Stroke — what is it? Causes and types of strokes
Strokes are terrible a vascular lesion of brain tissue, cerebral and peripheral. A brain stroke is one of the first places in frequency among all causes of death. Every year in Russia is fixed about 500 000 strokes. Up to 30% of patients affected by stroke die in the acute phase, i.e. in the first month of the disease. 80% of surviving patients remain with persistent consequences, as a rule, motor and speech disorders.
What is stroke and how does it occur?
Stroke is the reduction of brain function due to acute obstruction of its blood supply. This may be due to several mechanisms:
- the embolization;
Thrombotic strokes are caused by blockage of blood vessel by clot. Blood clots are formed gradually on the atherosclerotic plaques and, ultimately, close the lumen of the vessel. Blood clots tend to disintegrate and their particles (called emboli), travel through your bloodstream and clog any arteries organs and vessels. For example, when blockage of the orbital artery, a stroke occurs eyes. Ischemic stroke is the lack of arterial blood supply to the brain due to narrowing of atherosclerotic vessel. In violation of the integrity of the vascular wall is bleeding into the brain.
Causes of strokes
Numerous mechanisms, predisposing, provoking and causing increased morbidity and mortality from vascular diseases of the nervous system are known as risk factors. The development of stroke and its consequences can be caused by:
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- vascular hypotension;
- being overweight or obese;
- nicotine and alcohol addiction;
- burdened heredity;
- coronary atherosclerosis;
- endocrine disorders;
- disturbances in mineral metabolism, for example, with cervical osteochondrosis;
- accommodation in geophysical zones with sharp and frequent fluctuations of adverse meteorological factors;
- increased intellectual stress.
The types of strokes
Depending on the mechanism of violation of local cerebral blood flow and strokes are divided into three types:
- ischemic (cerebral infarction), including cardioembolic stroke and a low pressure;
- hemorrhagic, otherwise known as a stroke with bleeding in the brain;
- subarachnoid hemorrhage.
Depending on how soon the neurological symptoms regressed, distinguish what are the types of strokes:
- the actual strokes, progressive or total, in which regression is more than a month from the moment of cerebral accident.
- small, or mini-stroke, in which the regression is less than a month from the onset of the disease;
- transient NMK, also called transient ischemic attacks, when the neurological signs regressed completely within the first day.
In addition to the actual movements of the brain are distinguished:
- stroke of the cerebellum;
- a stroke of the brain stem;
- a stroke of the spinal cord.
The clinical picture of stroke is characterized by the presence of General cerebral and focal neurological symptoms. General cerebral symptoms may occur:
- dizziness, accompanied by loss of orientation in space;
- impaired consciousness, most serious of which is a lump;
- a stupor, drowsiness, accompanied by loss of orientation in time;
- bouts of excitement when experiencing hallucinations;
- transient episodes of loss of consciousness;
- found migraine variant, in which the patient unbearable headache and been vomiting;
- autonomic signs fever, sweating, palpitations and a dry mouth;
- if you develop swelling of the brain, generalized seizures begin, to critical numbers body temperature rises.
For focal symptoms, characterized by the fact that it entirely depends on which area of the brain is affected by the infringement of blood supply of the station.
For example, if this area, providing motor function, develop paresis or different degrees of paralysis in the limbs, accompanied by lowering of sensitivity, and related disorders of speech and vision. If this area of the brain that coordinates, marked unsteadiness of gait, imbalance, dizziness and uncontrollable vomiting. The clinical picture of the individual in each patient, the disease innumerable. Re-stroke the layers of your symptoms in the neurological picture of the effects of the previous one.
The first condition of the success of the therapeutic efforts in strokes is their timeliness. The patient should be delivered in a special Department of a hospital within the first hours of the disease. Depends on whether the recovery of patients without persistent irreversible effects. Therapeutic interventions in stroke is a complex of General and specific courses. The complex of therapeutic measures consists of:
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- basic treatment, carrying out the stabilization of the vital functions of the organism, prevention and treatment of complications;
- specific therapy, including maintaining metabolism and homeostasis of brain tissue;
- thrombolytic therapy in the absence of data for hemorrhage;
- antiplatelet therapy reduces the risk of thrombosis and embolism of the vessels;
- neuroprotective therapy;
- hemodilution and measures to improve the rheological properties of blood in ischemic nature of the stroke.
