Every person should know about the symptoms of a stroke. Even if you do not consider yourself to be at risk, knowing about the signs of this most dangerous disease may help save someone's life. So what is a stroke?
In the ICD-10 this pathology has a separate code in the section "Cerebrovascular diseases" I60-I64. This disease in the predominant number of cases leads to death or disability. Everyone knows that acute cerebrovascular accident is an incredibly life-threatening condition. The consequence of a stroke is damage to the central nervous system, the death of nerve cells. The threat to the he alth of a patient with this disease lies in its spontaneous and rapid development. If you do not start treatment in time, do not provide assistance at the first signs of a stroke, women and men have practically no chance of survival.
At the first symptoms of circulatory disorders of the brain, you need to call emergency medical care! This is the only way to save a person's life and minimize the likelihood of irreversible complications.
About the reasons
Acute cerebrovascular accident is localized in a separate area of onefrom the hemispheres. The symptoms of a stroke result from a thrombosis or rupture of a blood vessel. It is difficult to answer what provokes this violation, being a trigger mechanism. But something is known about the factors that increase the likelihood of the disease:
- arterial hypertension and frequent hypertensive crises;
- narrowing of the lumen of the carotid arteries;
- thrombosis of cerebral and neck vessels;
- embolism;
- blood clotting problems;
- aneurysms;
- heart disease and arrhythmias;
- atherosclerosis;
- diabetes mellitus;
- alcohol abuse, drug use;
- sleep disorders, including sleep apnea;
- increased physical activity;
- traumatic brain injury;
- vasospasms caused by hypothermia;
- age-related changes in the walls of blood vessels.
Regardless of the causes of the disease, "stroke" is extremely dangerous for human life, so awareness of its signs and first aid rules is of great importance.
Types of stroke
In the predominant number of patients diagnosed with ischemic stroke. Its cause is a narrowing or blockage of the arteries of the brain, which leads to a cessation of blood circulation and the inability to get oxygen to the brain cells.
Two minutes of ischemia is enough for brain cells to begin to die. Types of ischemic stroke include:
- Thrombotic –occurs due to the formation of a blood clot in one of the arteries supplying the brain with blood. Most often occurs in patients suffering from atherosclerosis
- Embolic - A blood clot forms in a blood vessel outside the brain due to an irregular heartbeat.
The second group of acute disorders of cerebral circulation - hemorrhagic strokes, provoked by rupture of a blood vessel. The second name for this pathology is intracerebral hematoma. Hemorrhage can also be subarachnoid, i.e. occur in the space between the surface of the brain and the skull bone.
Transient ischemic attack
There is another type of acute cerebrovascular accident - a microstroke. In this case, the clot partially obstructs blood flow, but does not cause serious damage, since the blockage of the vessel is short-term. A transient ischemic attack lasts no more than 5 minutes, but this episode is characterized by the appearance of the same symptoms that occur with thrombotic stroke.
Stroke symptoms
In men and women, the manifestations of this disease do not have any differences and proceed according to a single scenario. The difference can only be in the causes of development and features of the course of the disease. Having recognized the signs of an acute violation of the blood supply to the brain, it is important to act immediately - urgently call a medical team and provide first aid to the patient before the doctors arrive.
Signs of a stroke in women and men look like this:
- spontaneous headache with dizziness, sometimes nausea andurge to vomit;
- sudden numbness or tingling in the face, limbs;
- weakness in the limbs - legs and arms become "cotton";
- complete or partial loss of control over the muscles of the body;
- violations of speech and its perception (the inability to clearly and articulately pronounce words, understand someone else's oral speech);
- vision problems (short-term blindness, double vision);
- impaired consciousness of varying degrees, up to a coma;
- loss of body coordination and balance;
- convulsive seizures;
- increase or decrease in heart rate, respiration;
- a sharp jump in blood pressure;
- swallowing disorder.
How to recognize a disease in another person
The behavior and condition of a person who has had a stroke may seem strange or resemble alcohol intoxication from the outside. Cerebral hemorrhage or ischemia can be recognized in several ways:
- First, you should look at the person, ask if he needs help. Pay attention to how he answers the question: after a stroke, speech becomes difficult.
- Ask him to smile and do a simple test: if the corners of the mouth are at different levels, and the smile seems skewed, this is a definite symptom of a stroke.
