Stroke. Principles of treatment

Acute cerebrovascular accident is difficult problem modern neurology.

Despite the presence of a clear methodology for providing first aid and hospital measures, it is necessary to act as quickly as possible, which requires the doctor to react quickly and be highly qualified. The life of the patient, the probability of preserving neurological functions depends on this.

Treatment of a stroke consists in eliminating the provocative element, restoring minimal vital activity, and combating additional damaging factors (hematoma, blood clot, and others).

The first stage is strictly hospital, because it is impossible to cure such a condition at home. The duration is about a month, sometimes a little more.

The basis of therapy is medicines, drugs for blood thinning, lowering blood pressure. Operations are required as a last resort. This is not curation of the condition itself, but the elimination of its consequences.

Looking at the issue globally, treatment includes three aspects:

Providing first aid. From the moment the symptoms were discovered to the arrival of the doctors. Actions are aimed not so much at therapy as at stabilizing the condition of the victim so that it does not worsen and does not lead to complications or death.

Given the low awareness of the population in Russia and the countries of the former Soviet Union, it can be assumed that the bulk of complications and deplorable consequences occur precisely at this stage, which leads to generally negative forecasts and adverse outcomes.

As statistics show, this is true.

Primary hospital events. Treatment aimed at correcting vital signs and maintaining basic functions: respiration, cardiac activity, reflexes. This stage is urgent, does not tolerate delay.

The task of specialists is to distinguish between different types of strokes, as well as from other pathological processes.

There are many diseases that have similar clinical picture. This imposes a significant responsibility on the medical staff.

Further therapy, restoration of normal vital functions in the late hospital period. Supportive care. This is the recovery phase. It plays the greatest role in the prevention of relapses, as well as the restoration of the functions of the central nervous system.

All three tasks are being solved gradually. The first does not apply to specialists. Persons without medical education are strongly advised to familiarize themselves with the basic rules for providing urgent action in case of acute cerebral ischemia.

Starts immediately. The main thing that should be done by others or the victim himself is to call an ambulance.

On your own, it is impossible not only to cure a stroke, but even to determine an emergency.

Considering that experts are unable to diagnose cerebrovascular accident by eye, it becomes clear what are the chances for the same thing in a person without medical knowledge.

The fact is that in Russia and the countries of the former Soviet Union there is a high workload of ambulance crews. Therefore, the telephonist is forced to rank situations as they are urgent. If you hide any details, there is a possibility of a long wait for many hours.

Before the doctors arrive, the algorithm is as follows:

Sit down a person. The angle between the torso and lower back should be about 45 degrees. It is impossible to lay in any case, because there is a high probability of cerebral edema with all the ensuing consequences (the rapid development of a secondary emergency will lead to wedging of the brain stem into the posterior cranial foramen and the sudden death of the patient).
Open a window or vent for fresh air. This will ensure a better supply of cerebral structures with oxygen, which will reduce the risks of further progression of the death of nerve clusters.
Calm down the person. Negative emotions have physical manifestations. Stress hormones are released, brain vessels narrow, which leads to an increase in blood pressure, as well as further progression of the dystrophic process.
Unfasten your tie, loosen your shirt collar, remove tight body jewelry. Pressure on the carotid sinus, which is located in the area of the carotid artery, will lead to a reflex drop in pressure and heart rate. Under conditions of ischemia of cerebral structures, this will have a disastrous effect on the patient. Nutrition will weaken even more, which means that death from progressive respiratory or heart failure and other complications is not far off.
Do not try to ask the patient, talk to him. The person is in a serious condition, therefore it is necessary to ensure complete peace, silence.
Turn your head to the side first. A stroke is often accompanied by loss of consciousness, and then vomiting. Reflex nature, regardless of the fullness of the stomach. This will help to avoid aspiration: the entry of the contents of the digestive tract into the respiratory tract.
Lower your arms and legs. To avoid an increase in peripheral blood flow due to a weakening of the cerebral. Hemodynamics is unstable, so you need to move as little as possible.
It is recommended to regularly measure blood pressure and heart rate. Better every 10-20 minutes, fix the indicators. Then transfer to the doctors from the ambulance team so that they can evaluate the levels in dynamics. This will allow you to navigate the violation.

Upon the arrival of the doctors, you need to talk about the condition, briefly and to the point. If necessary, accompany the person to the hospital.

What do doctors do

As for professional first aid as part of transportation to the hospital. The patient is also seated with the head elevated and given oxygen inhalations to restore the normal supply of the cerebral tissues.

Upon arrival, the patient is placed in intensive care unit to correct the condition.

There is no fundamental difference in the order of first aid for ischemic and hemorrhagic stroke. With the difference that rupture of the vessel reduces the chances of success. Much less time.

Always proceed from the worst assumption.

Treatment of hemorrhagic stroke

The subsequent period is directly related to the type of acute cerebral circulation insufficiency.

The described condition is understood as a rupture of a vessel with an outpouring of blood into the surrounding space.

Classify the pathological process in different ways. The principles of primary therapy are approximately the same, differences are observed in the subsequent period.

The basis is the use of medicines:

Correctors of arterial pressure. Depending on the area of brain damage, the indicator may fall or rise above normal. In the first case, the use of tonic agents (Adrenaline, Epinephrine, Dopamine) is indicated. In the second drug antihypertensive properties (Captopril, Enap and others). The situation is assessed by the predominant symptom, which is why it is so important to control the level of blood pressure even at the stage of first aid.
Introduction of albumin proteins. It helps to reduce the area of brain damage, prevents the development of the expansion process, spread.
Antiarrhythmic. Only if subcortical structures are affected. Especially the brain stem. Usually limited to beta-blockers. What exactly is determined by the specialist.
Water-salt solutions. Classic sodium chloride is also suitable. To restore metabolism in cerebral structures.
Anticonvulsants. If there are tonic or tonic-clonic spasms, as part of an epileptic seizure or outside of it.
Means to combat vomiting. For example, Cerucal. According to indications.
Cerebroprotectors. Allow to protect the brain from the progression of the pathological process. Such names as Actovegin, Piracetam, Glycine (nootropic) and others are used, as prescribed by a neurologist.

This is enough at an early stage to correct the patient's condition.

If necessary, surgical treatment is carried out. This extreme case. Before resorting to such drastic measures, it is necessary to conduct a thorough diagnosis.

MRI and electroencephalography are usually sufficient. If there is a risk of neurological deficit, cerebral edema, compression of healthy tissues and other risk factors, surgical intervention is advisable.

It is carried out by classical access with trepanation of the skull.

