Disorders of arterial circulation of the brain: forms, signs, treatment. Ischemic stroke, its symptoms and treatment Clinical symptoms of stroke

02.01.202427.05.2017

Ischemic stroke is a severe disorder of cerebral circulation (also called stroke). Its consequences can be very severe, depending on how much time has passed since the onset of the attack and what area was affected. A stroke localized in the right hemisphere (right hemisphere) is often accompanied by the loss of some cognitive functions, as well as motor disorders. These disorders can be so large-scale that the phenomenon of hemiparesis develops - partial paralysis or weakening of muscle tone on one side of the body. Movements are difficult and sluggish.

Areas of specialization of the cerebral hemispheres

What can be the consequences of a right hemisphere stroke with hemiparesis of the left side and how long do they live with it? Is there a treatment to restore mobility?

Symptoms

Ischemic stroke of the right hemisphere is characterized by a gradual worsening of negative symptoms. This is its difference from a hemorrhagic stroke, which begins with an acute attack. As pain and dizziness intensify, disturbances of consciousness develop - hallucinations appear, space begins to “float”, the perception of time and one’s own personality disintegrates.

Other signs that a person has an ischemic stroke of the right hemisphere with hemiparesis of the left side:

numbness of the left half of the body;
paresis, decreased muscle tone on the left side of the body;
the severity of symptoms depends on how much time has passed since the onset of stroke;
the left hand does not rise up;
the sense of time and space is lost, everything around stretches to infinity;
it is not possible to complete the thought - the patient cannot dial the phone number, as he forgets it every second;
hallucinatory states, visions, changes in the perception of volume and color;
short-term memory is impaired, and new impressions obtained through sensory perception are not recorded in long-term memory;
headache on the right side, heaviness, as if after a blow;
nausea leading to vomiting.

During a stroke, motor activity is always impaired on the side opposite to the affected area: a stroke of the right hemisphere leads to hemiparesis of the left side, and a stroke of the left hemisphere leads to paresis of the right.

This occurs due to the location of nerve cells and pathways responsible for movement functions. The consequences of their defeat are “mirrored” paresis. So, if after a stroke your left hand moves poorly, we can assume that the right hemisphere was affected.

Complications after illness

Left-sided hemiparesis after stroke

Ischemic stroke is dangerous not only because of the threat to life, but also because of the consequences that arise after the attack is stopped. Nervous tissue recovers slowly and is easily destroyed. Disruption of blood supply leads to the death of many cells, which is why the usual pathways of brain signals are disrupted. Until these pathways are restored by neighboring cells, and according to some neurogenesis scientists, the effectiveness of certain cognitive tasks will be reduced. One of the worst consequences is dementia.

In addition, hemiparesis on the left side of the body can persist for a long time or permanently. The process of restoring movement functions is very long; the patient is required to take measures aimed at returning range of motion. Ischemic stroke sometimes leads to the development of epilepsy. The degree of pathophysiological disorders depends on the massiveness of the lesion, sometimes the consequences are irreversible.

Some people experience changes in the emotional sphere - their personality undergoes changes. The sense of tact and the ability to empathize are lost, and emotional involvement decreases. The sense of humor may also disappear - the former cheerful person suddenly becomes a bore. Any damage to the brain is not only damage to the body, but also serious consequences for the individual.

Other severe consequences of ischemic stroke in the right hemisphere: impaired consciousness, complete immobility, severe mental disorders.

The worst thing is a relapse of the attack. It has been statistically established that after suffering an ischemic stroke, 50% of patients expect a second relapse over the next few years. However, compliance with all precautions, diet, medical procedures and patient care is the key to a relatively complete recovery and life for many years.

Disease therapy, recovery

Stroke therapy should be early, comprehensive and comprehensive

Ischemic stroke of the right hemisphere requires high-quality treatment in a hospital. You can prevent a recurrent attack and stop the consequences of the disease by providing a restorative effect on the nervous tissue and blood vessels. An important place is occupied by the lifestyle and diet; comprehensive treatment also includes a consultation with a psychotherapist - after suffering ischemia, patients are prone to depression. Supporting their psychological state is important so that patients regain the motivation to live.

