A stroke is an acute cerebrovascular accident, as a result of which blood flow to certain parts of the brain is partially or completely stopped. This condition leads to tissue damage, resulting in a loss of their functionality. In the event of a severe disruption in the functioning of the brain, irreversible consequences for human he alth are possible, leading not only to disability, but also to a possible death.
Mechanism of disease progression
Depending on the mechanism of development and causes of the disease, hemorrhagic and ischemic strokes are distinguished. Hemorrhagic stroke, the symptoms of which increase suddenly, occurs as a result of a hemorrhage in the brain. A prolonged increase in blood pressure leads to pathogenic changes in the walls of blood vessels, they lose their strength and elasticity, can no longerfully perform the function of a conductor for a constantly circulating volume of blood. Aneurysms appear, which, after rupture, cause hemorrhage. The sudden flow of blood permeates the brain tissue, causing swelling and increased pressure on them. Cells die, lose their functionality.
More common and accounts for approximately 80% of all cases of ischemic stroke. Symptoms, the first signs should be identified as early as possible. The mechanism of development of ischemic stroke differs from the causes of hemorrhagic stroke. The ischemic type of the disease appears after the cessation of blood access to a certain part of the brain. This condition leads to blockage of blood vessels by a thrombus or atherosclerotic plaque. Over time, lipid deposits appear on the walls of the vessels of the human body, which can form a large thickening, partially or completely blocking the blood flow. In addition, various inflammatory diseases, congenital anomalies, some chronic diseases, such as diabetes, and damage to the vertebrae lead to vasoconstriction. The human body has a powerful compensatory system that allows maintaining normal blood circulation even in the event of damage to one of the major main arteries. At the same time, the circulatory system is unable to cope with multiple vascular lesions and the formation of a large number of atherosclerotic plaques.
Risk factors
There are certain risk factors that increasethe risk of developing both ischemic and hemorrhagic strokes. These include:
- Atherosclerosis. This disease is especially dangerous in relation to the carotid and vertebral arteries.
- Old age. Over time, all body tissues lose their functionality. This also applies to vessels. In addition, more and more atherosclerotic lipid deposits accumulate on their walls, leading to the formation of plaques.
- Arterial hypertension. This condition leads to the development of both ischemic and hemorrhagic forms of the disease.
- Diabetes. Under the influence of this chronic disease, the vessels are destroyed and cease to perform their functions of supplying tissues and organs with oxygen and blood-borne nutrients.
- Heart disease, as a result of which the normal process of blood circulation in various organs and tissues of a person is disrupted.
- Bad habits such as smoking and alcohol abuse.
Types and periods of ischemic stroke
Ischemic stroke of the brain, the symptoms of which sometimes increase within 3 days, can be classified according to various criteria:
By the rate of neurological symptoms:
- Ischemic transient attack is a neurological disorder that is focal in nature. It disappears within a day from the moment of the first manifestation. Such a violation can be, for example, blindness in one eye.
- Microstroke is a combination of ischemicsustained attacks. In this case, neurological defects appear in the period from 2 to 22 days.
- Progressive stroke. Symptoms, the first signs are manifested by an increase in neurological disorders over several days. After such a state, the normal functioning of damaged areas of the brain is extremely rarely fully restored.
Completed stroke is characterized by constant regression in brain function and persistent neurological disorders.
According to the degree of tissue damage and the condition of patients, they are distinguished:
- Mild stroke with minor symptoms and fully recoverable brain function.
- Stroke of moderate severity with a predominance of focal lesions of brain tissue and more significant neurological disorders. Consciousness in these patients is usually not disturbed.
- A severe form of stroke is characterized by impaired consciousness, severe symptoms of neurological deficit, and multiple loss of brain tissue functionality.
There are also different periods of the course of the disease. Each of these time intervals corresponds to certain symptoms of the disease and methods of treatment.
- the most acute period takes the time of the first three days from the onset of the disease;
- the acute period of the disease lasts about a month - up to 28 days;
- the period of early recovery takes about 6 months in the patient's life;
- late recovery period continuesapproximately two years;
- residual effects can become companions of a person for the rest of his life after a stroke.
Hemorrhagic stroke: symptoms
Hemorrhagic type of disease, unlike ischemic, appears suddenly. The symptoms of a stroke and microstroke develop very quickly, and there is very little time to call an ambulance and return a person to normal life. The main signs of a hemorrhagic stroke include:
- weakness in the limbs, especially on one side of the body;
- poor understanding of speech, inability to speak;
- sudden visual impairment;
- coordination disorder, chaotic limb movements;
- severe and causeless headache that suddenly appeared.
Often the patient has involuntary urination, nausea and vomiting. Muscle reflexes are impaired on the side opposite to that in which the hemorrhage occurred.
Ischemic stroke symptoms
Signs of ischemic stroke may come on gradually, rather than appear suddenly, as in the hemorrhagic form of the disease. The first symptoms of a stroke depend on the part of the brain in which blood circulation was difficult. The most common ischemic type of disease is manifested by speech disorders. All symptoms of stroke and microstroke can be divided into groups:
- Speech disorders. A person does not perceive well the speech addressed to him, cannot express in wordsyour thoughts. Pronunciation worsens, the patient's speech is incomprehensible and incoherent. Speech disorders are often the first symptoms of a stroke in women.
- Motor disorders. The patient's movements are weak, coordination is disturbed. Symptoms usually affect one side of the body. There may be problems with swallowing. The sensitivity of the body on one side is often disturbed.
