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The consequences of a stroke for health and life

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Stroke in men belongs to the category of serious and dangerous diseases requiring immediate qualified help to the patient and carrying out mandatory rehabilitation measures, consisting of restorative treatment aimed at preventing relapses and complications of this serious illness.

In Russia, about 400 thousand strokes are observed every year and this disease is second only to myocardial infarction in terms of the number of deaths.

Disagreeing statistics and disability patients after a large stroke - after an attack of out of 100 people, only 20 can return to their previous work , and the rest partially or completely become disabled and receive one of three groups of disabilities.

Scale of risk

The consequences of strokes of any severity and types are often associated with impaired motor functions and, unfortunately, this is far from all complications of this dangerous disease. .. That is why the treatment of such patients should be under the close attention of physicians of various specialties in the conditions of specialized sanatoriums and rehabilitationCenters. A complete return of the patient to the previous level of the functioning of the organism is not always possible. In patients with stroke, headaches, speech, memory, urination and defecation, vision, swallowing and sensitivity can be noted.

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Regardless of the severity of the consequences of a stroke, the patient has to deal with the need for outside help. As a result, his habitual way of life changes, and such changes, directed far from the best, influence not only his level of well-being, but also the lives of his relatives and relatives. In the vast majority of cases, the consequences after this disease are quite serious, because the brain suffers as a result of the pathological changes that have occurred.

The probability of eliminating the consequences of a stroke with the least loss in the first place depends on the area( see Figure 1), the extent of brain tissue damage and the timeliness of the patient's care. Important in the success of rehabilitation of the patient is his age and general health. Slower recovery of elderly patients, because their body is no longer so strong and young. However, at a young age, the scale of the consequences of stroke and the rate of recovery of the patient largely depend on the severity of the damage to the brain tissue and the location of their localization.

The consequences of stroke in men

Fig.1 - The consequences of stroke in men depend on the place of its occurrence in the brain.

According to statistics in Russia, only 20% of patients who have suffered a stroke, go to a specialized sanatorium or rehabilitation centers. The remaining 80% either receive treatment at home or do not undergo comprehensive rehabilitation programs at all.

The statistical data on the level of early 30-day lethality is also disappointing - it occurs in 43% of patients treated at home and 24% in treatment in specialized treatment centers.

Consequences of stroke

The most typical effects of strokes that accompany the patient for a long time and require comprehensive treatment and supervision are:

Movement disorders - paresis and paralysis. Observed most often and usually occur as unilateral hemiparesis. To restore the motor functions in most cases it takes from 3 to 6 months. More complex professional and household skills can be restored over longer periods.

The elimination of such consequences is achieved with the help of kinesitherapy, including exercise therapy and walking training, complementary massage, electro-stimulation techniques of the neuromuscular system and biofeedback methods with feedback( the use of auditory, visual, tactile and other stimuli signals reproduced by computer orMicroprocessor technology, to obtain information about changes in physiological processes).

Sensitivity disorders. Such consequences are often accompanied by motor disorders. The most significant role in restoring motor disorders is the elimination of pathological changes in the musculo-articular feeling. It occurs in about 1/3 of patients and greatly hinder the implementation of purposeful action, ie. To. Commit any purposeful movement requires constant monitoring, which in the disorder of muscle-joint senses becomes impossible. This consequence of stroke in men makes it much more difficult for many self-service and walking skills to be restored and makes it impossible to do finely directed activities.

The correction of sensitivity disorders is achieved with the help of special courses of exercise therapy and biofeedback techniques with feedback. Speech disorders - aphasia, dysarthria. Approximately one-third of patients are observed. Aphasia can be:

  • sensory( speech understanding is impaired);
  • motor( his own speech is broken);
  • amnestic( the patient forgets some words - the names of some actions or objects);
  • sensorimotor( disturbance and reproduction and understanding of speech);
  • total( complete lack of own speech and lack of understanding of the speech of others).

Speech violations are often accompanied by a violation of reading and / or writing. With dysarthria, the patient retains an understanding of the speech of others, they can read and write, but because of the defeat of the brain tissues, they have an upset articulation.

main way to restore speech become systematic and long sessions with a speech therapist, aphasiology aimed at the recovery of speech, writing and reading. They should begin as early as possible( already in the acute period of the disease) and be supplemented by the reception of nootropics( Enerbola, Nootropil).Recovery for speech disorders occurs in longer periods than the violation of motor functions, and takes years.

Changes in muscle tone. As a rule, such consequences of a stroke occur according to the spastic type. In some cases, the patient develops a hypotonic muscle( more often in the leg).Spastic muscle tension complicates motor disorders and may increase in the first months after a stroke.

To eliminate such violation patients were administered muscle relaxants( Liorezal, Sirdalud, baclofen, Mydocalm) and method of physical effects( special massage, acupuncture, passive gymnastics, special stacking limbs, paraffin, hydrotherapy, acupressure, application of mineral wax, cryotherapy).To eliminate muscular hypotension carried activating technique massage prozerinoterapiyu( subcutaneous administration of neostigmine with gradual dose escalation) and electrical stimulation.

