Stroke , mini stroke - Causes, Symptoms and Treatment .MF .
Symptoms of stroke
First aid, recovery period and rehabilitation, patient care
consequences of stroke
prevention of recurrent stroke
Stroke (synonym - acute cerebrovascular accident) - isthe death of a brain area associated with the termination of his krovoosnabzheniya.
If the reason for the termination is krosnabzheniya blockage artery atherosclerotic plaque and / or thrombus talk about ischemic stroke .
If the cause is an artery rupture and hemorrhage talk about hemorrhagic stroke .The most common causes of hemorrhagic stroke are participating gap expanded artery (congenital abnormality of the vessel called an aneurysm) or artery rupture against high blood pressure.
When brain cells die golvnogo a certain area of the brain, broken or completely fall out functions for which this area of the brain responsible.Typically, a stroke occurs in one half of the brain functions and loss occurs in the opposite half of t
The brain consists of several parts: the top of the brain cortex, which is responsible for thinking, feelings, speech, muscle movement rights.Subcrustal part of the brain responsible for basic functions: breathing, heart function, blood pressure maintenance, etc.In addition to the brain is posterior cerebellum, which is responsible for the coordination of movements.Depending on the affected area violated certain functions.Most often it affects the cerebral cortex.
Symptoms of stroke:
- movement Violations , especially in the extremities.Force reduction or complete cessation of movement in the arms or legs
- sensitivity disorders : reduction or loss of the perception of pain, temperature, etc.usually most notable in the limbs
- Violations of .For example may fall half view (left or right) of one eye
- speech disorders : muffled, indistinct speech, complete inability to speak or understand speech
- Violations standing : standing the patient sways and may fall
- Confusion: from drowsiness to complete loss confessed.
- less important symptoms often occur in other diseases are: headache (perhaps migraine), dizziness (often for diseases of the ear), muscle cramps (epilepsy).
If a person suddenly appeared above symptoms, you should suspect a stroke and immediately prokonsultirovatsya a doctor.
If you are near someone with MDM suspect stroke development, it is necessary to put it conveniently and immediately call an ambulance.Giving the patient any medication or not.If the patient is unconscious, it can not be left to lie on your back!The man unconscious reduced muscle strength and tongue may close in the respiratory and throat man dies of suffocation. unconscious person always need to keep on side, so that his mouth could leak saliva and tongue could not impede breathing.
Approximately three out of four mild stroke symptoms are expressed and tested during the day.This transient ischemic attack (also known as transient ischemic attack).The name " microstroke " Now the doctor is not in use.
Such short-term or transient stroke mikroinsuly serve as a warning.The risk of large strokes with heavy consequences after them is very high, requiring the appointment of a planned treatment for the prevention of recurrent stroke.
Nezavimo the nature of the stroke shows the emergency hospitalization to a hospital in severe condition monitoring in a critical care unit.Rejection of hospital patients with stroke due to old age (usually at age 70-80 years) is a gross mistake.In this situation, the patient's relatives need perseverance.
Stroke Treatment depends on the nature of brain injury (stroke type): hemorrhage or ischemia (vessel closure).
To confirm the diagnosis, determine the nature of the stroke performed computed tomography of the brain (cerebral CT) or magnetic resonance imaging of the brain (brain MRI).This is the most informative methods to make an accurate diagnosis and determine prognosis.
hemorrhagic stroke (bleeding) flows tend to be more severe than ischemic stroke.When hemorrhage requires consultation of a neurosurgeon and a decision on the possible neurosurgical surgery to remove a portion of the blood (hematoma) or clamping bleeding vessel.Neyrohirugicheskie operations are often necessary, but carry a high risk for the patient.
