Stroke: what is it, symptoms, treatment, consequences, prognosis

What is a stroke?

Stroke - This is a sudden violation of the blood supply to the brain. Most strokes are caused by a sudden blockage of the arteries leading to the brain (ischemic stroke). Other strokes are caused by bleeding in the brain tissue when a blood vessel ruptures (hemorrhagic stroke). Because stroke occurs quickly and requires immediate treatment, the condition is also called “

brainstroke». When the symptoms of a stroke do not last long (less than an hour), it is called a transient ischemic attack (TIA) or mini-stroke.

The consequences of a stroke depend on which part of the brain is damaged and how badly it is damaged. The illness can cause sudden weakness, loss of feeling, or difficulty speaking, seeing, or walking. Because different parts of the brain control different areas and functions, the area immediately surrounding the stroke is usually affected. Sometimes people with a stroke have a headache, but sometimes it can be completely painless.

It is very important to recognize the warning signs of a stroke and seek immediate medical attention if they occur.

Types of stroke

There are three main types of stroke - ischemic, hemorrhagic and transient ischemic attacks, differing in the type of problem and duration.

Ischemic stroke

The most common type of stroke, accounting for nearly 80 percent of all strokes, is caused by a clot or other blockage in an artery leading to the brain.

Intracerebral hemorrhage (hemorrhagic stroke)

Intracerebral hemorrhage is a type of stroke caused by the sudden rupture of an artery in the brain. After the artery ruptures, blood enters the brain, compressing its structures.

Subarachnoid hemorrhage

Subarachnoid hemorrhage is also under the type of hemorrhagic a stroke caused by a sudden rupture of an artery. Subarachnoid hemorrhage differs from intracerebral hemorrhage in that the rupture site causes the blood to fill the space around the brain rather than inside it.

Transient ischemic attack

Transient ischemic attack (TIA) is sometimes referred to as a "mini stroke." It differs from the main types of strokes because blood flow to the brain is blocked only for a short time - usually no more than 5 minutes.

Causes and triggers of stroke

The causes of stroke are well known and in most cases they can be prevented or controlled by lifestyle factors or diseases causing them. Risk factors include:

• heart diseases;
• diseases of the carotid arteries;
• hypertension and malignant hypertension;
• high cholesterol, fat, and triglyceride levels;
• diabetes;
• blood clotting disorders and infections;
• obstructive sleep apnea;
• overweight or obesity;
• passive lifestyle;
• excessive stress (stress);
• drug or alcohol abuse.

Stroke prevention requires lifestyle adjustments as well as good medical care, aimed at identifying and regulating health conditions that are known to lead to disease.

Brain damage from a stroke is the result of a series of biological events that occur when there is not enough blood supply to an area of ​​the brain. The flow of blood to the brain is vital because blood contains oxygen and nutrients needed for every cell in the brain to function properly.

Even a few minutes of interrupted blood flow is enough to cause brain damage.

Signs and symptoms of a stroke

During an attack, every minute counts! Prompt treatment can reduce the brain damage caused by stroke.

Knowing the signs and symptoms of a stroke can help you take quick action and possibly save a life - perhaps even your own.

Signs of stroke in men and women

• Sudden numbness or weakness on the face, arm, or leg, especially on one side of the body;
• Sudden confusionhaving trouble speaking or having difficulty understanding speech;
• Sudden vision problems in one or both eyes;
• Sudden trouble walking, dizziness, loss of balance or lack of coordination;
• Sudden Strong headache for no known reason.

Call 112 now if you or anyone else has any of these symptoms.

The consequences of a stroke

The brain is an extremely complex organ that controls various functions of the body. If a stroke occurs and blood flow cannot reach an area that controls a certain function of the body, that part of the body will not work as it should.

For example, if a stroke occurs towards the back of the brain, it is likely to result in some disability related to vision. The consequences of a stroke depend primarily on the site of obstruction and the degree of damage to the brain tissue.

The consequences of a stroke depend on several factors, including the location of the obstruction and the extent of the damage to the brain tissue. However, since one side of the brain controls the opposite side of the body, a shock affecting one side will lead to neurological complications on the side of the body it affects.

Complications

After a stroke, symptoms usually stabilize and often improve. However, new symptoms may develop, such as epilepsy, spasticity, muscular atrophy, depression and trouble swallowing.

The long-term effects of a stroke may include the following, some of which are a continuation of the very symptoms that have been present since the onset:

• weakness on one side of the body;
• weakness on one side of the face;
• drooping eyelid;
• loss of vision or partial loss of vision;
• double vision or haze;
• slurred speech;
• trouble understanding words or language problems;
• balance and coordination problems;
• loss of sensation on one side of the body or face;
• lack of awareness of your environment or your own body;
• difficulty in solving problems;
• dizziness, headaches;
• urinary incontinence.