Other ways to eliminate the consequences of a stroke with hemiparesis:

the use of aspirin to thin the blood (Thrombo ACC - the drug is surrounded by a special impermeable shell, therefore it does not harm the stomach, dissolving only in the intestines, it is excluded in the presence of gastroenterological diseases, gastritis, ulcers);
use of medications such as Actovegin, Berlition;
drugs that dissolve blood clots;
increase the consumption of pears, coffee (reduces cholesterol levels in the blood), fish (containing unsaturated fatty acids) - use only as prescribed by a doctor, since in case of a stroke with high blood pressure, coffee is strictly prohibited;
exclude alcohol, fatty foods;
move more, but do not push yourself to the point of overexertion.

The duration of recovery after stroke depends on the type of stroke and the severity of the patient’s condition

In order for the consequences of left-sided hemiparesis to disappear, a massage is performed on the left side of the body; the patient must regularly perform exercises from a complex of therapeutic gymnastics. This will restore muscle tone and force the nerves to conduct signals to the brain again. Physiotherapy is used - exposure to laser, current to restore neuromuscular conductivity. Supported by medications, these measures can help patients get back on their feet, learn to smile, and take care of themselves.

Treatment of a stroke is not a matter of one month. A relapse is possible even after a year of remission, so from now on you will always have to maintain a healthy lifestyle. The long recovery period after discharge from the hospital can be whiled away in a sanatorium, where the patient will be provided with full care.

ACVA of ischemic type.

Many people ask the question of what an acute stroke is and what consequences there are after it. This article will examine the main causes of stroke and consequences.

ONMK - what is it?

Many people who have nothing to do with medicine probably do not know what stroke is. So, an acute circulatory disorder in the brain is a stroke, which causes damage and death of brain cells. The cause of this disease is the formation of a blood clot in the blood vessels of the brain or the rupture of some blood vessels, which causes the death of a huge number of nerve cells and blood cells. According to statistics, acute stroke ranks first among diseases that cause human death. Every year around the world, as the federal register of patients with acute stroke indicates, 14 percent of people die from this disease, as well as 16 from other types of diseases of the circulatory system.

Reasons why stroke may occur.

In order to prevent the occurrence of this disease, it is necessary to pay attention to your lifestyle from an early age. For example, constant exercise can significantly reduce the possibility of developing stroke. You already know what it is; some of the causes of this disease will be discussed further.

As a rule, this disease does not come suddenly; very often the diagnosis of stroke can be established as a consequence of certain diseases.

Often the cause of this condition can be:

hypertension;
obesity;
diabetes;
high cholesterol;
heart disease;
alcohol and smoking;
various types of medicines;
high hemoglobin level;
age;
traumatic brain injury;
genetic predisposition and so on.

Now it’s clear what ONMC is. These are the consequences of an incorrect lifestyle. Therefore, it is very important to monitor your health and physical condition

Ischemic stroke

Ischemic stroke is a stroke caused by damage to brain tissue and disruption of blood flow to one or another part of it.

Most patients with stroke of ischemic type have common diseases of the cardiovascular system. Such diseases also include arteriosclerosis, heart disease (arrhythmia, rheumatic disease), and diabetes. This type of stroke is characterized by sharp and frequent manifestations of pain, the consequence of which is a deterioration of blood circulation in the cerebral cortex. As a rule, such attacks can occur several times an hour and last for 24 hours.

Causes of ischemic stroke ACVA

The main reason for the manifestation of ischemic stroke is a decrease in blood flow to the brain. Very often, this is why the cause of death of a person is ischemic stroke. So, we found out the features of ischemic stroke, what it is and what its symptoms are.

This is usually the result of damage to the vessels of the neck and some arteries of the brain in the form of occlusive lesions and stenosis. Let's find out the main reasons for its occurrence.