Ischemic stroke treatment

It is considered a somewhat less dangerous type of pathological process, which is not always true. Depends on the extent.

Although, indeed, one of the factors of damage (a hematoma that compresses the tissues and can lead to their necrosis) is absent, which facilitates therapy. Treatment is strictly medical.

Several pharmaceutical groups are used:

Antithrombotic or antiplatelet agents. Prevent the formation of blood clots. In the course of development ischemic stroke clumped platelet cells do not occur, however, it is blood clots that can cause an emergency.

They do not always develop directly in the cerebral vessels. More often in the area of the lower extremities. Aspirin and other variations of acetylsalicylic acid are most actively used.

Attention:

It is important to clearly distinguish between different forms of cerebrovascular insufficiency. Because with hemorrhage, the use of such drugs is contraindicated.

Angioprotectors. Protect blood vessels from destruction and the influence of negative factors. Increase elasticity. This is the prevention of both re-ischemia and rupture of blood supply structures. The classic medicine of this group is Anavenol.
Treat stroke, continue with cerebrovascular agents. Some of them have already been named. These are Actovegin and Piracetam. In the form of intramuscular injections. They contribute to the normalization of brain nutrition, restore adequate trophism, which is important for correcting the condition.
Nootropics. They are also used almost immediately. Restore metabolic processes.

The same medications can be used during the rehabilitation period as part of the correction of cognitive functions, intelligence and memory. Glycine and other analogues.

Nootropics often provoke allergic reactions, therefore it is recommended to carefully monitor the condition and well-being.

Attention:

The use of funds is contraindicated in the presence of tumors of cerebral structures, because active growth of formations will begin.

Antihypertensive or drugs to increase blood pressure. Depending on the primary condition and its cause.

Thrombolytics are used immediately after admission to the hospital. They differ from antiplatelet agents in the purpose of use. If the latter are prescribed as part of prevention, the former dissolve existing blood clots.

Treatment for ischemic stroke is aimed at solving three problems:

relapse prevention. The probability of a repeated episode of cerebrovascular insufficiency in the first few days is more than 50%, then gradually decreases. The risk persists throughout the life of the patient, although to a small extent.
Resorption of a blood clot, removal of a cholesterol plaque. That is, the elimination of the root cause of the pathological condition.
Restoration of normal tissue nutrition.

Surgical intervention is practiced extremely rarely. However, in some cases, it cannot be dispensed with. Absolute indications for surgery are advanced atherosclerosis, with calcification of a cholesterol plaque or persistent vasoconstriction.

In the first case, mechanical removal of the formation is shown. In the second - ballooning or stenting (physical expansion of the lumen of the artery).

Variants with anverisms or malformations are possible. The gap of such formations is not considered although discussions about terminological features are actively conducted.

Drugs after ischemic stroke are represented by cerebrovascular agents, thrombolytics, antiplatelet agents, angioprotectors, tonic, antihypertensive.

Such a complex is assigned entirely, based on the indications. Each drug solves one specific problem.

Further management of patients, rehabilitation

There is no cure for stroke. This is an erroneous concept. Irreversible changes develop in the brain. The task of the recovery period is to teach healthy structures to work for the dead.

Cerebral tissues have tremendous adaptability, so you can count on high-quality recovery.

At this stage, there is no fundamental difference which stroke occurred: hemorrhagic or ischemic. Apart from the possible severity of the neurological deficit.

Rehabilitation activities continue for about a year. The first month and even two the patient is under the control of doctors. First in a hospital, then in a specialized center. However, the main period falls on home events.

Rehabilitation includes four areas: restoration of speech, motor activity, cognitive functions and psycho-emotional sphere.

The first question is solved by constant repetition of articulation exercises, passive perception of a large amount of oral speech, pronunciation of simple sounds, then syllables, words and full-fledged sentences. This will qualitatively and relatively quickly restore the ability to speak.
Motor activity involves obligatory passive exercises at an early stage and independent activity at the end of the initial stage of treatment. In the first case, the movements for the patient are made by doctors. Next, you need to move without help, develop muscles. And then walk and move. First with a walker or cane, then without aids.
Cognitive functions require a constant load on the brain. Overworking, however, is absolutely impossible. Memorizing simple symbols, numbers, phrases, simple intellectual, board games, working with graphic material (description of what is happening in the picture, drawing up a diagram-sequence of episodes depicted on cards) allows you to activate the intellectual sphere.
The psycho-emotional state is corrected under the supervision of a specialized specialist. Cognitive-behavioral therapy, if necessary, taking antidepressants, sedative medications, talking with other patients. The key task that they solve is to provide a positive attitude, a harmonious emotional background.

At all stages, massage, physiotherapy and physiotherapy exercises are carried out. If possible, also acupuncture.

Stroke is treated with conservative methods, according to the indications, an operation is performed. The therapy presents great difficulties and is implemented gradually.

The duration of the primary events is several days. The same amount is spent on partial restoration of functions.

Then begins a long responsible period of rehabilitation. It directly affects not only the future life and its quality, but also whether the neurological deficit will persist or not.

Wrong lifestyle, bad habits, eating fatty high-calorie foods - all this leads to damage to blood vessels, which leads to impaired blood circulation in the brain. Stroke manifests itself in an acute form and is typical for older people. Neurological symptoms manifest themselves depending on the location of the hemorrhage.

What is a stroke

Violation of the blood supply and nutrition of any part of the brain, followed by rupture of the vessel, outpouring of blood into neighboring tissues, or death of nerve cells due to hypoxia is called a stroke. The intensity of blood flow may decrease or stop completely. An acute condition develops for a long time - from several hours to several days.

In the first case, irreversible consequences can occur quickly, and the patient will not have time to receive medical care. In the second, the symptoms are less acute, but it will be more difficult to eliminate the consequences.

On average, a person has 5 hours from the onset of characteristic symptoms to seek help and take a number of measures to improve well-being.

When a part of the brain dies, there is a violation of the functions in the human body, for which this area is responsible - speech, movement. Pathology can occur in mild, moderate and severe forms.

Kinds

There are 2 types of strokes - ischemic and hemorrhagic.

In the first case, blood access is impaired due to blockage of blood vessels by a thrombus, a cholesterol plaque, or due to a narrowing of the lumen.

In the second, an artery ruptures, a hematoma forms, which compresses the surrounding tissues, and their work is disrupted.

Older people have a higher risk of developing an acute condition than younger people. This is facilitated by various concomitant diseases of the heart, blood vessels, metabolic disorders.