The General scheme of treatment will depend on the type of stroke and severity of its course. These factors and the presence of life-threatening complications determine which of a dropper put the patient and any prescribed injections. Discharged from the hospital the patient continues treatment on an outpatient basis. Patients a long time to take drugs to improve cerebral circulation, neuroprotective agents, undergoing rehabilitation. Rehabilitation courses and clinical supervision should continue for as many years as I live after a stroke.
Many patients include in the course of traditional medicine natural medicines prepared according to recipes of traditional healers who know how to be saved or to be healed from stroke. It is known that, for example, pine cones negate the process of dying brain cells. Tincture of pine cones is used both as a preventive measure and for rehabilitation of patients after stroke. It is taken in teaspoons three times a day. In the rehabilitation period, a single dose is three spoonfuls, enough to prevent one.
The main aspects of rehabilitation post-stroke patient
Rehabilitation in post-stroke period is a complex event. It includes medical, psychological, pedagogical, social and legal aspects. Efforts should be directed at recovery of lost functions and the activation functions impaired by stroke. Close attention should be paid to social and personal recovery of the patient, that is, its social and psychological rehabilitation. What is restored is reduced in stroke features:
- primarily, it is due to the involvement of neuronal interconnections that have never been claimed;
- the second reason I think the resorption of swelling around the hearth of a heart attack, or zone of hemorrhage in the brain;
- restores the efficiency of the blood supply to these parts of the brain;
- awakening is functionally inactive neurons.
Forecast the degree of success of rehabilitation depends on the size and localization of stroke lesion. To hinder the recovery process can:
- emotional or volitional dysfunction;
- the lowering of mental activity;
- limitation of physical capabilities;
- severe depressive disorders;
- cognitive impairment-reduction in intellect, distortion of memory and attention.
It is overcoming these obstacles decides how effectively restores the neurological status of the patient, which group of disability gives him at the end of rehabilitation. When planning rehabilitation measures in the elderly must be considered contraindications. Active physical rehabilitation is contraindicated:
- in heart failure;
- in acute inflammation;
- in chronic renal failure.
In addition to contraindications, there are many circumstances that impede the rehabilitation process. For example, extremely difficult to restore the speech of patients with dementia. And only a specialist can know how to develop arm or leg in patients with severe cognitive and mental disorders that prevent contact, understanding of commands and instructions, how to prevent the contracture if the extension is sick paralyzed arm.
Guiding principles for post-stroke recovery are recognized:
- Timely, the earliest possible start – the classes are even in the first days of the disease. This speeds up a full recovery dysfunction, to eliminate the possibility of a secondary infectious and trophic complications: pressure ulcers; thrombophlebitis; contractures; congestive pneumonia.
- Systematic remediation and persistence allow them to achieve persistent positive dynamics, alienate a disability. Rehabilitation starts in hospital and continues in the outpatient clinic. The best solution is the completion of the rehabilitation process in neurological rehabilitation centre or sanatorium.
- The duration and continuity of the course, persistence and discipline of the patient are rewarded with the recovery of motor skills and speech, cognitive abilities and stabilization of the emotional background. It depends on them whether there can be full recovery, to return the patient to their workplace, whether it is possible to drive a car, play sports, whether it is possible to fly the plane.
- The adequacy of rehabilitation therapy can be carried out only under the supervision and guidance of specialists: neurologists, doctors of physical therapy, apasionado, physiotherapists, psycho — and occupational therapists. Necessary is active complicity not only of the patient but also his family. All members should, to the extent possible be included in the rehabilitation process, for example, in performing all sorts of «homework» the patient in the evening after work or on weekends.