The main factors that can affect the decrease in blood flow include the following:

Occlusions and stenoses of the main arteries of the brain and vessels of the neck.
Thrombotic layers on the surface of an atherosclerotic plaque.
Cardiogenic embolism, which occurs when there are artificial valves in a person’s heart.
Dissection of the main arteries of the cervical spine.
Hyalinosis of small arteries, as a result of which microangiopathy develops, which leads to the formation of lacunar infarction of the human brain.
Hemorheological changes in blood composition, which occurs with vasculitis, as well as coagulopathies.

Very rarely, the cause of this disease can be external injuries to the carotid arteries and various inflammatory processes, which can significantly impair the flow of blood through the vessels. Also, very often, the main cause of stroke in the brain can be osteochondrosis of the cervical spine, during which blood vessels are significantly pinched, which can lead to a decrease in blood flow. Patients with osteochondrosis are constantly recommended to massage the cervical spine and smear it with various warming preparations, which can significantly dilate blood vessels and improve blood circulation.

Symptoms of stroke

Signs of this disease can often appear abruptly or increase gradually. As a rule, the main symptoms of this disease include speech and vision disorders in the patient, disturbances in various reflexes, movement coordination, headaches, disorientation, sleep disturbance, noise in the head, memory impairment, paralysis of the face, tongue, lack of sensation in some limbs, etc. further.

In acute cerebrovascular accident, the following consequences occur - cerebral stroke, circulatory disturbance in the cerebral cortex due to the formation of blood clots in the vessels and main blood arteries of the head, etc.

When symptoms of acute cerebrovascular accident last more than a day, a stroke is diagnosed. In the first stage of this disease, severe headache, dizziness, nausea, gag reflexes, and so on may also occur. If you do not immediately pay attention to these manifestations, this can cause a person’s death.

According to the register of patients with stroke, according to statistics, the main cause of these manifestations may be high blood pressure, which can be observed during severe physical exertion. A sharp increase in blood pressure can cause rupture of cerebral vessels, followed by hemorrhage and intracerebral hematoma.

In most cases, the above symptoms are observed before ischemia. Typically, they can last several hours or several minutes. As a rule, with the manifestation of ischemic stroke, the symptoms constantly become more active. According to experts, when these symptoms appear, most people experience disorientation, as a result of which the person loses vigilance, coordination of movements worsens, so many patients simply fall asleep. According to statistics, 75 percent of ischemic heart attacks occur during sleep.

Diagnosis of acute cerebrovascular accident of ischemic type

To identify the problem, it is necessary to conduct diagnostics and various studies using the ICD system. Doctors will be able to diagnose stroke after the following procedures:

Blood test for electrolytes, glucose, hemostasis, lipid spectrum, antiphospholipid antibodies.
Electrocardiography of changes in blood pressure.
Computed tomography of the cerebral cortex, as a result of which it will be possible to detect the affected parts of the brain and the resulting hematomas without any problems.
Cerebral angiography and so on.

Treatment of acute cerebrovascular accident in ischemic type.

The most common cause of death is stroke. Treatment should therefore take place under the supervision of experienced doctors. For this disease, the following therapy is carried out:

Maintaining vital functions of the human body. The patient should take antihypertensive drugs when the blood pressure in the body is 200 to 120 mm. rt. Art. The use of anticoagulants (used for concomitant pathologies and used for a long time after normalization of the condition), vasoactive drugs, antiplatelet agents, decongestants, neuroprotectors, and so on is also prescribed.
Various sets of exercises are performed - speech therapy classes and breathing exercises.
The issue of thrombolysis is being considered when a patient is admitted to a medical facility within 3-6 hours from the onset of the disease.
Secondary prevention of disease.
Various rehabilitation measures are carried out and so on.

As a rule, the main points of treatment will be prescribed only by a doctor, who will become more familiar with the victim’s illness.

If there is a suspicion of acute cerebrovascular accident, it is necessary to contact highly qualified specialists in this field of activity. As a rule, first of all it will be necessary to undergo magnetic resonance imaging, which can accurately determine all pathologies of the cerebral cortex. In this way, it will be possible to prevent the possibility of complications of the disease and begin treatment even before it fully manifests itself. A specialized department of acute stroke, as a rule, must have special equipment that will significantly improve treatment.