Ischemic stroke

The forerunner of ischemic stroke (from the Latin word for stroke) is a transient ischemic attack. This is a syndrome that occurs due to partial blockage of blood vessels and restricts blood flow to the brain. Violations most often occur in the carotid artery or brain vessels, there is swelling of the perivascular tissues. Small blood clots resolve, blood circulation is restored, and the person feels good again.

If the thrombus is large in diameter and completely blocks the blood flow, an ischemic stroke develops, the consequences of which cannot be predicted. This is the more common type of brain disorder, occurring in 80% of cases.

Parts of the carotid artery, anterior, posterior or middle arteries, vertebral vessels can be affected. Unlike hemorrhagic stroke, with ischemic, there is no outflow of blood into the brain tissue. The pressure in a stroke is increased, the pulse is quickened, sweating is increased, swallowing is difficult.

With a repeated stroke, a slight increase in blood pressure is enough for the process to move into an acute stage.

Ischemic stroke is of several types:

Acute, passing in 5 stages. Symptoms gradually decrease if medical care is provided on time. Ends with a recovery period.
Atherothrombotic. Occurs when blood vessels are clogged with blood clots or cholesterol plaques. Causes one-sided blindness. This species can provoke a second stroke if the disease is not treated and the diet is not followed.
Cardioembolic. It is typical for patients who have undergone heart surgery or have valvular malformations; it can occur in parallel with myocardial infarction.
Hemodynamic. May occur with high blood pressure. There is a risk of rupture of blood vessels. Paralysis of the limbs occurs on the opposite side of the body. If the rupture occurs in the central part, complete paralysis is possible.
5. Lacunar. It is the result of constant pressure surges. It is possible to identify brain lesions only after a detailed diagnosis.

Violation of blood circulation in the frontal part leads to:

to the loss of self-consciousness;
inability to control their actions;
lack of memory, thinking, will;
speech and motor coordination disorders.

The consequences are manifested in an abulic or disinhibited type. A person becomes either lethargic and apathetic, or aggressive and unpredictable.

Hemorrhagic stroke

Occurs less frequently - in 8% of cases. But the consequences are severe: 50% of people die, 80% become disabled.

The condition manifests itself with local and general symptoms:

headache;
articulation changes;
vomit;
partial paralysis of the muscles of the face, limbs;
photophobia.

If a person with signs of a stroke is unconscious, you should not try to bring him back to consciousness. It is urgent to call a team of doctors and deliver the patient to a medical facility.

Types of hemorrhagic stroke:

subarachnoid - the subarachnoid space is affected;
subdural - between the bones of the skull and the hard shell of the brain;
extradural - accumulation of blood between the hard shell and the inner surface;
intraventricular - hematoma inside the ventricles;
parenchymal - hemorrhage in the substance of the brain;
mixed - the presence of several species at the same time.

The most severe are parenchymal hemorrhages and subdural hematomas with displacement of the membranes.

The first signs of a stroke in an adult

If an approaching stroke is recognized in the first minutes, a person's chances of recovery and a normal life increase.

To do this, you need to know which precursors signal a change in state:

Severe weakness and numbness of the limbs.
Flickering "flies" or white dots before the eyes.
Nausea or vomiting.
Loss of vision, as the visual area of the brain may be affected.
The person is hard of hearing and unable to speak - he is deafened.
Muscle changes - spasms or lethargy.
Loss of coordination or paralysis of the body.

If there is a suspicion of the onset of a stroke and the person adequately perceives others, you can ask him to do the following:

Smile - the smile will be one-sided, or the person will not be able to do it.
Show tongue - it is not in the center of the mouth, but is beveled in any direction.
Raise both hands up - one of them will not be able to rise, as it is paralyzed.

This applies more to the environment of a person, since he himself is not able to determine the degree of danger and help himself.

Diagnostics

In a medical setting, the first task of doctors is to visualize the brain and the damaged area in order to assess the degree of pathological changes.

Diagnosis procedure:

Visual examination and checking of reflexes by a neurologist.
Computed tomography or MRI of the brain vessels - depending on the patient's condition.
Blood clotting tests.
General types of diagnostics - ECG, EEG.

It is impossible to delay the diagnosis, since the symptoms of hemorrhagic stroke are growing rapidly, and the patient is likely to die before the diagnosis is made.

Causes

Risk factors for stroke and pre-stroke conditions:

Hypertonic disease. Slowly affects the vessels, as they are constantly subjected to increased pressure, because of this they lose their elasticity and do not withstand the next jump.
Heart failure. Heart rhythm disturbances contribute to the formation of blood clots, which, passing through the bloodstream, block the vessels of the brain. The larger the thrombus, the wider the vessel when blocked, and the larger the affected area.
Violation of the process of splitting fats, the formation of cholesterol plaques and damage to blood vessels.
Diabetes mellitus, in which the vessels become fragile and easily damaged.
Aneurysm. Thinning of the walls of blood vessels. With pressure surges, the vessel may burst, and blood will pour into the medulla.
The formation of clots due to a violation of the blood clotting process.
Excess food intake, which provokes the formation of cholesterol clots.
Bad habits - smoking, alcohol - make blood vessels brittle, contribute to increased pressure and hypertension.
Head injuries in which the main cause is mechanical damage vessels.
Stenosis (narrowing) of the arteries of the brain and cervical arteries.
Stop breathing during sleep for more than 10 seconds.

Old age is an aggravating factor for any reason.

First aid

Before the arrival of doctors, a person with signs of a stroke can be helped as follows:

lay on a flat surface so that the head is raised at an angle of 30 °;
provide fresh air;
unfasten the belt and the top button on the clothes;
if a person had vomiting, you need to turn him on his side and clean his mouth from the remnants of vomit;
in the absence of a heartbeat and pulse, an indirect heart massage is done;
if possible, measure blood pressure and record the values.

You can not give a person to drink. If swallowing is disturbed, asphyxia is possible. You can not give pressure-lowering drugs before the arrival of doctors.

How to recognize a stroke

It is difficult to distinguish a person who has a stroke from a person who is in a state of intoxication.

If a person has a staggering gait, discoordination of movements, inadequate reaction to speech (misunderstanding, lack of reaction), you can apply the stroke recognition technique BLOW to him:

U - a smile that will either be absent, or the muscles on one side of the face will not work;
E - simultaneous movement of arms or legs on the opposite side of the body from the damaged hemisphere, the limbs will rise more slowly, or the limbs will be paralyzed, which indicates the presence of general symptoms;
A - articulation, a person will not be able to pronounce this word clearly, or will not be able to speak due to a stunned state;
R is a decision that needs to be made urgently.

