Ischemic stroke is manifested as cerebral vascular spasm. Mortality in this pathology reaches 20% of all cases, half of the patients remain disabled.
why is there
In many cases, if done right life routines, prevention of atherosclerosis, The occurrence of this disease can be avoided. In order to prevent a tragic outcome, the first signs of disease should immediately seek medical help.
Cerebral infarction - an acute cerebrovascular accident, accompanied by necrosis of the brain. brain ischemia It comes from the fact that thrombus or embolus does not give the blood to move freely through the vessels. It increases the risk of cerebrovascular accident atherosclerotic process.
If the cerebral infarction was diagnosed, the reasons may be the following:
- Congenital heart or blood vessels.
- Too thick blood.
- Slow blood flow.
- Thrombosis mitral or aortic valve.
- Separation of thrombotic masses after defibrillation.
- Artificial pacemakers and pacemakers.
- Coronary heart disease.
- Heart failure.
- Myocardial infarction - a common cause of ischemic stroke.
- Atrial fibrillation.
- Violation of lipid metabolism.
- Diabetes.
- Age older than 60 years.
- Alcohol abuse and smoking.
- Physical inactivity.
- Oral contraceptives.
- Migraine.
- Hematologic Disorders.
The above pathology leads to arterial emboli or atherosclerotic lesions basilar, vertebral branches of the internal carotid artery, which contributes to a stroke.
Kinds
Several distinct types of acute cerebral circulation on ischemic type. Each stage has its own characteristics and mechanism of development.
Acute
This initial period of stroke. It lasts no more than 21 days. At this time, growing the pathogenic processes in the brain tissues, especially fast it occurs within the first 6 hours of the disease. The core is formed from damaged cells within 5-7 minutes. After 1 hour 30 minutes penumbra around the nucleus increases by 50% for 6 clocks - on 80%.
If within the first 6 hours to carry out the necessary therapeutic interventions, cerebral infarction will be held with a minimum of adverse effects. Because It switched from the first minute pathogenetic cascade that leads to cell death. Untreated apoptosis will expand exponentially. 3-5 day comes necrosis of damaged cells.
Intensive therapy during the first 6 watches include weatherproof of:
- Hemodynamic improvement of brain tissue.
- Protection of cells.
- Improving viscosity and clotting of blood microcirculation.
- Prevention of cerebral edema.
Besides OI, there are other, more complex types of brain stroke.
Extensive
massive stroke It affects large arteries that supply blood to the brain. Also a massive stroke is a condition in which affected a lot of small areas or, on the contrary, a large amount of the brain. OI is classified as a severe stroke with pronounced cerebral symptoms:
- Depression of consciousness.
- Swelling of the brain.
- Hemiparesis or hemiplegia defeat opposite side.
- Paresis gaze toward the paralyzed limbs.
- Disturbance of consciousness.
- Autonomic disorders.
- Trophic disorders.
The manifestation of certain symptoms depends on which hemisphere have been damaged. Common symptom of ischemic stroke is faint. In this case, to test pupils at once. If the exposure to light is not marked narrowing of the pupil may be a manifestation of OI. The patient should be transported immediately to a medical facility, where he was placed in the intensive care unit and is connected to a life support system.
lacunar
According to the classification lacunar stroke it is the most common form of the disease. Early diagnosis prevents complications, but it can detect only in the hospital. LEE leads to pathological disturbances in the deep layers of the brain and formation of gaps (cavities) having a diameter of 1 to 15 mm. Gaps can coalesce, and then there are large cavities that are filled with blood or plasma and fibrin.
In patients with lacunar ischemic stroke is not impaired speech, vision, consciousness and other functions of the cerebral cortex. Symptoms of brain stem are completely absent. These distinctive features make it possible to differentiate the IS with other types of the disease.
Lacunar ischemic cerebral infarction may occur against the background of sharp spikes in blood pressure. The risk group includes persons who suffer from pathologies such as:
- hyaline degeneration AG;
- atherosclerosis;
- infectious inflammation of the arterioles;
- diabetes.
THERE may be a consequence of vasculitis.