First aid for stroke

The very first thing to do when you notice symptoms of this disease is to call an ambulance. During the manifestation of symptoms of this disease, a patient should in no case be disturbed without reason, therefore, immediately after the first signs it is necessary to isolate him.

At the next stage, all patients with stroke should lie in such a way that the upper body and head are raised, it is also necessary to rub the collar area of the body in order to make breathing easier for the patient. It is also necessary to provide fresh air access to the room where the patient is located (open the window, doors, and so on).

If the patient experiences vomiting, it is necessary to turn his head to the left side and clean the mouth with gauze or just a clean napkin. This is done to prevent the possibility of vomit entering the lungs when breathing, which can lead to additional problems.

One of the most common symptoms of stroke is an epileptic seizure - a person completely loses consciousness, after a few seconds a wave of convulsions sweeps through the body, which can last for several minutes. It is also worth noting that such attacks can be repeated several times.

How to prevent the occurrence of stroke diseases

Based on the above statistics, it is clear that this disease manifests itself even in children. It is easy to guess that every year there are more and more people who suffer from this disease. All this is associated with poor diet, inactive lifestyle and high mental stress.

If a person does not lead an active lifestyle and constantly spends time at the computer, he has a high chance of contracting this disease. Obesity, as stated, is the main cause of this disease, which is why the issue of maintaining physical fitness is very relevant today for the younger generation.

Sudden loads also very often become a source of problems, since with an increase in blood pressure there is a risk of rupture of blood arteries and veins, which will also lead to stroke. Therefore, it is necessary to constantly exercise, lead an active lifestyle, eat right - and the risk of stroke will significantly decrease.

The most deadly and terrible disease in our time is stroke. You already know what it is and why this disease occurs, so you must adhere to the above recommendations in order to prevent the disease in the future.

Content

Cerebral infarction or ischemic stroke is a dangerous disease with a very high mortality rate. It is very important to find the right approach to its treatment, because this is the only way to save the patient’s life. It is worth talking in more detail about the features of the treatment of this pathology.

Acute ischemic cerebrovascular accident

During a stroke, neurons in a specific area of the brain are damaged and die. An ischemic stroke causes neurological disorders that do not disappear after a day. A person can paralyze one half of the body, and speech is severely impaired. He may partially or completely lose his vision. This happens if the arteries supplying blood to the brain stop functioning due to a blood clot or ruptured blood vessel. Without receiving it, the organ tissues begin to die.

When a person develops an ischemic stroke, their life changes dramatically. He becomes less active and acts lost. Possible facial distortion. If you ask the patient to smile, then instead of a proper smile there will be only a specific twisted grimace. Motor functions are impaired, and it is difficult for the patient to navigate in space. It is difficult for a person to answer the most ordinary questions. His limbs stop obeying him.

Acute cerebrovascular accident can occur for many reasons, but all of them in one way or another lead to the development of heart and vascular diseases. Stroke symptoms appear periodically throughout the day. This often happens at night. Stroke is one of the main reasons that young able-bodied people become disabled. The degree to which a person can get rid of the neurological disorders described above depends on how quickly the disease is identified and the correct treatment tactics are chosen.

Basic therapy for stroke

It got its name because it applies to all types of acute cerebrovascular accidents. Basic treatment is aimed at maintaining the patient's life chances until the type of stroke is determined, and begins immediately after the patient enters the hospital. After this, when the nature of the disease is established, differentiated therapy is carried out. Basic treatment is a set of specialized measures, the main goals of which are the following:

normalize respiratory function;
stabilize the functioning of the heart and blood vessels (it is very important to reduce blood pressure with sodium solution and other drugs);
maintain water balance;
protect brain cells from damage;
prevent or eliminate swelling of brain tissue;
prevent pneumonia;
apply symptomatic treatment.