- With this disease, the muscles are greatly weakened, and to be convinced of this, it is enough to ask the patient to raise his hands up or shake hands with him. In both cases, the taskwill seem difficult to him.
First Aid Rules
Regardless of whether the patient is in an unconscious or conscious state, an ambulance must be urgently called. At the same time, it is extremely important not to waste precious time for saving before the arrival of specialists. Remember that every minute is precious, so you need to clearly follow the algorithm of actions described below:
- The patient should be in the supine position with the head elevated by approximately 30°.
- If he vomits, turn his head and torso on his side to avoid getting vomit into the respiratory system.
- It is important to clear the airway and clear the mouth if vomiting has already occurred.
- The casu alty should not be given water or food, as stroke often causes airway spasms.
- The patient must ensure the supply of fresh air by opening the window or window. In this case, it is necessary to remove or unbutton tight clothing, loosen the belt, collar.
If there is a tonometer and a glucometer in the room where the patient is located, it is necessary to take measurements and record the indicators of blood pressure, blood sugar, and as soon as the team of doctors arrives, report the data. If the pressure is elevated, in no case should it be reduced by the use of medicines! In the first hours after a stroke, the symptom indicates adaptation of the brain. Antihypertensive drugs are given to the victim only a few hours after the incident.
In case of respiratory and cardiac arrest, you need to act without delay, perform chest compressions and give the patient artificial respiration. The rest of the rescue activities are the task of professionals.
Examination
The symptoms of a stroke are usually not in doubt among professionals, but in order to prescribe a suitable intensive care program, it is important to find out the type of disease and the degree of brain damage. In addition, it is necessary to differentiate a stroke from a malignant neoplasm.
After examining the patient and studying the medical history by the attending physician, a clinical diagnosis of stroke is carried out, which usually consists of several research procedures:
- blood tests;
- computed tomography (CT);
- magnetic resonance imaging (MRI);
- Ultrasound of vessels of the neck and head, including carotid arteries;
- angiography;
- echocardiography.
Examination is carried out in a short time - no more than an hour should pass from the moment the patient enters the emergency department to the start of intensive care measures. Based on the results of an emergency diagnosis of a stroke, medications and medical procedures are prescribed.
Basic principles of treatment
Therapy of a stroke takes place in several stages. First, the victim is provided with emergency medical care, which allows you to stop irreversible processes, save life and notprevent the development of recurrent cerebrovascular accident. The sooner therapy is started, the greater the patient's chances of preventing negative consequences and restoring he alth. Usually, a lot of medications are prescribed for the treatment of a stroke, and self-administration of medications without the doctor's recommendations is unacceptable. In addition, the scheme of therapeutic measures will directly depend on the type of stroke.
In the following days, the patient is prescribed maintenance drugs, and his he alth indicators are constantly monitored. To identify positive dynamics, a second examination may be prescribed, regardless of the severity of stroke symptoms. After the course of treatment, a difficult stage of rehabilitation begins.
Ischemic stroke emergency treatment
The treatment of this type of disease is fundamentally different from the principles of therapy for intracerebral hematoma. First of all, specialists select drugs that can dissolve a blood clot that has blocked a vessel. In addition, treatment should be aimed at preventing recurrent ischemic stroke. According to ICD-10, several varieties are distinguished, each of which is assigned a separate code. Among them are cerebral infarctions of the precerebral and cerebral arteries due to blockage or stenosis, as well as cerebral infarctions of an unspecified type.
Complex treatment for acute cerebrovascular accident is the use of tablets, injections and medical procedures. Special attentiondeserve drugs of tissue plasminogen activator ("Aktivaz", "Aktilise"). For the treatment of ischemic stroke, these drugs are the main ones, since their direct purpose is to dissolve blood clots. At the same time, they cannot always be used, as they have a number of contraindications and features:
- Firstly, you can use them no later than 3-4 hours after ischemia.
- Secondly, tissue plasminogen activator is not used to treat a second stroke and subsequent ones.
- Thirdly, these funds are not suitable for patients with diabetes, gastrointestinal ulcers, kidney failure.
In addition to tissue plasminogen activator drugs, patients with ischemic stroke will be prescribed:
- antiplatelet agents (Aspirin, Ticlid, Pentoxifylline, Clopidrogel, Dipyridamole);
- anticoagulants (Warfarin, Dabigatran, Heparin, Calcium Nadroparin, Enoxaparin Sodium, Phenylin);
- statins (Atorvastatin, Atoris, Simvastatin).