Lacunar infarction of the brain may lead to memory loss, disorientation, depressive states, and then to dementia.
What are the symptoms
Identify signs of pathology can be on the outside of the patient mind, behavior, response to stimuli:
- disturbance of consciousness (from mild sedation to coma);
- reduction / loss of pain sensitivity of certain areas of the body;
- decrease / loss of motor, voice functions;
- headache;
- vomiting.
At the first signs must call resuscitation teams. Clinical doctor's conclusions are confirmed by measurement of blood pressure and electrocardiogram. The hope for a favorable outcome is possible for the first 3-6 hours of the onset of stroke prior to the intensive care unit or intensive care unit. Signs of ischemic stroke - is a personal feeling of the person or the obvious description of a bystander.
They should be aware of all the people, regardless of medical education. These symptoms are primarily related to the violation of the innervation of the head and body muscles. If there was a right-sided stroke, The result would be paralysis of the left half of the body, because in this case the disease touches areas that are responsible for motor activity of the other party in breach of it. If the left hemisphere is damaged, refuse the right half of the body.
Define pathology in the home can be the following symptoms of ischemic brain stroke:
- Looks unnatural smile, the corners of the lips are located on different lines, due to the inability to reduce the facial muscles.
- Hands go up asymmetrically, the hand on the affected side is devoid of power, weak handshake.
- Difficulty pronunciation of words and phrases.
The determination of the beginning data confirms irreversible processes in the brain.
Signs of some types of stroke occur before the development of changes in the brain tissue. These symptoms are also easy to identify in the home. Confirmation of the diagnosis is the presence of the patient's symptoms of these 2:
- Pain in the head without a clear localization, often associated with fatigue and change of weather.
- Dizziness, which increases with the change of body position in space.
- The noise in my head.
- Memory impairment.
- Sleep disturbance and efficiency.
Such signs are called initial manifestations of insufficient blood supply to the brain (NPNKM). They consist in passing ischemic attacks.
Harbingers of disease in men and women are somewhat different. The latter exhibits such signs:
- prolonged bouts of acute or dull pain in the chest;
- unexplained anxiety;
- redness of the face;
- the variability of blood pressure;
- palpitations (more than 120 beats per minute);
- acute pain in the abdomen;
- sweating;
- Disorders of the digestive tract.
harbingers of stroke in the following men:
- suddenly emerging and rapidly passing headaches;
- strange bouts of nausea;
- unexplained changes in mood;
- numbness in one of the limbs;
- suddenly blood abides to-face;
- impaired hearing and vision;
- disruptions in the coordination of movement or speech.
The disease is expressed in such symptoms:
- excessive lowering of quality;
- seizures.
Anxiety symptoms may disappear quickly, but after a while begin stroke.
How to diagnose
For diagnosis in the hospital a number of activities:
- Anamnesis. Doctors find out in the accompanying how the disease began, what it was the first of his signs, how quickly they develop. The doctor needs to know whether the patient's heart or vascular disease, whether it has bad habits. Help in establishing the diagnosis of information, whether in the cases of stroke of blood relatives and at what age.
- Blood chemistry. This kind of research will help determine the type of cerebrovascular accident. In the pathology of increased potassium and total protein.
- MR. It is used for the detection of stroke in the trunk and the substance of the brain.
- Doppler. Research is needed to visualize blood flow and possible cholesterol plaques and vascular constriction areas.
Furthermore, such methods are used:
- Cerebral angiography. The patient is injected contrast agent, and then make a series of shots.
- MR angiography of the major cerebral vessels. It is carried out to detect impaired blood flow and thrombus formation.
- Echocardiography of the heart. It gives the opportunity to see the potential causes of blood clots within the body.
- ECG. Carried out for the diagnosis of arrhythmias, which can cause a stroke.
The results to be valid, before being sent to the hospital can not give the person medications.
How to treat
After the initial appearance of symptoms of ischemic stroke, treatment should begin within the first 6 hours. During this time, no time to form the hearth tissue necrosis, so the chances of a full recovery are higher. Apply complex treatment:
- Appointed basic therapy to maintain the body's vital functions - control of breathing and cardiac work, thermometry, a decrease in brain edema, measures for the prevention of pressure ulcers, hypostatic pneumonia, urinary infections system.