Thrombolytic therapy for stroke

Its second name is thrombolysis. Currently, this is the only truly effective method of bringing a person back to life after a stroke. Thrombolytic treatment is aimed at restoring blood flow in a vessel that has been damaged due to a blood clot or atherosclerotic plaque in the acute period. This allows you to protect brain tissue from destruction and increase the chances of a favorable outcome. With thrombolysis, neurological pathologies disappear quickly and almost completely.

Thrombolytic treatment of ischemic stroke in the acute period involves the administration of drugs that dissolve blood clots, thereby restoring blood flow. Therapy is suitable only for this type of acute cerebrovascular accident. The procedure is effective only when 6 hours have not passed since the formation of the blood clot. There are two types of thrombolysis:

Standard. An outdated system in which the patient was simply given an intravenous drip with pharmacological drugs. It was carried out only after a long, detailed examination and had many contraindications and consequences.
Selective. The drug for dissolving the blood clot is injected specifically into the canal of the damaged artery, and not just into the vein, due to which it works faster and more accurately.

Thrombolytic treatment of ischemic stroke in the acute period is strictly prohibited when:

bleeding of any origin;
aortic dissection;
arterial hypertension;
liver diseases;
recent surgery;
acute renal failure;
pregnancy.

Thrombolytic treatment of stroke is carried out with the following drugs:

Streptokinase, Urokinase (1st generation);
Alteplase, Prourokinase (2nd generation);
Tenecteplase, Reteplase (3rd generation).

Medicines to improve brain circulation

Ischemic stroke of the brain is treated with the following medications:

Piracetam. Prescribed under almost any conditions, it increases cerebral blood flow.
Aminalon. A medicine for normalizing blood microcirculation in the brain and inhibiting neurological pathologies. It will help you get out of the acute period faster.
Phenotropil. Increases blood flow, helps improve memory and concentration.
Vinpocetine. Vasoactive drug to improve blood circulation.
Phenibut. A drug to stimulate brain activity.
Glycine. It not only improves blood circulation in the brain, but also helps to quickly end the acute period and helps fight depression.
Vaso collected. Effectively improves blood circulation.
Cerebrolysin. A very good drug for extensive stroke, which is administered intravenously.
Cortexin. Helps in the treatment of ischemic stroke in the acute period, as well as at the stage of early stabilization, when therapeutic massage is prescribed.
Pentoxifylline.
Instenon. Improves cerebral circulation.
Gliatilin. Stroke medication is prescribed in the acute period. If the patient is in a coma in the intensive care unit, then the drug must be prescribed.
Calcium blockers.

Antiplatelet drugs for stroke

These drugs trigger the blood clotting process. The most famous among them, used in the treatment of ischemic stroke in the acute period, are Aspirin, Dipyridamole, Sulfinpyrazone, Ticlopidine. All of these medications are recommended for the prevention of recurrent acute cerebrovascular accident. It is worth noting that the advisability of using antiplatelet agents for stroke is still questionable in medicine. The drugs are used according to the following principles:

Aspirin. Depending on the situation, 30 to 325 mg per day is prescribed.
Dipyridamole. 0.5 g three times a day.
Sulfinpyrazone.
Ticlopidine. 2.5 g three times a day.

Antiplatelet drugs have side effects, so before treating a stroke, you need to consult a doctor, weigh all the risks and act only under the supervision of specialists. Among the undesirable actions are the following:

Aspirin causes gastrointestinal problems.
Taking dipyridamole can cause headache, nausea, weakness, and rash, but side effects are very rare.
Sulfinpyrazone leads to various complications. As a result of taking it, gastritis and kidney stones may appear. Rash and anemia are common.
Ticlopidine may cause bowel problems.

Blood clotting drugs

The second name is anticoagulants. As a rule, stroke in the acute period is treated with Nadroparin, Heparin, Enoxaparin, Dalteparin, Fraxiparin. The action of the drugs is aimed at preventing the growth of blood clots and preventing neurological pathologies from progressing. Anti-clotting drugs are also prescribed to prevent recurrent strokes. They have a number of contraindications, so they are always prescribed with caution. It is important to understand that these medications do not help reduce blood clots, but simply prevent them from growing.