Recovery from illness can take time. Before any irreparable damage can be assessed, the brain needs time to heal. Many stroke patients undergo physical or occupational therapy to regain skills lost as a result of the illness.

Diagnostics

Although the severity of a stroke can vary, it is one of the leading causes of death and disability. Prompt diagnosis and treatment is the best way to prevent consequences and reduce disability for most survivors of the disease.

The disease is usually confirmed on the basis of studies such as CT scan (CT) or Magnetic resonance imaging (MRI) of the brain. Other examinations such as blood test, electrocardiogram (ECG), ultrasound of the carotid artery, CT or MRI angiography of the arteries in the neck and head are often done to find out what caused the stroke.

Stroke treatment

Stroke treatment is all about stopping potential problems that a stroke can cause before damage is done. Depending on the type of stroke, it can be used to improve blood flow to the brain. blood thinnersuch as tissue plasminogen activator (TAP). Doctors will also use medications and fluids, depending on the situation, to control blood pressure, electrolytes and other substances that, if not maintained, can worsen situation. In certain cases, surgery may be required to improve recovery potential.

The key to treating a stroke is as early as possible, right after the onset of symptoms. Only highly qualified emergency medical teams can prescribe treatment for the subtle signs and variations of the disease.

If you are sure that a stroke has occurred, or simply suspect that it is possible, call an ambulance immediately.

Prescriptions

Blood thinners are prescribed while the stroke is still ongoing. When it becomes clear that a blood vessel is partially or completely closed, these drugs can help prevent progression stroke by allowing some blood to flow, which is critical to preventing or minimizing head injury brain.

One of the main problems of acute stroke is quickly determining whether the disease is hemorrhagic or ischemic. As a blood thinner should never be used in the first case. Doctors during therapy quickly spot any bleeding in the brain before deciding whether a patient is a candidate for any of the following blood thinners.

Blood thinners should be prescribed by a qualified medical team as potential side effects include bleeding in the brain, gastrointestinal system, or other parts body. Careful administration is also important to prevent an ischemic stroke from becoming hemorrhagic.

Tissue plasminogen activator (TAP)

Tissue plasminogen activator (TAP) is a powerful blood thinner that is given intravenously for some cases of acute progressive stroke. The drug is called Aktilize (alteplase).

TAP has been shown to partially or completely prevent permanent damage from stroke in in some situations, allowing blood to flow through a blocked artery and thus preventing ischemia.

TAP can only be prescribed by a well-trained medical team during the first few hours after the onset of a stroke. In particular, intravenous TAP has been shown to be the most beneficial when administered within the first three hours after the onset of the first symptoms of a stroke. However, some studies have shown that the drug can even help when used for four and a half hours after the onset of symptoms.

Since Actilize must be administered almost immediately after arriving at the emergency room, there is no time to ponder a decision. Emergency drug therapy decisions are made according to established protocols for maximum safety and efficacy.

Intra-arterial thrombolysis.

TAP can also be injected directly into the artery where the blockage has occurred. This is done by placing a catheter directly into a cerebral blood vessel in a procedure called a cerebral angiogram. The use of intra-arterial TAP is an interventional procedure that is not as widely available as intravenous TAP because it requires physicians with experience in this type of therapy.

Intra-arterial thrombolysis is a procedure for which, like intravenous TAP, there are strict criteria for patient safety.

Heparin

Heparin is a medication that is given intravenously. IV heparin can be used if an acute stroke has occurred and the following specific conditions are met:

• the blockage is recent;
• you have symptoms of a stroke (new attack);
• cerebral hemorrhage is excluded.

Heparin is not recommended if there is a risk of gastrointestinal bleeding or bleeding due to a surgical or traumatic wound.

Heparin is sometimes used to treat acute stroke, but it is more commonly used in transient ischemic attacks.

Aspirin

Aspirin is primarily used to prevent stroke because it is not considered powerful enough to dissolve a blood clot or prevent a growing blood clot from growing. However, aspirin is very often prescribed within the first 48 hours after the onset of an ischemic stroke to prevent further events.

Systemic treatment

One of the most important aspects of stroke treatment is to maintain the best possible physical condition during the hours and days after the stroke to give the brain the best chance of recovery. Certain parameters have been set in relation to blood pressure, blood glucose levels and several other measures to maintain the best possible physiological environment.

Blood pressure

Blood pressure management is surprisingly one of the most important, challenging and controversial physical measures after stroke. Doctors will pay close attention to blood pressure, using medications to keep it at a level that is neither too high nor too low; both of these conditions are dangerous.

However, since blood pressure naturally fluctuates during the week following a stroke, the medical team will also closely monitor the relationship between neurological condition and blood pressure as a definition and management of normal blood pressure in the days ahead.

Blood glucose

Blood sugar levels can become unstable in response to an acute stroke. In addition to this problem, you are unlikely to feel hungry.

