to prevent it, you need to deal with the prevention of stroke. Keep track of pressure, lead a healthy lifestyle, and follow all doctor’s instructions.

When does a stroke occur?

A stroke occurs when the lumen closes or the wall of a vessel located in the brain ruptures. A stroke can be ischemic (when a blood clot completely blocks the lumen of the blood vessel) and hemorrhagic (when the wall of an artery supplying blood to a particular part of the brain breaks, a hematoma forms). In this case, of course, the normal blood supply is disrupted and the death of brain cells begins. The process of damage to brain structures can develop extremely rapidly, and the longer a person does not receive proper medical care, the more irreversible changes occur.

What causes a stroke

There is no single reason for the occurrence of a stroke, therefore it is customary to talk about a complex of risk factors that can lead to a stroke. First of all, this is, of course, heredity. If a person has “weak” vessels (that is, a genetically determined weakness of the connective tissue is observed), he may develop an aneurysm (expansion or stratification of the wall of the vessel that feeds the brain), which, having reached a certain size, can “tear” and hemorrhagic stroke will occur. If a person has a tendency to accumulate "bad" cholesterol, then atherosclerotic plaques will form in his vessels, narrowing the lumen and contributing to the formation of blood clots. Risk factors such as smoking, hypertension, arrhythmia, overweight and diabetes mellitus also “work”. Therefore, no one can feel insured against a stroke.

Learn the rules of stroke

“Why do they need me,” you say, “I’m quite a healthy person, and my family and friends include young people full of vitality, people.” Unfortunately, stroke is rarely interested in the age of the person it comes to. Of course, men at the age of 45 and women over 55 are at risk, but today there are frequent cases of stroke in both 30-year-olds and those who are only 25 years old. Moreover, the younger the person, the less expected he may have signs , characteristic of a stroke, and therefore - the longer it will remain without help, and the more sad may be the consequences of a brain disaster.

Smile - speak - raise your hands

Symptoms of a stroke usually develop very quickly. The scenario, approximately the same, can only change the sequence of their occurrence. Usually, a person begins an attack of a sharp, unbearable headache, he complains that his head is literally “tearing apart”. The gait may change, it becomes unstable, the person falls, or paresis (numbness) of the muscles of the limbs or face begins. A stroke is characterized by unilateral paresis, when muscle weakness manifests itself only on the left or on the right side of the body. Because of this, the patient's mouth is “distorted”, as it were, and even facial features change. Speech becomes less clear - or slows down, or, conversely, a person begins to speak very quickly, but it is not clear. Fog before the eyes, defocusing of the gaze are also possible, it becomes difficult for the patient to formulate his thoughts and select words.

Doctors recommend remembering the three basic techniques for recognizing the symptoms of a stroke: SMILE - CONSPIRACY - RAISED HANDS (UZP)

  1. Ask the person SMILE. With a stroke, a smile turns out to be “crooked”, because the muscles of one side of the face are much worse.
  2. TALK with him and ask him to answer a simple question, for example: “What is your name?” Usually, at the time of a brain disaster, a person cannot even speak his name coherently.
  3. Offer him to LIFT BOTH HANDS at the same time. As a rule, the patient is unable to cope with this task, his hands cannot rise one level, since one side of the body listens worse.

What to do next?

Urgently, without delay, call an ambulance. If this is not possible - take the patient to the nearest hospital or first-aid post yourself. But very, very fast! You do not have to wait for anything, much less “be led” to the victim’s words that “now everything will pass”. If this stroke doesn’t work, the patient will feel worse, he may die or remain a deeply disabled person for life! Before the ambulance arrives (or while you are taking the victim to the hospital), do the following:

  • put it so that the head is above the body, provide fresh air (open the window, if it is impossible to take the patient out of the stuffy room to the street), remove all constraining clothes (collars, cuffs, belt),
  • put 10 tablets of glycine simultaneously under the tongue. Attention! Not to be confused with nitroglycerin (it is contraindicated in brain disasters.), Namely Glycine ® - a drug that has been proven to improve cerebral circulation. Since 1999, glycine has been added to the equipment sheet of all ambulance teams, but the sooner the patient receives the drug, the better, therefore it is better if he is in your office or home medicine cabinet all the time,
  • measure blood pressure, most likely it will be elevated, so a person needs to be given a drug that he takes “from pressure” all the time (if he has been prescribed this medicine by a doctor). If there is no medicine at hand - lower the patient’s legs in a basin with hot water,
  • if vomiting begins, turn the patient’s head to the side so that vomit does not enter the airways. When vomiting stops, try again to give the patient glycine and its medicine for hypertension.