Brain hemorrhage treatment options
Treatment of intracerebral hematoma is focused on stopping the hemorrhage as soon as possible and removing a blood clot from the artery, which puts pressure on brain structures. Often, patients with hemorrhagic stroke have indications for neurosurgical intervention.
Drug therapy consists of:
- antihypertensive drugs (Enalapril, Labetalol) or drugs that increase blood pressure("Dopamine");
- selective beta-blockers (Atenolol, Bisaprolol);
- antipyretic drugs ("Paracetamol");
- broad-spectrum antibiotics to prevent congestive pneumonia and uroseptics to prevent urinary tract infection;
- diuretics (Lasix, Furosemide);
- decongestants ("Mannitol", "Albumin");
- anticonvulsants, antiemetics (Thiopental, Cerucal).
Medications after discharge
A patient who finds himself in his native walls is waiting for the next stage - rehabilitation after a stroke. At home, medication continues to be taken. During the recovery period, the patient is prescribed:
| To stabilize metabolic processes in brain cells |
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| To improve brain and mental activity |
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| To restore normal blood supply |
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To eliminate the accompanying symptoms of stroke in men and women (vomiting, nausea, irritability, fever, etc.), medications are used in consultation with the doctor.
Consequences of cerebrovascular accident and prognosis
Normal lifeafter a stroke is possible, but in order to recover from this disease, you will have to go through a difficult path of rehabilitation. Complications of a previous ischemic and hemorrhagic stroke are often:
- paralysis or paresis;
- violation of coherent speech, swallowing;
- amnesia;
- loss of current self-care skills;
- pain or numbness of the body.
A person who has had a stroke especially needs the love and care of loved ones. It is important to understand that the prognosis largely depends on the actions of the persons caring for the person. A brain stroke in 2% of cases develops again - in this case, the chances of recovery decrease exponentially.
In general, the prognosis of the disease is unfavorable. With hemorrhagic stroke with hemorrhage in the center of the brain, 90% of patients die within the first month. If the victim fell into a coma, provoked by swelling in the brain, the likelihood of his recovery in the future, unfortunately, is close to zero. A second stroke that occurred less than a month after the previous one leaves no chance of recovery at all.
Rehabilitation exercises
Together with taking medications, rehabilitation exercises after a stroke are of great importance. In the absence of the opportunity to undergo a rehabilitation period in a specialized medical center, the patient expects persistent, painstaking and long-term work on the restoration of lost functions and motor activity. During rehabilitation afterstroke at home, it is important to follow the recommendations of a physiotherapist and a rehabilitation therapist. The effectiveness and duration of a course of therapeutic exercises depends on the area of the damaged brain and the degree of its damage.
Despite the variety of existing methods of exercise therapy for various types of stroke, they are all based on the same principles. So, the initial course of therapeutic exercises, regardless of whether the patient has suffered a hemorrhagic or ischemic stroke, includes passive movements of the limbs and massage, which is done taking into account the affected muscle. Extensors are massaged on the hands, and flexors of the legs and feet are massaged on the legs. The transition from passive exercises to the active part of exercise therapy involves the gradual involvement of the muscles of the paralyzed part of the body. Exercises are performed at a slow pace, gently and smoothly, while they should not cause discomfort and pain in the patient.
Next, let's dwell in more detail on one of the possible sets of exercise therapy exercises after a stroke:
- Exercise number 1. Performed first with the unaffected hand, the elbow and wrist joints are involved. Repeat movements 4-5 times. Then do the same with the affected limb. If necessary, help the patient to make flexion movements.
- Exercise 2. Inhale deeply and exhale, repeat 8-10 times.
- Exercise 3. Try to raise and lower your shoulders. The exercise must be done rhythmically for 20-30 seconds.
- Exercise 4. Circular movements of the feet (first with a he althy leg, then with a paralyzed one). Repeat at least 5-6 times.
- Exercise number 5. With bent legs, abduct and adduct the thigh. The exercise is done with both limbs 4-8 times.
- Exercise number 6. Bend your back without lifting your pelvis, with partial tension. Repeat several times.
- Exercise number 7. Do a minute breathing exercises.
As improvements occur, the exercise therapy complex becomes more complicated in the late period of hemiparesis treatment. Further, physiotherapy exercises are performed in reclining, sitting, standing positions. Also, gymnastics is complemented by walking and learning self-care.