Treatment and rehabilitation after a stroke

After delivery to a medical institution, doctors carry out a set of measures to eliminate the symptoms of a stroke, which include bed rest, medication, and rehabilitation and removal of the patient from an acute condition.

Restoration of motor activity is the ultimate goal of this stage. The choice of medication depends on the type of stroke. Predictions can only be made after the diagnosis is made, taking into account the time that has passed since the onset of the attack.

It is impossible to carry out treatment until the diagnosis and identification of the type of stroke.

Rehabilitation activities

In ischemic stroke, drugs are administered that accelerate the resorption of a blood clot that has clogged a vessel. If hemorrhagic, urgent surgery may be needed to remove the spilled blood.

At first, intensive therapy is carried out, the purpose of which is to reduce damage to the brain tissue and reduce the risk of a second attack.

Some drugs work faster if they are administered in the first hour after the onset of an acute process.
For hemorrhagic stroke, the prognosis is less encouraging. It should quickly stop intracerebral bleeding and remove the hematoma, which presses on neighboring areas. Showing drugs to stabilize blood pressure.

During the rehabilitation period, all medications are taken strictly under the supervision of a doctor and on his recommendation.

Folk remedies to restore the body after a stroke

After treatment in the hospital, a person recovers for about six months. All this time you need to take medication. In parallel, you can be treated at home with folk remedies.

Alternative methods can be used after consultation with a neurologist.

Traditional medicine offers the following treatment options for the consequences of an attack:

sage - to restore speech functions;
coniferous cones as a general tonic;
Dioscorea Caucasian;
thyme - with paralysis of the limbs;
gray jaundice - to restore the work of the heart;
infusion of juniper for rubbing.

Hydrogen peroxide is suitable for rinsing the mouth - the procedure is carried out for a minute with a solution diluted at a concentration of 1: 1 with water.

With paralysis, massage and water procedures with rubbing are useful. To restore the work of the muscles of the face, dried dates are used. If it is possible to get fresh chicken eggs, then once a day you need to drink 2 pcs. - people restored their memory and thinking in this way after an experienced attack.

Rehabilitation centers

Rehabilitation centers for people who have had a stroke provide methods for the accelerated removal of a person from a state of illness and helplessness.

The set of activities includes:

Several sessions of therapeutic massage (20 - 25).
Gymnastics and physiotherapy exercises to restore coordination.
The use of devices that teach people to walk after paralysis of the limbs.
Respiratory gymnastics, contributing to the restoration of the respiratory system after forced bed rest.
Physiotherapy procedures.

The purpose of the events is to train the brain and switch the disappeared functions to other areas that have healthy tissue.

How many years do you live after a stroke?

Life expectancy after an attack depends on:

on the age of the patient and the presence of severe concomitant diseases;
on the quality of treatment after an acute condition and the degree of recovery;
on the area and degree of brain damage;
on the type of stroke.

At ischemic type mortality is 37%, with hemorrhagic - over 80%. According to statistics, up to 35% of people die after the first month. The following year - 50%. A relapse of a stroke has a great influence on life expectancy - over the next 5 years, a recurrent attack is observed in 25% of women and 40% of men.

Prevention

Preventive measures are aimed at treating the underlying disease that led to a stroke or pre-stroke condition.

People who have an increased risk of developing an acute process should adhere to:

Proper nutrition with restriction of the use of animal fats. Enrich the diet with raw vegetables and fruits, fiber. If necessary, take drugs that replace enzymes and contribute to better digestion of food.
An active lifestyle so that blood clots do not form. It is necessary to strengthen the vessels.
Give up smoking and alcohol, control blood pressure with folk or medications.

Prevention is better tolerated than treatment for stroke complications.

Consequences of an attack

Ischemic stroke causes behavioral changes and emotional disturbances that are difficult to reverse. The damage to the brain tissue depends on the diameter of the vessel that was blocked by the thrombus and the time spent by the patient before the start of treatment.

Hemorrhagic stroke causes a complete imbalance of body functions - both physiological and mental. In most cases, a condition occurs in which a person loses the ability to self-service due to hemiparesis - loss of sensitivity of the muscles of the face and limbs. A partial decrease in muscle tone on the opposite side of the body is characteristic. In severe cases, complete paralysis is possible.

Soporous state

Sopor is a borderline state between confused consciousness and coma. If left untreated, a coma may occur. The patient may be conscious, but weakly react to what is happening, or be unconscious. Contact with the patient is limited due to damage to the right-sided brain structures responsible for face recognition.

Speech impairment after stroke

It manifests itself in two variants - the absence of speech and impaired diction. Variations are possible - misunderstanding of one's speech, someone else's. Hearing his own speech, a person is not able to analyze what was said.

cerebral edema

May develop 2 days after the acute condition. Symptoms are clearly manifested on the 3rd - 5th day. Requires treatment.

convulsions

Dangerous manifestations of the disease, as they provoke re-hemorrhage. May cause coma.

Headache

The nature of the headache varies depending on the type of stroke. With ischemic pain less intense. With hemorrhagic, painkillers are required during the recovery period. If several months or years have passed since the attack, it is necessary to do gymnastics and massage to relieve tension headaches.

Memory loss

With damage to the vessels of the temporal lobe, memory lapses or its complete loss are observed. Psychiatrists are engaged in the restoration of such patients.

Paralysis

The complete absence of motor activity and reflexes occurs with central brain damage. Unilateral or partial paralysis is possible, depending on the hemisphere of the brain or its department in which the circulatory disorder occurred. With peripheral paralysis, the general tone decreases, but is not completely lost.

Coma

There are 4 degrees of coma:

at the first, patients come to their senses in 2-3 hours;
in the second case, the patient has a chance of recovery if brain function gradually stabilizes
in the third degree, a person is under the control of an apparatus for artificial stimulation of vital signs;
in the fourth, brain disorders do not allow the patient to survive, most often such cases end in death.

Hemorrhage in the brain

Rebleeding occurs in the first year in 1/3 of patients. If the recommendations of the doctor and nutritionist are not followed, the risks increase. Mortality with a second attack is 70%.

Motility disorder

Decreased fine motor skills are seen in 70% of stroke survivors. The strength of the hands, the mobility of the joints, the sensitivity of the fingertips are subject to restoration.

Aphasia

There are motor, sensory and semantic, in which a person pronounces words poorly, understands other people's words poorly, speaks independently, but does not perceive what is said. Severe aphasia is a misunderstanding and lack of speech functions at the same time.

Peripheral neuropathy

Symptoms are muscle pain, decreased sensation, and weakness. After an acute condition, the nerves are not affected, but lose their connection with the brain and are difficult to control. Restore tone with gymnastics, massage, physiotherapy.