Central pain syndrome. Expressed in the occurrence of pain of central origin, observed in 3% of patients. More often there is a presence of lesions in the zone of the visual tuber - thalamic syndrome. Usually it develops not immediately after the attack, but after a few months, and has a tendency to further intensify the pain syndrome. In the patient there are burning intense pains in the body and face with the opposite focus of the lesion side. They become stronger with changes in weather, pressure, touch or psycho-emotional overstrain. In patients with frequent pain, frequent mood swings occur, and astheno-depressive syndrome develops.

Antidepressants, Finlepsin and transcranial electrostimulation are prescribed for treatment.

trophic disorders( arthropathy of the joints, muscle atrophy, shoulder pain syndrome, bedsores). most common in patients after stroke, there is a painful shoulder syndrome, which is expressed arthropathy of the shoulder joint and the loss of the head of the shoulder joint under the weight of the affected arm paresis. The patient has pain that may occur in the first days after the attack. They are amplified by the withdrawal or displacement( anterior or posterior) of the arm.

For the treatment of this and other trophic disorders, specially developed programs are used that include the appointment of anabolic hormones and the carrying out of analgesic electroprocedures, vacuum massage, ozocerite or paraffin therapy, turbulent hydromassage and kinesitherapy. When the head of the humerus falls out, the patient is shown wearing a special fixative bandage and carrying out electrical stimulation of the muscles of the shoulder girdle and shoulder.

Visual disorders. Visual disorders occur when the visual analyzer and visual pathways in the occipital lobe of the brain are affected. They are expressed as a one-sided loss of the left( with lesions of the right hemisphere) or right( with lesions of the left hemisphere) fields of vision. In the presence of lesions in the hemispheres or brainstem, the patient develops paralysis of the eye, and if the upper trunk is damaged, double vision is observed. Bulk and pseudobulbar violations. Bulbar consequences of stroke in men are expressed in violations of swallowing, articulation of sounds, and pseudobulbarnye - in the appearance of spontaneous violent crying or laughing( i.e. crying and laughter appear for no reason and can not be suppressed by the will of the patient).

To eliminate bulbar disorders, electrostimulation of the muscles of the larynx, tongue and soft palate is used, and exercises prescribed by the speech therapist are performed. When expressed violation of swallowing, the patient is given a probe feeding. To eliminate violent crying or laughter, the administration of Clonazepam or Amantadine( Symmetrel, Madantan) is prescribed.

Disorders of higher mental functions. Stroke can lead to memory impairment, loss of intelligence and concentration of attention, emotional and volitional disorders, disorientation in space, violation of performance( in the absence of pareses) of complex movements, violation of gnosis( recognition, recognition and comparison of images) or ability to perform targetedMotor acts. Such patients are shown long-term courses of nootropics( EneBROL, Nootropil) and other neurotrophic drugs( Cerebrolysin, Pikamilon), the appointment of methods of kinesitherapy and psychotherapy. When asthenia and depression appear, antidepressant medication and psychotherapy are indicated.

Coordination and balance disorders. These effects occur in the defeat of the cerebellum and often make it difficult to restore walking and self-service skills.

To eliminate them, specially designed for each patient exercise programs and biofeedback methods are used.

Post-stroke epilepsy. This consequence of stroke develops in 6 months or 2 years after 6-8% of patients who underwent hemispheric stroke.

For the prevention and elimination of epileptics, such drugs as Finlepsin, Depakin and Phenobarbital are used.

When can I expect a positive result from ongoing rehabilitation treatment?

The acute period during a stroke lasts approximately 28 days. After this, the patient has to go through the period of early recovery, which is about 6 months. The period of full recovery after a stroke will take about 2-3 years( depending on the severity of the stroke), and the residual effects can be felt throughout the rest of life.

When is the most complete recovery possible after the disease?

  1. Recovery after a stroke is more rapid in young patients.
  2. The effectiveness of rehabilitation largely depends on the accuracy of diagnosis( CT, MRI), the completeness and correctness of first aid and early treatment, which should not only be timely, but also qualified and comprehensive.
  3. If the acute period of the disease was mild or moderate, then the recovery will be more complete.
  4. Stroke localized in the pool of vertebral arteries passes without residual focal consequences - the patient is dizzy, gait unsteadiness and speech disorders disappear.
  5. The organization of proper care for the patient and constant psychological support from relatives and friends at all stages of treatment and rehabilitation in many ways helps to reduce the risk of subsequent disability.

In many cases, recovery of speech and motor functions after an attack of a stroke is not so fast and the elimination of these consequences of stroke in men requires a persistent and long-term rehabilitation. It should include such directions:

  • the correct organization of care of the patient;
  • drug therapy;
  • diet therapy;
  • ergotherapy;
  • massage;
  • acupuncture;
  • chiropractic;
  • exercise therapy;
  • physiotherapy;
  • speech therapy;
  • training in household skills;
  • psychotherapy;
  • hirudotherapy, etc.

Comprehensive rehabilitation programs should be supplemented by frequent outdoor walks, careful attention from medical and attendants and constant care and support of the patient from relatives and friends. Such a comprehensive approach and joint efforts of rehabilitation specialists, doctors of polyclinics, social workers and close people help to make a fuller recovery and to avoid exacerbating the consequences that stroke has brought to the life of the patient. Remember this and be healthy!

Cardiologist Petrova Yu.

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