Heparin is a direct-acting blood clotting blocker that is prescribed first. It is injected into a vein several times a day. Injections under the skin or into the muscle are also acceptable, but they are not nearly as effective. Along with it, and also at the rehabilitation stage, it is necessary to take indirect anticoagulants: Dicumarin, Pelentan, Sinkumar, Phenilin. All of them are available in tablets. The dosage is calculated separately for each patient. The period of admission can be up to several years.

Video

Found an error in the text?
Select it, press Ctrl + Enter and we will fix everything!

Acute cerebrovascular accident (ACVA) of the ischemic type in the middle cerebral artery basin (I65) is a sharply occurring focal neurological and/or cerebral symptomatology caused by focal ischemic disorders in the brain, lasting longer than 24 hours.

Prevalence of strokes: 1-4 cases per 1000 people per year. Ischemic stroke accounts for 70-85% of cases.

Risk factors: hypertension, lipid metabolism disorders, smoking, increased body weight, diabetes mellitus, alcohol abuse, sedentary lifestyle.

Acute cerebrovascular accident occurs as a result of atherosclerotic damage to the vessels of the head, cardiogenic embolism in heart disease, increased blood clotting, etc.

Symptoms of acute cerebrovascular accident

Before the onset of stroke, precursors may appear in the form of short-term neurological disorders. In 75% of cases, an ischemic episode occurs during sleep. Symptoms appear over several minutes or hours and may gradually increase. An increase in blood pressure is typical on the first day of the disease. Patients are concerned about the following complaints: headache (90%), weakness (75%) and/or numbness (70%) in one half of the body/limbs, decreased vision (30%), speech impairment (45%). 15% of patients may deny the presence of weakness/numbness in the limbs.

A neurological examination reveals a general cerebral syndrome, contralateral hemiplegia, hemianesthesia, homonymous hemianopsia, adversion of the head and concomitant deviation of the eyes, central paralysis of the face, tongue on the contralateral half of the lesion, motor-sensory aphasia, alexia, acalculia. Anosognosia, a disorder of the body diagram, is determined by damage to the non-dominant hemisphere.

Diagnosis of acute cerebrovascular accident

To identify the etiology of stroke of ischemic type, the following diagnostic methods are necessary:

Blood tests (electrolytes, hemostasis indicators, glucose, lipid spectrum, antiphospholipid antibodies).
Electrocardiography, blood pressure measurement.
Auscultation of vessels on the extremities, duplex scanning, transcranial Dopplerography of precerebral arteries.

Computed tomography (CT) of the brain shows a hypodense zone 12-24 hours after the development of an ischemic stroke. SPECT (in earlier stages of cerebral ischemia).

Cerebral angiography (stenosis, occlusion, ulceration, aneurysm).

Differential diagnosis:

Acute hypertensive encephalopathy.
Dysmetabolic or toxic encephalopathy.
Migraine stroke.
Traumatic brain injury.
The debut of multiple sclerosis.

Treatment of acute cerebrovascular accident

Maintaining vital functions of the body, antihypertensive drugs (at blood pressure 200/120 mm Hg), anticoagulants (the appropriateness of prescription is determined by the duration of the disease and concomitant pathology), antiplatelet agents, vasoactive drugs (Cavinton, Actovegin, Cinnarizine) , "Instenon"), neuroprotectors ("Cerebrolysin", "Ceraxon", "Piracetam", "Gliatilin", "Semax"), "Reopoliglyukin", "Trental", decongestants ("Lasix", "Mannitol").
Passive exercise therapy, breathing exercises, speech therapy classes.
Consider thrombolysis upon admission within 3-6 hours of illness.
Rehabilitation activities.
Secondary prevention.

Treatment is prescribed only after confirmation of the diagnosis by a medical specialist.

Essential drugs

There are contraindications. Specialist consultation is required.