Psychosis

Violation of the perception of reality. Psychosis after a stroke progresses slowly. The first signs are aggression, irascibility, suicidal thoughts, lack of logical reasoning.

Visual impairment after stroke

Vision is restored, but not immediately, if the area of neuronal damage is small. Blockage of blood vessels leading to the organs of vision is treated in parallel with general therapy.

Central prosoparesis

The degree of damage to the facial nerve after a stroke - prosoparesis - is determined by the movements that a person can perform with the muscles of the face. A severe degree is characterized by complete paralysis of facial muscles with the inability to close the eyes.

Risk reduction

The diet of people at risk for stroke should be saturated with vegetable dishes in order to reduce the level of cholesterol in the blood and the possibility of their deposition on the walls of blood vessels. Berries and fruits reduce the likelihood of a second attack by 25% due to the potassium they contain, which is also good for the heart.

It is better to replace meat dishes with fish. Cooking method - stewing or boiling with a small amount of salt.

Do not use white flour, as it is worse digested by the body. Whole grain bread or steamed bran is an alternative to white bread. You can use corn or oatmeal.

Heavy physical exercise after a stroke should be excluded. Hiking and light gymnastics in the air will be useful.

For the treatment of metabolic diseases, they turn to specialized specialists. The recommendations received will help support other organs and systems that affect the state of blood vessels and their patency.

Stroke, or acute cerebrovascular accident, regardless of its form, is a serious illness. Due to a stroke, the performance of various parts of the brain is disrupted. And this means that a person is unable to carry out his usual activities.

Fortunately, a stroke is not a death sentence. In most cases, it is possible to restore lost brain function - in whole or in part. And the rehabilitation program can be completed at home.

Treatment

A stroke is caused by a blockage (ischemic stroke) or a violation of the integrity (hemorrhagic stroke) of the vessels of the brain. As a result, blood circulation in the brain suffers, and nerve cells die due to lack of oxygen. Thus, due to a stroke, the human brain loses some of its part, which is responsible for certain functions- speech, intellect, memory, sensitivity, vision, hearing, movement, administration of natural needs (eating, urination and defecation).

A type of stroke is a transient ischemic attack, in which the symptoms of circulatory disorders in the brain disappear after some time. However, it also requires careful attention and examination by a neurologist, since it can often transform into a full-fledged stroke.

Stroke treatment is a multifaceted undertaking. If an acute cerebrovascular accident is suspected, the patient is immediately hospitalized. If the diagnosis is confirmed in the hospital, then the treatment of the patient begins. Usually conservative methods are used for this purpose. However, in some cases, surgery is necessary.

At first, treatment can only be carried out in a hospital. However, after the patient's condition stabilizes, and his life ceases to be threatened, he is discharged. And further treatment should be carried out at home, but under the supervision of a neurologist.

The following methods are used in the treatment of stroke:

taking medications,
psychotherapy,
proper organization of the patient's life,
physiotherapy procedures,
diet,
physiotherapy.

Treatment in the post-stroke period is also aimed at reducing the likelihood of recurrence of the disease. It is no secret that many people who have had a stroke experience a relapse within the first and second year after the event. The probability of this event is approximately 10%. And repeated strokes can often be fatal.

The recovery period is divided into three stages:

early - up to 6 months,
late - 6-12 months,
residual - more than a year.

The sooner work is begun to restore brain function affected by a stroke, the greater the chance of success. In addition, activities should be systematic. You can’t give up and leave the rehabilitation program halfway through.

It is also worth remembering that a stroke does not appear just like that. Usually it is a consequence of some systemic disease or several at once:

elevated blood cholesterol levels,
atherosclerosis,
heart failure
changes in blood composition,
vascular aneurysms.

However, most often strokes occur against the background of excessive alcohol consumption and smoking. It would not be an exaggeration to say that nicotine and alcohol literally destroy the vessels of the brain. You should not discount such risk factors as excessive physical activity, stress, work in difficult conditions, and malnutrition.

Therefore, simultaneously with the treatment of the consequences of the stroke itself, it is necessary to deal with the treatment of the disease that caused it. And the patient after successful rehabilitation should permanently change his lifestyle, if it was he who led to a stroke.

How to recover after a stroke

Practice shows that after a stroke it is quite possible to regain the lost physiological and mental abilities. Damaged brain tissue can recover over time, and the place of dead neurons will be taken by healthy ones. However, this will take time. Unfortunately, it is very difficult to predict in advance when this will happen, and whether it will happen at all.

Here, much depends on the severity of the disease, as well as on the individual characteristics of the patient's body. The brain of some patients can recover from the most severe lesions, while in others even minor deviations remain for life. In addition, ischemic stroke responds better to therapy than hemorrhagic stroke.

Equally important is the support from loved ones. Most patients after a stroke have astheno-depressive syndrome, which is expressed in depression, lack of interest in life. Patients may attempt suicide.

Therefore, psychological rehabilitation should be carried out simultaneously with treatment. It should continue after the basic motor functions are restored. For this purpose, you can trust the patient with some small household chores. It is important to make it clear to the patient that he is a full-fledged member of the family, and not a helpless disabled person.

It is best if the recovery takes place in special rehabilitation centers. Statistics show that in this case, the likelihood of recurrence of the disease is less. However, even at home, the patient can be provided with acceptable conditions for recovery and treatment. Some specialists, such as masseurs, can be invited to the house.

However, one should not hope that the patient will recover from a serious illness in a week or two. It often takes months, years, or even decades to partially restore the functions of the nervous system and brain. Usually, the recovery of patients with cerebral hemorrhage takes longer than the recovery of patients who have suffered a circulatory disorder of an ischemic nature.

Rehabilitation after ischemic stroke at home

The recovery strategy largely depends on how badly the brain is affected and on the general condition of the patient. As a result of a stroke, a patient may experience:

memory,
speech,
ability to move (up to complete paralysis),
higher mental functions
vision and hearing
functions of the vestibular apparatus.

Depending on this, a treatment and rehabilitation strategy is developed. The minimum program is teaching the patient self-care skills, communication, movement, speech, and intellectual skills. Only then can you think about restoring professional skills.

The rehabilitation program must comply with the following principles:

early start,
systematic,
subsequence,
multidirectionality.

The sooner a rehabilitation program is started, the higher the chances of success. Recovery, if possible, should begin in the hospital. Lost time can negatively impact a person's potential to improve health.

Systematic means that all rehabilitation activities must be carried out continuously. You can not take breaks in classes, as this levels out all the progress made earlier.