- Specific therapy. By means of special drug dissolved thrombus. To curb the growth of blood clots and the prevention of complications treatment is prescribed anticoagulants. To repair damaged neurons appointed neuroprotective.
Treatment after the removal of the causes of stroke is aimed at the elimination of neurological symptoms and aid in the formation of new neural connections. To this end, the patient prescribed amino acids, medications nootropic action, piracetam, prescribe a course of therapeutic massage, or physical education.
In some cases of ischemic stroke form can be cured by surgery. Operation is assigned to:
- remove cholesterol plaque from the carotid arteries;
- increase the vessel lumen;
- dissolve the clot medicine that drips through a catheter inserted into the diseased vessel.
Therapy can be followed only for diagnosing and accurate diagnosis can only be a doctor. For this reason, the sooner the patient gets a medical facility, the faster the doctor will hold the right survey and tell us how to heal and restore the patient, which will increase the chances of a return to full lifestyle.
How to recover
In many cases, find the lost physiological and mental capacity possible. Place dead neurons eventually supplant new and damaged due to cerebral infarction recover tissue vessels. But predict when that happens, it's hard.
Much depends not only on the severity of the disease, but also on the individual characteristics of the patient. The brain of some people can recover from heavy losses, while others even small deviations remain for life. However, ischemic cerebral infarction can be treated better than the hemorrhagic form, and therefore recover from it a little easier.
Along with the physical rehabilitation should take place, and psychological. The majority of patients after stroke observed asthenic-depressive syndrome, which is expressed in depression and lack of interest in life. To people with stroke, quickly joined the society, he should trust the small household chores. It should feel a full-fledged member of the family, not the helpless invalid.
Rehabilitation in the home must meet the following principles:
- an early start;
- regularity;
- sequence;
- mixed.
The patient should be taught self-help skills, movement, speech, intellectual skills.
Only then can we think about the restoration skills.
Rehabilitation after ischemic stroke at home - not an easy process, all aspects of which are difficult to take into account. It should be conducted under the supervision of a neurologist.
One of the main areas of rehabilitation - recovery of motor functions. First of all, suffer from the hands and feet. Since the hands perform more complex movements than the feet, their recovery period takes longer. The patient must carry out a complex of physiotherapy. Exercise should not be debilitating, high loads can bring a deterioration state. The main purpose of physical therapy - not an increase, but a decrease in muscle tone. Gymnastics can be no more than an hour a day should take place a maximum of 2 classes.
Be recovered in the home memory and speech. This process takes even longer time than the return of motor function. Here to help special exercises - memorization of numbers, words, objects in the pictures. Well develop memory board games can be every evening to remember with the patient events that happened during the day. In some cases it is necessary to seek help from a speech therapist and a psychologist.
For the development of the speech will be a useful exercise for the development of facial muscles:
- oskalivanie teeth;
- folding the lips into a tube;
- opening and closing the mouth;
- tongue protruding;
- tongue licking the lips;
- biting teeth lips;
- inflating cheeks.
Recover faster patient physiotherapy can help:
- massage;
- mud therapy;
- magnetic therapy;
- laser therapy;
- manual therapy.
Effective tool in post-stroke rehabilitation - massage helps relieve muscle tension, reducing blood flow.
Consequences and forecasts
Stroke causes the death of nerve cells that carries heavy consequences. If the lesion is small, vital centers were not affected, the patient is conscious, can even partially serve itself controls the natural needs of the body, the outcome will be favorable. In this case, the patient must comply with the prescribed regimen and do gymnastics.
The most dangerous consequence - a brain tumor after a stroke. Signs of disease are:
- strong paroxysmal headache;
- amnesia;
- weakness in the limbs;
- nausea;
- vomiting;
- convulsions;
- fainting;
- respiratory disorders.