Ischemic stroke not require neurosurgical treatment.Early hospitalization, irrespective of the age of the patient (!), Observation in a hospital setting, the attentive care of the patient and determine the outcome of symptomatic treatment of the disease.Already in the first days of the disease, with stable, shows the activation of the patient to conduct physical therapy.
must be remembered that effective drugs for the treatment of stroke does not exist.Medications prescribed to prevent strokes and potornyh to combat oslozhneiyami disease.Careful monitoring of patients and symptomatic therapy to maintain optimal blood pressure numbers, management of complications, as well as prescriptions for the prevention of stroke repetition - the mainstay of treatment!
treatment of stroke includes
a course of vascular therapy,
use of drugs that enhance brain exchange,
rehabilitation treatment or rehabilitation (physiotherapy, physiotherapy,massage).
In the case of stroke, immediately call an ambulance!If you do not provide immediate relief, it will lead to the patient's death!In the treatment of stroke and rehabilitation of some of the consequences of stroke can be alleviated, while others are completely eliminated.Many people, however, some of the physical or neurological deficiencies remain until the end of life.
Symptoms of stroke depend on which area of the brain they struck.Accordingly violated functions that are controlled this area.Possible after the stroke loss of muscle control over any part of the body or great weakness and paralysis of one side of the body.They can be disrupted ability to speak and understand speech.People affected by stroke often show confusion, helplessness, emotional instability.
What to do immediately after a stroke: first aid
If you have symptoms of acute cerebrovascular accidents necessarily immediately call emergency services as soon as possible to begin treatment.
In the early hours of the disease it is impossible to predict its further course: if 24 hours the symptoms regress, or a month, or a year.TIA and minor stroke is certainly more favorable, but still did not give a reason for joy and relief.These types of disorders of cerebral circulation are the "first call", which could be followed more terrible outcome.That is why it is necessary not only to begin treatment early, but after the restoration of lost functions, to start secondary stroke prevention.
Why require hospitalization immediately after stroke
If your doctor has diagnosed a stroke, it is not necessary to abandon the proposed hospital, as patients often do.Often the refusal is motivated by the need to stay at home due to family problems, requiring the active participation of the sick.Sometimes people express distrust of hospital care, asking the doctor: "What do they do there?"Call other reasons.This behavior is erroneous.
On the first day of stroke patients should be hospitalized for examination and treatment.The recommended conducting ultrasound examinations that show the state of the vessels responsible for the cerebral blood flow during the first 3 days.These include duplex scanning of the main arteries of the head (DS), transcranial Doppler (TCD).Always Heart examination: ECG, echocardiography and study hemorheological properties of blood (. Hematocrit, viscosity, fibrinogen, platelet aggregation, red blood cells, etc.)
accurate diagnosis that reflects the location and nature of stroke (ischemic or hemorrhagic), set during computed tomographybrain or magnetic resonance tomography.If necessary, cerebral angiography, holerovskoe ECG monitoring may include survey design, daily monitoring of blood pressure and other methods that take into account the individual characteristics of the patient.
As a result, an integrated clinical, instrumental and laboratory examination fails to reveal the underlying cause of the stroke and mechanisms in individual patients.It is necessary to know in order to carry out proper treatment, which takes into account and stroke subtype. Researchers Institute of Neurology, Russian Academy of Medical Sciences have identified five subtypes of ischemic stroke and their diagnostic criteria that defines a treatment option in each case. vdaemsya We are not here in a professional difficulty, it is the task of the special medical literature.Our mission to teach people to respect related to their health, to properly assess the situation and sharply properly dispose of a chance to survive.
Eating immediately after a stroke
Stroke - a serious disease that requires large energy consumption by the patient.But often patients are weakened and can not eat normally or they violated swallowing.In these cases, a health food special protein mixtures:. Nutrizon, berlamin-modular, etc. These compounds can be administered through a tube mounted through the nose into the stomach (nasogastric tube) if the patient does not swallow, or are in the form of basic food or added to anotherfood.On the packaging of the preparation must be indicated: for food by mouth or nasogastric tube.Pharmacies commercially available drug nitridrink 200 ml, 5 different flavors.It is enough to fully meet the patient's nutritional drink slowly (better to suck through a tube attached, this contributes to a better assimilation of food) 3-4 nutridrinka pack a day.