Sequence means following a specific lesson plan, in which complex exercises can be done only after the patient has mastered simpler exercises. You can not immediately demand from the patient things beyond his current state.

It is also important to consider that the various functions of the body must be restored simultaneously. If the patient has several functions of the central nervous system impaired at once, then one should not engage in only one direction to the detriment of others. This principle is implied by the multidirectional rehabilitation.

Home rehabilitation is a complex process, all aspects of which are difficult to consider. Therefore, it should be carried out under the supervision of a neurologist. Of course, a certain control of the patient's condition can be carried out by himself or by people close to him. So, patients suffering from hypertension, it is necessary to measure the level of blood pressure all the time, diabetes mellitus - blood sugar, atherosclerosis - cholesterol in the blood.

If the goals are set realistically and the program to achieve them is carefully followed, then in most cases it ends in success. Although much here depends on the severity of the initial state.

Recovery of motor functions

More than 90% of stroke patients have paralysis or paresis of various parts of the body. This is due to the fact that areas of the motor cortex are affected in the brain. Therefore, the restoration of motor functions is one of the main directions of rehabilitation. The first to suffer are the limbs - the legs and arms. The inability to control the muscles of the legs leads to the fact that a person loses the ability to walk, the muscles of the hands - to the fact that the ability to manipulate various objects is lost. Since the hands perform more complex movements, the restoration of their functions is often longer and more difficult. Both limbs on the same side of the body are often affected.

Nerve functions lost as a result of a stroke will not recover by themselves; long training is necessary. For this purpose, it is necessary to carry out the prescribed complexes of physiotherapy exercises. They help to restore the functionality of those parts of the body, control over which has been partially lost - walking, hand movements, fine motor skills of the fingers. Of course, the exercises do not have to be exhausting. After all, stress can lead to a deterioration in the condition. If exercise causes pain, you should reduce the load. Before performing complex exercises, it is necessary to prepare the muscles with massage or rubbing. It should also be remembered that the main goal of physiotherapy exercises is not to increase muscle tone, but, on the contrary, to reduce it, since muscle hypertonicity is usually observed after a stroke. Gymnastics should last no more than an hour. There are usually no more than 2 classes per day.

Memory recovery technique

No less, and perhaps more difficult is the process of restoring speech and memory. After all, a person, due to the consequences of a stroke, not only loses his professional skills, the ability to navigate modern life, but may not even recognize people close to him. Therefore, patience is required. Only a benevolent attitude towards the patient can change the situation.

Mnemonic exercises can help here - memorizing words, numbers, objects depicted in pictures. Board games are very good for developing memory. You can recall together with the patient those events that took place during the day.

Speech restoration technique

The ability to understand language and speech generation is one of the most important functions of the human psyche. Without this opportunity, a person will feel inferior, his social adaptation become noticeably more difficult. Unfortunately, if the speech center of the brain in the left hemisphere is affected as a result of a stroke, then a complete restoration of speech functions (its perception and generation) may not occur. Also, with the defeat of this area of the cortex, mathematical abilities are violated.

In addition, difficulties in speech can be caused by paralysis of those muscles of the larynx and face that are responsible for the articulation of sounds.

However, in any case, you should not lose hope, even if there is no progress in the treatment of this condition at first. After all, it is not uncommon for speech to return to the patient spontaneously. This is where a speech pathologist can help. In some cases, it is possible to teach the patient sign language.

It is recommended that a person constantly hear some words, speech and sounds. Without this, gaining the ability to understand speech and speak is impossible. The work of restoring speech must also be done gradually, step by step. First, the patient must learn to pronounce individual sounds, then - to add syllables from them, and then - words and sentences. Sometimes listening to songs and singing on your own helps. Exercises to develop facial muscles can also be useful:

teeth grinding,
curling lips into a tube,
mouth opening and closing
protruding tongue,
tightening the corners of the lips in the form of a smile,
tongue licking,
lip biting,
cheek puffing.

Physiotherapy and massage

Physiotherapy procedures used during the rehabilitation period:

mud treatment,
massage,
magnetotherapy,
laser therapy,
manual therapy,
electrical stimulation of the affected muscles and limbs.

Massage is the most widely used in post-stroke rehabilitation. effective remedy, which does not require expensive equipment, and helps relieve muscle tension, restore normal blood flow.

Bed patient care

What if a person is completely or partially paralyzed and unable to walk as a result of a stroke? In this case, he needs to equip a special bed. It must be placed in the center of the room, so that it can be accessed from at least 3 sides. The bed should be wide (at least 120 cm), and the mattress should be hard. It is also desirable to install a special handrail above the bed, so that the patient could grab onto it.

The toilet and bathroom also require some alteration. They can also be equipped with special handrails so that a person with limited mobility can grab onto them.

Caring for a bedridden patient is one of the most difficult tasks for his relatives. It is necessary to ensure that bedsores do not form on the body, as they lead to the development of infectious diseases. There is also a risk of pneumonia due to congestion in the lungs. To prevent this, it is necessary to turn the person on their side every 2-3 hours. Changing the position of the body also improves blood circulation in the limbs. To avoid skin diseases, it is necessary to use special creams and ointments.

Also for bedridden patients may need:

vessel,
appropriate size diapers
anti-decubitus mattresses.

Bed linen should be changed as it gets dirty and should not be allowed to get wet. If the patient has problems with urination and defecation, then they can be solved with the help of catheters and enemas.

Feeding

Great difficulties arise if a person loses partially or completely swallowing or chewing functions due to a stroke. In this case, the food must be mashed. Cocktail sticks can be used for feeding. In no case should you force-feed a person - this can cause an attack of vomiting. The patient should take food in a reclining position. Portions should be small, but feeding should be carried out often - up to 6 times a day.

Devices for people affected by a stroke

For non-walking patients with paralysis of the lower extremities, a wheelchair may be required. If motor functions are only partially impaired, then crutches, walkers or canes can help in recovery.

To restore motor skills and motor functions of the muscles of the hands, rosaries, expanders, rubber rings, gymnastic sticks, and light dumbbells can be useful.

Physiotherapy

The most important method used to restore motor functions is physiotherapy exercises. It not only allows you to restore the lost ability to control muscles, but also improves microcirculation in tissues, helps to reduce muscle hypertonicity. When performing physiotherapy exercises, it is necessary that someone be present next to the patient, control his condition, and protect him from injuries and falls.

