A stroke is an acute violation of cerebral circulation with a sharp depletion or cessation of blood flow in a certain area of the brain, which leads to the death of neurons and the loss of important neurological functions. This is a dangerous vascular disease of the brain, which is treated at different stages by several specialists. Which doctor treats a stroke in a particular patient depends on the severity of the disease, the length of stay in the intensive care unit and the responsiveness to rehabilitation.
Staging of disease and treatment
Cerebral infarction (ischemic stroke) is an acute disease of the circulatory system, resulting in neurological symptoms with paresis and paralysis, impaired speech, and muscle coordination. The extreme danger of pathology to life requires quick action, which must be brilliantly debugged in hospitals. And to decide which doctor treats a cerebral stroke, the patientand his relatives never have to. It is enough to contact an ambulance, whose specialists will take the patient to the desired hospital.
Difficulties in therapy
How a stroke is treated in a hospital needs to be looked into in more detail. From the moment of admission, the tactics of treatment and, if possible, revascularization will be decided. This term refers to the choice of a method for restoring blood circulation in the arteries of the brain, if this is appropriate in a given clinical situation. Since the possibility of revascularization is very limited in time, you should seek treatment as soon as symptoms appear.
The most appropriate method of revascularization is thrombolysis, for which it is necessary to apply earlier than 3 hours from the moment of the onset (but not detection) of symptoms, after which, based on the results of computed tomography, the question of the appropriateness of TLT in a particular patient will be decided. Regardless of which doctor treats stroke, in the course of communicating with relatives or EMS staff, he must make sure that the time of onset of the first symptoms is reliable and that there are no contraindications for TLT.
If it is performed, the probability of a complete regression of the disease is still quite low, since some parts of the brain died during the first 10 minutes from the development of arterial thrombosis. It cannot be restored, only the activation of those parts of the brain that have not died, but are in a state of ischemia and hibernation, is permissible. Afterrestoration of blood circulation, their work will reduce the volume of lost neurological functions, as well as improve the prognosis of rehabilitation and the degree of disability.
Treatment Goals
Part of the functions as a result of nootropic therapy will be restored, although this will take more time than patients and their relatives wish. This is the first goal of treatment, although the possibility of restoring neurological function, regardless of which doctor treats the stroke, is probabilistic. Treatment allows you to increase this likelihood and give a chance for more effective rehabilitation.
The second goal of treatment is to prevent recurrent cerebral infarction. These points should be adequately understood, because the impossibility of full restoration of functions lost as a result of a stroke is not a flaw in the personnel, but an objective inevitable reality associated with the scale of damage.
Specialists
At different stages of work with a patient in medical hospitals, where stroke is treated well, many specialists are involved. Their list consists of emergency physicians, a neurologist, an internist, a neurosurgeon, an anesthesiologist-resuscitator, a cardiologist, a rehabilitation therapist, and a general practitioner. The main role in the treatment is played by the neurologist and the rehabilitation specialist, while the efforts of other specialists are auxiliary. Which doctor treats a stroke depends on the current stage the patient is in and the level of the hospital. In district centers, the possibility of thrombolysis will most likely be absent due to the impossibility of promptly performing computerizedtomography. In large cities and the capital, the possibility of using modern technologies improves the rehabilitation potential.
Personnel activities
Cerebral infarction is treated by several groups of specialists at different stages of the development of the disease and its correction. At the time of the formation of the first clinical signs of the disease in the acute period of the development of a stroke, an ambulance team works with the patient. Its task is to stabilize the patient's condition, preliminarily decide on the possibility of performing TLT, antihypertensive, symptomatic and antihypoxic therapy.
After delivery to the hospital, a neurologist examines and decides on treatment tactics, who is consulted by a general practitioner, a cardiologist and, if necessary, a neurosurgeon. The patient must be hospitalized in the intensive care unit, where the resuscitator will support the work of organs and systems. Transfer to the general somatic departments of hospitals (in this case, to the neurological department) is possible only in a stable condition.
Neurological Department of Hospital
From this moment, rehabilitation is available, which, depending on the chosen treatment method and the presence of complications, begins either from the first day or is delayed until stabilization. In the question of which doctor treats after a stroke, a rehabilitation specialist is the most obvious answer. He is working on an individual scheme, according to which attempts to activate the patient and recovery will be gradually made.lost functions. Among his methods of treatment are physiotherapy, massage, reflexology, occupational therapy, motor activation.
One of the main objectives of the treatment of cerebral infarction in hospitals is to prevent complications and save the patient's life. The issue of restoring lost functions is considered after stabilization, when nothing threatens life. In this condition, the patient can be discharged home or referred to an inpatient rehabilitation facility.
Rehabilitation in these conditions helps to restore motor activity and speech. The completeness of the restoration of functions for the most part depends on the extent of brain damage and the choice of treatment methods in the early stages of the disease. Instructions on how to treat a cerebral stroke in a particular medical center are available in the standard protocols for the provision of medical care, and are also formed based on the existing material base of the he althcare facility.
Rehabilitation and prevention
One of the main goals of outpatient treatment and dispensary observation of the patient is to prevent the development of recurrent cerebral infarction. At the same time, there are almost always significant comorbidities, including coronary heart disease, angina pectoris, hypertension, atrial fibrillation, or diabetes mellitus. This requires the appointment and intake of specialized drugs, and the relevant specialists observe the dynamics of well-being,track the completeness of treatment.
Which doctor treats after a stroke, more precisely, after discharge from an inpatient he althcare facility, depends on concomitant diseases. Most often, the patient is observed and treated by a neurologist, internist, cardiologist and endocrinologist. The most important are the efforts of the therapist, since effective prevention of recurrent cerebral infarction is realized mainly through high-quality and complete antihypertensive therapy. Its appointment and control is carried out by the therapist.
Features of observation
After a patient with cerebral infarction enters a neurological hospital and undergoes rehabilitation measures after discharge, he switches to an outpatient treatment regimen. Here, doctors (local internist and neurologist) appoint a patient to appear at a certain time to control the well-being and completeness of treatment, the actual dynamics of the disease. This is implemented in the conditions of a city clinic or a medical outpatient clinic. If the patient's condition worsens or if the dynamics is unsatisfactory, the doctor treating the stroke will routinely refer him to a hospital.
The patient should remember that he alth care is a professional activity of medical personnel, combined with the efforts of his relatives and assistants. It is unacceptable to leave a patient with existing dysfunctions without adequate supervision. You also need to monitor whether he really takes medications that are prescribed in a hospital or clinic. Oftendue to inadequate supervision of relatives and the impossibility of self-care, medication is ignored, resulting in a recurrent stroke.