High or low blood sugar levels can interfere with recovery. This is why doctors will pay constant attention to stabilizing blood sugar levels during this time.

Fluid management

After a stroke, cerebral edema may occur. This type of edema interferes with healing and can even cause further brain damage due to compression of vital areas of the brain.

If you have had a recent stroke, you will probably need an intravenous fluid. IV fluid after stroke is usually given more slowly and in a smaller volume than conventional intravenous hydration in a hospital setting, especially to prevent edema.

If the swelling progresses quickly, it can be reduced with medication. In cases of severe and dangerous swelling, surgery may be required to relieve the pressure.

Electrolyte control

Hydration in the face of a problem such as a stroke consists of water fortified with important electrolytes such as sodium, potassium and calcium. The concentration of these electrolytes must be carefully monitored to maintain the proper concentration of water and electrolytes in the brain to prevent edema.

Nerves that require the right amount of electrolytes control brain function. Thus, after a stroke, the concentration and amount of electrolytes is even more important than usual, since brain function and healing are in a delicate state of balance.

Surgical procedures

While this is not the most common approach to stroke management, if you have a major stroke with significant swelling, surgery may be required to maximize stroke recovery.

Removal of fragments of skull bones

Sometimes, when swelling from a stroke becomes severe and cannot be controlled by clinical measures, temporary removal of a portion the bones of the skull prevents the compression of vital areas of the brain, so that the swelling does not cause irreversible damage.

Procedures called craniectomy or hemicraniectomyinclude the temporary removal of a portion of the skull until the swelling subsides. The piece is retained and then returned to its original position for a short period of time to protect the skull.

Rehabilitation after a stroke

After a stroke, most patients undergo physical, occupational and other methods treatment to help restore function and teach adaptive strategies for performing daily action.

Stroke rehabilitation is based on a number of approaches, including physical and cognitive techniques, designed to stimulate stroke recovery.

Rehabilitation usually begins in the hospital after the condition has stabilized. Depending on the severity of the stroke, patients may be discharged from the hospital to a subacute treatment facility, an inpatient rehabilitation center, home or outpatient treatment.

Rehabilitation therapy is the best and most reliable method to promote healing and recovery from a stroke.

Physiotherapy

Muscle weakness and difficulty walking and other movements may be frequent after illness. Physical therapy addresses movement and balance problems and includes specific exercises to strengthen muscles when walking, standing, and other activities.

Occupational therapy

A stroke can affect your ability to take care of yourself and do daily activities such as dressing, hygiene, writing, and housework. Occupational therapy helps with strategies for managing these tasks.

Speech therapy classes

Some people have difficulty speaking or swallowing after a stroke, and a speech therapist can help. Speech therapy helps improve communication, including speaking, reading and writing after a stroke, and also eliminates problems with swallowing and feeding.

Prophylaxis

Looking at the data from the statistics department, you can understand that preventive methods are very important. After all, mortality from a stroke, or rather from its acute period, is equal to 25%, for a year this indicator can rise to 35%, speaking in another indicator, then mortality threatens every second patient to the patient.

It is important for everyone who has had this disease to regularly come to prophylaxis, since such people have a very high risk of catching a second stroke. A cerebral stroke is not only a disease of aged people, it can befall anyone. Statistics show that more and more cases of strokes are observed among the healthy, able-bodied population under the age of 45. When divided by gender, the rate of occurrence of the disease in men at this age is higher than in women.

Having looked at the list of factors provoking the disease, then everyone can find one such factor. Some "lucky ones" may even have several reasons. What to do in this case? It is very important not to start to panic. The main thing is to weigh everything with a cool head. You need to sit down and think about your lifestyle, habits, and taking care of your body. The best option would be to refuse or at least minimize the abuse of bad habits:

• to give up smoking;
• start playing sports;
• do not eat too much;
• do not drink strong alcoholic beverages;
• from time to time monitor the level of blood pressure, as well as the content blood glucose and an indicator of cholesterol.

All this is not just a waste of time, it is, first of all, taking care of your health and life in general. Wasted time will not be ineffectual. The result will be a strong and healthy future. There is no need to try to radically change everything at once; you need to go towards the goal smoothly and gradually.

Stroke prognosis

The forecast depends on type of stroke, the degree and duration of the obstruction or hemorrhage, as well as the degree of brain tissue death. Immediate treatment can help improve the prognosis in many cases. Most patients who have had the disease experience permanent disability, which can interfere with walking, speaking, vision, understanding, reasoning, or memory.

Approximately 70 percent of patients with ischemic stroke can regain their independence, and 10 percent recover almost completely. Approximately 25 percent of patients die as a result of the disease. The location of hemorrhagic stroke is an important factor in the outcome, and this type usually has a worse prognosis than ischemic stroke.