Various exercises can be performed not only to restore the capabilities of the limbs, but also for facial muscles immobilized as a result of paralysis, eyeballs, etc. At first, if a person is not able to carry out movements himself, the so-called passive physiotherapy exercises are used, when the instructor or the people helping the patient themselves carry out movements with their arms or legs for him. And gradually a person begins to help them, moving on to independent actions.

For successful restoration of lost functions, it is necessary to go from simple exercises to complex ones. Initially, the patient should learn to sit up on the bed on his own, then get up, and then walk.

Do not forget about the development of motor skills of hands and fingers. For this purpose, special exercises have been developed. For example, picking up small objects from the floor. fine motor skills they develop well such exercises as assembling puzzles, sorting out the rosary, laying out cards, playing board games, tying shoelaces, combing. Many of these exercises also help relieve nervous tension and restore memory skills.

Every day you should gradually increase the time of this or that exercise. For learning to walk, special devices are needed - walkers.

Therapeutic exercise for bedridden patients

Special complexes of physiotherapy exercises can also be developed for bedridden patients. They help restore the functionality of the forelimbs and prepare for the restoration of motor capabilities of the rest of the body. Usually, exercises consist in rotation of the hands (including in the carpal, forearm, elbow joints), flexion and extension of the arms and fingers, clenching the fingers into a fist. If possible, similar exercises can be performed for the legs. You can also move with both hands. To maintain synchronicity and consistency, you can take some object in your hands, for example, a towel.

Exercises for Patients Who Can Sit

If the patient is able to sit up in bed on his own, then the set of exercises for him can be expanded. One of the goals of such exercises is to prepare for the restoration of walking skills. Exercises can consist of lifting the legs, arching the back, moving the head.

Diet during rehabilitation

Stroke therapy will not be successful without the right diet. It must necessarily include:

vegetable oils;
seafood;
vegetables and fruits rich in fiber and folic acid.

It is also necessary to drink at least 2 liters of water per day (unless there are contraindications to this, for example, due to heart or kidney failure).

It is recommended to eat meat and fish of low-fat varieties. Meat and fish dishes can be boiled or steamed. Fried foods are prohibited. However, meat products should be eaten no more than 3 times a week. The same applies to potato dishes.

Contraindicated:

confectionery,
animal fats,
acute,
smoked,
salty,
marinades.

Salt is best eliminated from the diet. Coffee and strong tea are also prohibited. Under the absolute ban alcohol.

Folk recipes and herbal decoctions can be used with the permission of the attending physician.

Medical therapy

Groups of drugs used in rehabilitation:

nootropics and drugs that improve cerebral circulation;
metabolic drugs;
anticoagulants;
antidepressants;
muscle relaxants;
anticholesterol drugs (statins);
hypotonic means;
vasodilator drugs;
antispasmodics;
vitamin complexes, glycine;
decongestants and diuretics.

Nootropic drugs and drugs that improve cerebral circulation should be taken in long courses, for 3-6 months.

It should be noted that the list of drugs prescribed for the treatment various types disease can vary greatly. In particular, after a hemorrhagic stroke, anticoagulants and nootropics are contraindicated. Therefore, it is necessary to take only the drugs prescribed by the doctor, self-medication is unacceptable here.

Psychological support

An important component of treatment is to create a positive environment around the patient. psychological environment. Most people who have had acute cerebrovascular accident are in a state of depression, and for this reason they may reject any medical help. In this case, it will not be enough to take antidepressants alone; the help of a professional psychologist or psychotherapist is needed. You should not discuss in the presence of the patient his illness and disability. In a conversation with him, it is better to focus on the progress made in the rehabilitation process.

Disability and work

Unfortunately, the statistics associated with people affected by a stroke are depressing. Only one in five of them recover so successfully that they return to their work and normal life. Most become disabled.

If a person becomes able to move independently, this does not mean that he is immune from any problems. It is desirable that a guardian would accompany him at all times, especially when walking on the street. After all, a person can lose consciousness and fall at any moment, even if he walks leaning on a stick. But if a person still walks alone, then in this case he should have cellular telephone or a device with a panic button so that he can always call for help.

At first, a person, depending on the severity of his condition, is given disability for 3-6 months. In the future, the patient has the right to receive a disability of 1, 2 or 3 groups. Re-examination of disability is carried out every year (for the first group - every 2 years). But this applies only to people under the age of 60 and 55 (men and women, respectively). In elderly patients, re-examination is carried out only with a significant change in condition.

Even if a person successfully undergoes a course of treatment, restores his skills and his ability to work returns to him, then when choosing a job, he should take into account the following prohibitions:

to work with neurotoxic substances,
to increased nervous, physical and psychological stress,
to work in rooms with high temperature and humidity.

A stroke is a sudden disruption of blood flow in the brain structures, which leads to tissue necrosis. As a result of cell death, the functioning of certain parts of the brain is lost: speech is disturbed, limbs are paralyzed. The irreversibility of the consequences depends on the extent of damage to nerve cells. The disease does not appear on its own, it is a consequence of vascular pathologies.

Causes of the disease

The causes of a stroke are the development of an acute violation of the blood supply to the brain. The types of cerebral stroke are differentiated based on how the stroke occurs. Distinguish between ischemic and hemorrhagic stroke.

When an anomaly develops due to blockage of an artery or narrowing of the vascular lumen, an ischemic type of cerebral stroke is detected. When an artery ruptures and blood flows into the medulla, a hemorrhagic type of pathology is diagnosed.

Curious fact! In the time of Hippocrates, pathology was called apoplexy.

Causes of ischemic brain injury can be modified or unmodified. Modified causes of cerebral stroke include:

high blood pressure;
atherosclerosis;
diabetes;
myocardial infarction;
vasculitis;
osteochondrosis;
arrhythmia;
vascular disease;
carotid artery injury.

Unmodified factors include age, genetic predisposition, obesity, alcohol and smoking abuse, drug addiction, emotional stress.

Leukemia, tumor processes, septic phenomena, uremia, and arterial hypertension lead to the hemorrhagic type.

The risk of developing a blockade increases with the presence of bad habits, diseases of the cardiovascular system. Other risk factors include malnutrition, which is dominated by fatty and salty foods, a sedentary lifestyle.

Features of each type

Types of stroke are differentiated depending on what causes the blockage. Stroke of the brain can be ischemic and hemorrhagic.

Ischemic

It also has another name - cerebral infarction, which appears after blockage of the vessel with a plaque or thrombus. The affected area of the brain does not receive the required amount of oxygen, ischemia develops. Vascular obstruction can last for a long time, leading to an increase in pathological signs: vomiting, headache, inability to move.