Gradually, as far as possible in the process of rehabilitation of the patient is transferred to a normal diet.
recovery after stroke
recovery period after a stroke begins on the first day (usually a few days) of illness.
most important components of the early recovery period is physiotherapy.It is particularly important to engage with the affected limb.If an arm or leg does not move is necessary to passive flexion of the limb joints, early light massage (stroking).
In more remote recovery period (1-2 weeks from the onset of the disease) is necessary to the patient's self-care training.Required visual and auditory load: music, conversations with family, watching TV, walking on the street in a sitting chair.Continues more active physiotherapy, massage therapy, especially the affected limbs.It is important to prevent immobilization of the affected joint konechnositey (the so-called contraction): sagging of the foot, bending the hand, etc.
patients with stroke may be urinary incontinence, the chair or vice-versa difficulties with urination, delayed stool.It is necessary to carefully monitor this.In addition, it is necessary to explain to the patient that Changes are temporary in nature and teach correct behavior (wearing diapers, enemas, etc.).
to rehabilitation to be effective, must be the desire of the patient to participate in rehabilitation.The patient must have sufficient mental capacity to follow, at least, simple commands, as well as being able to remember rehabilitation exercises.The patient is also suffering from ischemic heart disease (angina, myocardial infarction, arrhythmia), neurological rehabilitation program should be carried out in conjunction with the Heart.
frequency of in-hospital twice daily.House daily.The probability of improving motor function in the paralyzed limbs maximal in the first 6 months.Improving speech may last up to 2 years.Stir in the arm is usually restored worse than in the foot.The absence of any movement in the hand for at least 4 weeks after stroke is a poor prognostic sign for the recovery of motor function.According to statistics, 50% of patients with ischemic stroke can achieve good effects from holding rebilitatsii.For patients with hemorrhagic stroke perensshty the figure below.About a third of patients after stroke and survivors during the year remain dependent on aid postoronnney.This proportion has remained stable and within 5 years after the stroke.
When a stroke occurs, hospitalization and early initiation of treatment and subsequently conducting ponotsennoe rehabilitation of the patient - the key to the most favorable outcome of the disease.
Rehabilitation after stroke
Rehabilitation after a stroke is one of the most important problems of modern medicine.The basic principles of stroke rehabilitation are timely start early, regularity and duration of the ongoing rehabilitation treatment.
disorder of cerebral circulation leads to the formation in the brain of pathological focus.Core hearth constitute lost nerve cells and the cells near it are in a state of reduced activity or complete inhibition.Timely therapeutic measures can restore their activity.
begin rehabilitation is necessary in the first month after stroke, ie during the period of hospitalization.Much depends on the mental attitude of the patient.The optimism, the desire to achieve this goal, an active attitude to life to help defeat the disease.After discharge from the hospital, the rehabilitation process should be continued.It coordinates the work of specialists in the recovery of the patient after a stroke neurologist or a physician-rehabilitator.
recovery after stroke includes medication support, active non-pharmacological treatment (if indicated, depending on the type of violation: physical therapy, exercise therapy, massage, psychotherapy) and patient education disrupted or lost as a result of stroke skills.
motor and speech disorders resulting from stroke, more amenable to reductive treatment is in the first few months.
Patients undergoing minor stroke within a month all the functions normally restored.But microstroke - this is just a warning that the blood supply to the brain system that man is not in the best condition.That is, the stroke can be repeated at any time, and lead to more devastating consequences.What to do?
There is a unique modern approach to rehabilitation: to deal with the root cause of strokes - changes in the blood at the cellular and molecular level.This approach is unique: doctors by different physical, chemical and biological manipulations alter his own blood.Return to the body, it becomes a drug devoid of side effects and extremely effective.