- Vestibular disorders. The patient complains about the rotation of objects before the eyes, loss of spatial orientation.
- Visual disturbances. Ischemic stroke is characterized by complete or partial loss of vision in one eye, blurred and blurred vision.
- Personality disorders. The patient cannot perform habitual actions, his memory and perception of ongoing events are impaired.
During an ischemic stroke, headache, nausea, and vomiting often appear. There may also be common symptoms of stroke and heart attack - redness of the face, shortness of breath, rapid heartbeat.
Diagnosis
To save the life and he alth of a person who has had a stroke, he needs to get help as soon as possible. Otherwise, irreversible changes may occur in the brain tissues, resulting in severe neurological disorders. Therefore, it is very important to know what the symptoms of a stroke are and to seek help. If there is any doubt, you can ask the patient to perform several actions:
- Ask the person to smile. It is difficult for someone who has had a stroke to do this. The smile is skewed, the corners of the mouth are asymmetrical. One of them is down.
- Invite the person to raise both hands. If there is a stroke, one arm will stop below the other.
- Ask the patient to say a simple phrase. It will be difficult for a person to do this, even a sentence of three or four words will become incoherent.
- If the patient sticks out his tongue, it will be shifted to one side, skewed.
All these are symptoms of a stroke and a microstroke, which make it possible to suspect the disease even to a person who has nothing to do with medicine. Doctors make a diagnosis based on the presence of neurological disorders, deviations in human behavior, data from various studies. The main ones are general and biochemical blood tests, blood pressure measurement, computed and magnetic tomography of the brain.
First Aid
Experts in the field of neurosurgery believe that it is possible to return a person who has had a stroke to a full life if assistance begins to be provided no later than 3 hours from the onset of the disease, that is, the time when the first symptoms of stroke and microstroke appeared. In some cases, this time is extended up to 6 hours. If help is late, there is a high probability of irreversible changes in the brain, which threaten not only the he alth, but also the life of the patient. Therefore, emergency assistance to those around a person in a state of stroke should begin with calling an ambulance. Then you can lay the patient down, raising his head a little on the pillows. It is worth opening the window, providing access to fresh air. Necessaryrelax various belts and buttons that prevent a person from breathing freely. In the case of an increase in blood pressure, you can offer the patient those drugs that he usually takes. It is very common for a person to vomit during a stroke. In this case, it must be laid on its side to avoid getting vomit in the throat.
Stroke treatment
The tactics of stroke treatment depends on the time that has passed since the onset of the disease, the patient's condition and the severity of the attack. Medical and surgical methods are used. If a little time has passed since the onset of a stroke, special drugs are administered that dissolve the blood clot. It can also be removed surgically. In the case of a hemorrhagic stroke resulting from a cerebral hemorrhage and the formation of a hematoma, the latter must also be removed. These measures allow you to quickly restore blood circulation in the affected area and minimize possible complications. The treatment of a stroke is also to ensure those vital functions that were lost as a result of an attack. It is necessary to maintain the patient's heartbeat and breathing, to ensure normal levels of glucose and electrolytes in the blood. With the help of special drugs, blood pressure is corrected. Its level is left slightly elevated, as a rapid decrease can cause tissue necrosis.
During the recovery period, treatment is aimed at improving brain activity, compensating for neurological disorders. Their symptoms after a stroke may persist for a long time.time. Patients are prescribed drugs that improve blood circulation. A large role is given to physiotherapy exercises, classes with a speech therapist. If the patient's condition allows, minimal physical activity can be started already in the first days after hospitalization. The earlier rehabilitation treatment is started, the greater the chances for maximum recovery of brain function. The patient must also be observed by an ophthalmologist.
Consequences of the disease
In each individual case, there may be different complications for a person who has had a stroke. Symptoms and consequences are characterized not only by the severity of the disease itself, but also by the time during which the first aid was provided to the person, as well as by the localization of the place of impaired blood circulation. The most dangerous stem stroke, which causes damage to the respiratory and vasomotor centers. In this case, there is a possibility of death as a result of cardiac arrest or cessation of respiratory activity. Patients may experience complete or partial paresis of individual limbs or completely one side of the body, most often opposite to the focus of the disease. Speech disorders, memory loss are common, including problems with short-term memory. A person cannot write well and coordinate their movements. Especially often this disorder is associated with a stroke that occurred in the cerebellum.
The hemisphere affected also has an impact on the consequences of a stroke. People with circulatory disordersleft hemisphere suffer from more pronounced changes in psycho-emotional indicators. They have serious speech problems. Understanding the interlocutor, they cannot even pronounce simple phrases. At the same time, stroke survivors with localization in the left hemisphere recover faster motor functions.
Stroke Prevention
Stroke prevention is closely related to the fight against atherosclerosis. It is necessary to regularly check the level of cholesterol in the blood, follow the diet prescribed by the doctor, take drugs that prevent the deposition of plaques on the walls of blood vessels. Extremely attentive to their well-being should be people over 50 years old. Stroke, the causes of which are also associated with excess weight, can lead to jumps in blood pressure and the appearance of diabetes. Stopping smoking and drinking alcohol can help reduce your risk of developing the disease. Under special control it is necessary to keep diseases leading to the formation of thrombosis. The strong half of humanity is more at risk of stroke than women. Therefore, the symptoms of a stroke in men, even implicit ones, cannot be ignored. A he althy lifestyle, attention to your he alth and stress management will significantly reduce the risk of stroke.