Based on the cause of the development of a stroke, the following types of disease are distinguished:

Atherothrombotic. Formed due to atherosclerosis of the arteries. Signs increase gradually. This type usually appears at night. A thrombus leads to cerebral ischemia.
Cardioembolic. It develops against the background of cardiovascular diseases - arrhythmia, heart disease, heart attack. Accompanied by embolism of the vascular lumen. The neurological picture is especially pronounced.
Hemodynamic. It is fixed as a result of circulatory disorders - with a decrease in arterial values, a decrease in cardiac volume. The causes of the blockade are vascular anomalies, stenosis.
Lacunar. It is diagnosed in hypertensive patients, diabetics.
Rheological. Revealed in a healthy state of blood vessels.

Usually, cerebrovascular accident normalizes by arrival medical care, the person begins to feel better and refuses hospitalization. But cell destruction continues. In the absence of therapy, relapses develop, provoking paralysis, death. Ischemic cerebral infarction requires treatment aimed at rehabilitation and prevention of relapse.

Hemorrhagic

This type of stroke develops after a rupture of the vessel and hemorrhage, which is absent in the ischemic type. Brain bleeding is difficult to stop because traditional hemostatic drugs do not penetrate the capillaries of the brain. Pathology is severe, often leading to death.

Blood enters the brain structures, swelling and hematoma appear, squeezing the organ. Edema is formed due to a violation of the outflow of cerebrospinal fluid and venous blood. Increased intracranial pressure, compresses the brain stem. This causes a disorder in the functioning of the cardiovascular system.

A hypertensive crisis, emotional and physical overstrain, traumatic brain injury - this is what causes a stroke. An aneurysm also leads to this type, when the victim feels intense pain in the head, nausea, and loses consciousness. A stroke is accompanied by bleeding in the brain stem, which is connected to the spinal cord. Structures control the functions of respiration, heartbeat, blood supply.

It is characterized by a higher percentage of mortality compared with cerebral infarction. During the first year after the blockade, most of the victims die, the rest remain disabled.

Symptoms of pathology

Sometimes people confuse the manifestations of a small stroke and a large one, because some of the signs are similar. But diseases have different consequences. accompanied by temporary dysfunctions lasting for several minutes. But the normal state does not mean recovery, the victim must be hospitalized, since a mini-stroke often precedes an extensive blockade.

Symptoms after a stroke are differentiated into focal and cerebral.

Common manifestations include:

intense pain in the head, which is accompanied by vomiting;
the person becomes lethargic;
blurred consciousness;
cardiopalmus;
excessive sweating;
dizziness;
disorientation in space.

The severity of focal signs depends on which part of the brain is affected - each of them is responsible for a specific activity. The victim may lose sight, speech skills, lose balance.

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The most dangerous type of stroke is ischemic, since initially it does not have specific symptoms. This type of stroke resolves with headaches, dizziness, and then the symptoms disappear. With hemorrhagic blockade, a person immediately feels an excruciating headache, the condition is accompanied by loss of consciousness.

The first signs of an attack

Damage to the brain during a stroke usually occurs at night or in the morning as a result of physical or emotional overstrain. You can notice the asymmetry of the smile, the drooping of the corners of the mouth, impaired speech. The victim cannot raise both arms at the same time. .

The blockade is often preceded by an ischemic attack, which is expressed in a sharp dizziness, excruciating pain in the head, impaired motor functions, fainting. The patient notes numbness of the muscles on one side of the body, vision deteriorates, and there are problems with movement.

The nature of painful manifestations depends on the cause and localization of the lesion. With a blockade in the left hemisphere, there are failures in thought processes, some parts of the body become numb, and a misconception about the parameters of objects develops. If the occipital region is affected, blindness may occur.

How are strokes diagnosed?

To make a correct diagnosis, it is necessary to determine the exact area of the blockade, the extent of the lesion, and to identify the cause of the attack. This information is necessary to choose the right treatment tactics and prevent relapse.

As diagnostic method use the examination of blood vessels and the heart by means of magnetic resonance imaging. During the procedure, a three-dimensional picture of the brain tissue is visualized. The doctor sees all the changes and the focus of the affected brain structures.

Computed tomography is also used for stroke, which is advisable to carry out at the first suspicion of the development of brain dysfunction. The procedure detects bleeding in the brain tissues, assesses the extent of the damage to the organ.

Diagnosis of a stroke also includes an ultrasound scan of the carotid artery, which is the main vessel that carries blood to the brain. The study evaluates the condition of the vessels, reveals the presence of atherosclerotic plaques. Transcranial study in progress cerebral arteries. The doctor receives information about blood circulation in the vessels, the presence of plaques.

Magnetic resonance angiography reveals the localization of a thrombus in the arteries of the brain. For cerebral angiography, a contrast chemical compound is injected into the vessels of the victim, which visualizes the capillaries with x-rays.

The patient is given an electrocardiogram, an echocardiogram. These studies evaluate the work of the heart muscle, identify possible anomalies in the structure of the organ, disruptions in the rhythm. Such deviations often lead to a stroke.

An electroencephalogram is used to examine the brain for activity. The specialist attaches special electrodes to the patient's head. The electrodes allow you to detect the electrical activity of the brain.

Blood is taken to determine the concentration of glucose, lipoproteins, and a coagulogram. Latest research evaluates the rate of blood clotting in thrombosis or bleeding.

First aid

You can minimize the consequences of a stroke by knowing how to provide first aid to the victim. Initially, you need to call an ambulance. It is recommended to describe the patient's condition by phone so that a neurological team is sent to the person.

The patient should be laid down with a pillow under the head, fresh air should be provided, and straps and fasteners should be removed. When a gag reflex appears, you should turn your head to the right side and clear the oral cavity and airways from the released masses. If possible, you need to measure the pressure.

You can not panic, you should create a calm environment and wait for medical help. If it is difficult for a person to breathe, he has lost consciousness, then an indirect heart massage is required along with artificial respiration.

Therapeutic methods

The consequence of a stroke is the development of atrophic and necrotic processes in the brain tissues. Treatment of ischemic and hemorrhagic stroke is different. The goal of therapy for the hemorrhagic type of stroke is to prevent irreversible brain dysfunctions and prevent relapses. Treatment of ischemic stroke of the brain is aimed at restoring the affected areas, which speeds up the recovery of a person.

Ischemic stroke therapy

The patient is given treatment to prevent relapse. To eliminate the clot that clogged the artery, medications are administered that dissolve the formation (fibrinolytics). The drug is administered using a catheter. To minimize the extent of damage and reduce the severity of neurological disorders, reperfusion treatment is carried out - the introduction of the necessary medicinal substance.