Against this background, it can develop a deep coma, from which it is possible to enter 46% of patients. It begins to develop symptoms of cerebral edema in stroke in the first 2 days after the attack, and reaches its peak at 3-5 days. To determine the localization of fluid buildup makes MRI.
When conservative treatment to eliminate pain prescribe strong analgesics, and the liquid removed from the body using diuretics, more medicines are used to reduce the permeability of the walls vessels. operation is often required for removal of a brain edema stroke for outflow of fluid from the cranial cavity.
Coma - borderline between life and death - developed with extensive stroke.
Even after the release of the coma due to a stroke chance of complete recovery is low.
The signs of the onset of coma is a common confusion, rapid breathing, quiet and incoherent speech, weak pulse. This complication is most dangerous to the elderly.
Dementia - a consequence of vascular disorders in the brain areas that are responsible for mental activity. Its development begins with the defeat of the left hemisphere. In patients with marked intellectual disorder that progresses rapidly. Specific treatment does not exist. Recommended massage, exercise therapy, and drug therapy is appointed.
Paralysis - another common consequence of cerebral infarction. If the hemorrhage focus is in the right hemisphere - paralyzed the left side of the body, and therefore, if the damaged left hemisphere - the paralysis observed on the right side.
Later, the consequences can become bedsores. Due to the constant pressure on the soft tissues of developing local poor circulation, resulting in partial paralysis. May occur trophic changes in the joints of patients with limbs that appear swelling, tenderness of the motion and pressure.
Thrombosis - a dangerous consequence of stroke. Separation of a blood clot threatening blockage of the main blood vessels that can cause death. For prevention need to eat right, do physical exercises.
Inflammation of the lungs - a remote consequence of cerebral infarction. Pneumonia can be aspiration and hypostatic. The patient has been coughing, fever, respiratory failure. Inflammation develops as a result of stagnation in the pulmonary circulation. The immediate cause of the inflammatory process becomes a bacterial infection.
How many people live
How many people live after the ischemic form of stroke, it is difficult to predict. Statistics show that people after a stroke can live more than 10 years, but mortality rates are high. Numerous studies have revealed that in the first month after the disease killed approximately 30-35% of patients within 12 months - about 50%.
Greater danger is posed recurrent strokeWhich reduce the life span of 2-3 years. The likelihood of a new attack is seen in 5-15% of patients within one year, for 5 years - 25% of women and about 40% men due to unfavorable background in the body: a predisposition to the formation of blood clots, heart disease, arteriosclerosis and so on. P.
Quality of life depends on the age of the patient. Older people have a recovery period takes longer. In addition, the recovery rate is influenced by other factors:
- lesion volume and severity of the condition (for large lesions lifetime reduced);
- developing complications (formation lead to other adverse symptoms worsen the quality of life, for example, complexity may cause brain edema following stroke);
- general state of health;
- presence of paralysis (it promotes the formation of blood clots, increasing the risk of re-attack);
- patient safety (weakness and dizziness can lead to falls and injuries, deterioration of the general state of health).
Of great importance is the defeat of the party. Worsens the prognosis of life paralysis of the left side of the brain, because it is reflected in the work of the heart. In 30% of people with a diagnosis of a life cut short in the first year after a stroke.
Extensive paralysis condemns the patient to a supine position. Paralyzed person threatening congestive pneumonia, pressure sores and blood clots in the legs, which impairs the quality of life after an illness and can lead to death.
Future patient after stroke also depends on its cause and localization, speed of delivery to the hospital. After admission to the hospital on the outcome affect the adequacy of therapy and expression or absence of neurological complications. stroke form, the prognosis of which is quite heavy - atherothrombotic stroke and brain damage due to thromboembolism. These 2 types of pathology are up to 75% of all strokes and mortality in the first month is about 20-25%.
The most favorable outcome - with lacunar form. In this case the mortality rate within the first month of about 2%, health improves as rehabilitation. In old age, the recovery period is longer.
Thus, for the period of life after stroke is influenced by many factors. Does it matter how fast the professional medical assistance is undergoing rehabilitation, what are the individual characteristics of the patient. The biggest threat has brain swelling, but if the swelling was eliminated in time, the patient will return to a normal life.