(anticoagulant). Dosage regimen: IV or SC in the initial dose - IV (injection) 5000 IU, maintenance: continuous IV infusion - 1000-2000 IU/h (20000-40000 IU/day), pre-diluted in 1000 ml of isotonic NaCl solution; regular IV injections - 5000-10000 IU every 4-6 hours; s/c (deep) - 15,000-20,000 IU every 12 hours or 8,000-10,000 IU every 8 hours.
(diuretic). Dosage regimen: intramuscularly or intravenously (slow stream) 20-60 mg 1-2 times a day, if necessary, the dose can be increased to 120 mg. The drug is administered for 7-10 days or more, and then the drug is taken orally.
(nootropic drug). Dosage regimen: administered intramuscularly or intravenously, starting from 2.0-4.0 g/day, quickly increasing the dose to 4-6 g/day. After the condition improves, the dose is reduced and switched to oral administration - 1.2-1.6 g/day. (0.4 g 3-4 times a day).
(a drug that improves cerebral circulation). Dosage regimen: intravenously 20-25 mg in 500 ml infusion solution. Within 2-3 days, the dose can be increased to no more than 1 mg/kg/day. The average course duration is 10-14 days. After completing the course of intravenous therapy, it is recommended to continue treatment with Cavinton tablets, 2 tablets 3 times a day.
(vasodilator, improves microcirculation). Dosage regimen: two intravenous infusions per day (morning and afternoon), at a dose of 200 mg (2 amps of 5 ml) or 300 mg (3 amps of 5 ml) in 250 ml or 500 ml of 0.9% solution sodium chloride or Ringer's solution.

ACVA or acute cerebrovascular accidents are a group of clinical syndromes that are a consequence of impaired blood flow to the brain. The pathology can be caused by a blood clot formed in the blood vessels of the brain or damage to them, which leads to the death of a large number of blood and nerve cells. Highlight:

ACVA of ischemic type (ischemic stroke).
Stroke of hemorrhagic type (hemorrhagic stroke). This diagnosis is made when a cerebral hemorrhage is confirmed.

The above classification is very important for the correct choice of treatment method.

A stroke caused by damage to brain tissue and critical disruption of the blood supply to its areas (ischemia) is called ischemic stroke.

Show all

Reasons for the development of the disease

The main reason for the manifestation of pathology is a decrease in the amount of blood entering the brain. The following factors and diseases can lead to this:

Persistent increase in blood pressure.
Damage to the main arteries of the brain and vessels of the neck in the form of occlusion and stenosis.
Atherosclerotic changes.
Inflammation of the connective tissue membrane of the heart.
Inflammatory processes or injuries of the carotid arteries, which significantly reduce blood flow through the vessels.
Hemorheological changes in the cellular composition of the blood.
Cardiogenic embolism.
Changes in heart rate.
Myocardial infarction.
Various changes in the heart, as well as in the main arteries of the cervical spine (observed in 91% of patients).
Diabetes mellitus.
Immunopathological inflammation of blood vessels.
Pathological disturbance of blood vessel tone.
Thrombotic formations on the walls of blood vessels.
The presence of artificial valves in the heart.
Smoking.
Overweight.
Everyday stress.

At risk are the elderly (however, there are cases of the disease in children) and patients suffering from osteochondrosis of the cervical spine, since this leads to significant compression of the blood vessels.

Symptoms of pathology

The disease has a wide variety of symptoms. General symptoms of ischemic stroke include sudden headaches, deterioration in speech and vision, impaired reflexes and coordination, nausea, vomiting, dizziness and disorientation of the patient in space, pain in the eyeballs, paralysis of the face and limbs. Psychomotor agitation and short-term loss of consciousness and convulsions are also possible.

There are zonal signs of thrombolization of the cerebral arteries. Characterized by the following types of violations.

If the internal carotid artery is affected, the patient’s vision deteriorates (loss of visual fields occurs), skin sensitivity and speech are impaired, muscle paralysis and loss of orientation in his own body occur.

Impaired patency in the middle cerebral artery causes sensory disturbances in half of the body, the inability to focus on a specific object, loss of visual fields and loss of speech. The patient is unable to distinguish the right side from the left.