If after a complex of these measures a person is "relieved" - this does not mean that the stroke was passed by. It’s too early to relax, because all the above symptoms could be signs of a transient (transient) ischemic attack (TIA), that is, the cerebral vessel was not completely blocked, but only partially. But such an attack at any moment can turn into a real stroke. It can be prevented only by the qualified actions of doctors, a qualitative examination of the vessels of the brain, which is possible only in the clinic, and, of course, adequate therapy for this condition.

The main types of cerebrovascular accident

The main types of strokes

In accordance with the cause of the stroke, it is customary to distinguish its main types:

  • Ischemic. It is diagnosed in most cases, its cause is a sharp restriction of the flow of blood going to the brain. It becomes a consequence of complete or partial blockage of blood vessels, for example, a detached blood clot.
  • Hemorrhagic. It occurs when a vessel located in the brain ruptures. Intracerebral hemorrhage can be of various sizes, which compresses all surrounding tissues and blood vessels. The most severe type of pathology.
    • Subarachnoid. It occurs due to hemorrhage between the meninges, causing a secondary vasospasm and cerebral edema.

Help with a cerebral infarction should be provided within 6 hours - this is a “therapeutic window” when all measures taken will have the maximum effect. If this is not done, the prognosis for the patient will worsen every minute.

Lacunar stroke

In the vast majority of cases, lacunar stroke is localized as deep as possible in the hemisphere of the brain

Its consequences can be expressed to a minimum extent due to the fact that it is characterized by the defeat of any of the perforating arteries. With its occlusion, a focus of ischemia is formed, and subsequently cavities (gaps) with a diameter of less than 1.5 mm, which are filled with cerebrospinal fluid. Such a stroke occurs in approximately 20% of cases of ischemic strokes. For such a pathology, meningeal or cerebral symptoms are uncharacteristic.

The main symptoms in this case are the following:

  • atactic hemiparesis - coordination is impaired in half the body,
  • dysarthria - the impossibility of a clear pronunciation of words or sentences,
  • monoparesis - difficulty in moving a hand or foot.

The most common cause of lacunar stroke is atherosclerosis in patients with arterial hypertension. The prognosis for the patient depends on the localization of the focus and the speed of the initiated therapy.

Microstroke

This name "stuck" due to the rapid course - the symptoms of neurological deficiency completely disappear in a maximum of 21 days. With such a stroke, foci of ischemia form and remain for some time in the brain. To a certain extent, this microstroke is similar to a transient ischemic attack. This is the easiest form, the consequences for the patient are minimal, and the symptoms are rather weak. Usually 3-4 signs are present, and they can be as follows:

  • muscle hypertonicity
  • staggering gait
  • mono / hemiparesis, sensitive disorders,
  • speech disorders of varying degrees,
  • dizziness.

Such a pathology is more often noted at the age of 25-45 years. The reason is the combination of many factors, of which the main ones can be noted high blood pressure, systemic blood diseases, alcohol, venous thrombosis. Microstroke is a risk factor for the development of any of the completed strokes. The consequences for humans are almost imperceptible, but this pathology clearly indicates the need to radically revise your lifestyle.

Recovery from illness, or how to return to normal life

Even after two of the above forms of stroke for a person, certain consequences are inevitable. They may not appear immediately, but after a while. In order to help the patient recover from the disease faster and more efficiently, a fairly intensive rehabilitation is carried out. If at the hospital stage the focus of the lesion was medically mediated and the neurological deficit fought, then at the rehabilitation stage they help restore the lost brain functions - movement, speech, memory.

Rehabilitation after a stroke will help a speedy and effective return to a former life

A mild infarction is still accompanied by the death of a certain part of the neurons, which leads to the fact that the central nervous system is not able to perform those functions that were assigned to dead neurons. Heart attacks with small lesions and mild symptoms have a favorable prognosis, and the recovery period is easy, almost completely leveling the consequences of the disease.

Interesting! The number of brain neurons is much larger than it needs. If some of them die, the rest can take on their function, but for this they must be “turned on” and interaction between them should be established - all this can be done only by rehabilitation.

Rehabilitation directions

The choice of rehabilitation method and adequate measures is carried out by the doctor, but their directions are the same for all patients:

  • physiotherapy exercises and massage as a means of combating motor disorders,

Exercises: a - with the help of a device that balances the weight of a paralyzed arm, b - modeling from plasticine, c - grabbing and shifting cubes, d - building a pyramid

  • activities aimed at restoring speech and memory,
  • the work of psychologists aimed at facilitating adaptation in society,
  • the fight against post-infarction complications and the prevention of re-infarction, taking into account the identified risk factors.

In the success of the patient’s recovery, his family is of great importance - she must be directly involved in the process.

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