If disturbances occur in the posterior cerebral artery, the following may occur: blindness, seizures, complete or partial paralysis, breathing problems, large tremors and deterioration in swallowing function. In the worst case, a cerebral coma occurs.

When the anterior cerebral artery is damaged, unilateral loss of sensation and loss of speech are observed. The patient's movements slow down or there is no ability to walk or stand at all.

If the slightest symptoms of pathology are detected, it is necessary to carry out timely treatment of stroke.

Diagnostics

The purpose of diagnosis is to determine the necessary treatment method. It is very important to conduct an examination by a specialist in the first hour after the patient’s admission. The following procedures are followed:

Blood sampling to determine blood clotting: viscosity, hematocrit, fibrinogen, electrolytes and antiphospholipid antibodies.
CT and MRI. This is the most reliable method for detecting acute cerebrovascular accidents. It allows you to correctly determine the type of stroke, exclude tumors and aneurysms, determine the size and location of the lesion, and also diagnose vascular diseases.
Echoencephaloscopy. This technique is not very informative in the first hours of a stroke.
X-ray examination of cerebral vessels.
ECG changes in blood pressure.
Ultrasound of the brain. It is used if it is not possible to conduct computed tomography and magnetic resonance imaging.

Treatment of stroke of ischemic type

The main task is emergency and intensive treatment in the first minutes of the patient’s admission, since at this time the thrombolysis technique is effective. This will preserve the vitality of neurons near the necrosis zone, as well as weakened cells. Further, in the hospital, if the patient has a stroke, treatment is carried out in the following order:

1. A general complex is carried out to maintain the vital functions of the body.
2. If necessary, antihypertensive drugs, anticoagulants (if the patient has high blood pressure, ulcers, diabetes or bleeding), vasoactive and decongestant drugs, antiplatelet agents and others are prescribed.
3. To normalize breathing and saturate the lungs with oxygen, perform breathing exercises. In extreme cases, artificial ventilation is performed.
4. Restore blood circulation.
5. Using diuretics, they reduce swelling of the brain.
6. Antipsychotic drugs are prescribed to exclude the possibility of repeated convulsive seizures.
7. If the swallowing function of the body is impaired, the patient is prescribed a semi-liquid diet or undergoes parenteral therapy.

Consequences of the disease

Acute ischemic cerebrovascular accident can lead to the following complications:

paralysis or paresis of one side of the body;
disorders of pain sensitivity in any part of the body;
loss of taste, hearing, sudden blindness or double vision;
problems with speech (when speaking, it is difficult for the patient to select and pronounce words);
disorders of complex, purposeful movements (apraxia);
disorders of the body's swallowing function;
loss of visual fields;
spontaneous fainting;
involuntary urination.

It should be noted that with proper treatment and regular rehabilitation sessions, it is possible to completely eliminate the above complications, as well as complete restoration of the patient’s body. And after some time, a person can completely return to normal life.

First aid

If you have the slightest suspicion of stroke, you must immediately call an ambulance. At this time, the patient should not be disturbed for no reason (and it is best to isolate him) and put him in such a position that the upper body and head are elevated. Next, you need to allow the patient to breathe freely. To do this, you need to massage the neck-collar area and provide fresh air access to the room.

If a person experiences gag reflexes, turn their head to the side and clean the mouth with a napkin or gauze. This will eliminate the risk of vomit entering the respiratory tract.

Quite often, with stroke, an epileptic seizure occurs, which is accompanied by loss of consciousness and convulsions. In this case, the main thing is not to get confused. The patient must be positioned on his side and a pillow placed under his head. Next, you should place, for example, a pencil or pen in your mouth to prevent tongue biting. In no case should you restrict the patient’s movements (hold him by the arms and legs or press him with your body), as this will only increase cramps and the risk of a fracture or dislocation.

A common mistake is to use ammonia, which can lead to respiratory arrest. If a person has lost their heartbeat or breathing, direct cardiac massage and artificial respiration can help.