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Acute cerebrovascular accident (ACVA), or stroke, leads to massive death of brain cells. Even with a favorable development of the situation, this is fraught with serious negative consequences for the body. Complications of a stroke can be triggered by pathological processes in the brain or by the victim being forced to remain immobile for a long time. Proper organization of the early and late rehabilitation periods allows you to avoid many problems.

Consequences of cerebrovascular accident

Some complications after suffered a stroke occur in almost 100% of cases. If you know what to expect from the development of a certain form of pathology, you can begin preventive actions in time. Simple measures will reduce potential risks and minimize the severity of negative consequences and will increase the effectiveness of the rehabilitation period.

Ischemic stroke

It accounts for about 80% of stroke cases. In terms of recovery, this is the most favorable form of emergency. If the problem is identified in a timely manner and specialized therapy is carried out, one can count on eliminating the complications that have arisen and returning the patient to an active life.

After an ischemic stroke, the following phenomena may develop:

• paresis or paralysis of an arm, leg, or both limbs on one side of the body;
• impaired coordination, difficulty with orientation in space;
• problems with perception and understanding of what is heard;
• decreased motor activity, loss of body control;
• articulation disorder;
• loss or decreased sensitivity to pain, cold, heat;
• lack of basic household skills;
• committing inappropriate actions that could cause harm to the patient himself or others;
• apathy, passivity, depression;
• dementia and memory loss.

The listed conditions develop within 3-4 weeks after an ischemic stroke. They can appear separately or in combination. Their severity and persistence depend on the degree of damage to brain tissue.

Hemorrhagic stroke

Develops in 20% of cases. A third of patients die from cerebral hemorrhage and subsequent complications. Most of the victims do not even have time to receive emergency assistance. Even with a favorable prognosis due to the increased aggressiveness of the condition, we are talking about more serious consequences here.

Common results of hemorrhagic stroke:

• damage to vital centers, which leads to the death of the patient, even if profile treatment is started on time;
• stupor turning into coma;
• paralysis or paresis of arms and legs up to complete immobilization;
• loss of swallowing reflex;
• pain syndrome;
• lack of ability to think logically and adequately respond to what is happening;
• development of a vegetative state or profound disability;
• loss of the ability to speak and perceive information.

Probability of a negative outcome hemorrhagic stroke in men and women it is approximately the same, but ladies tolerate the critical and recovery periods of the disease much worse. They are more likely to have complications on the background of a stroke, and the risk of developing a recurrent stroke is high.

Hemorrhage into the subarachnoid space

A stroke that affects the subarachnoid spaces of the brain is most often the result of a head injury. This is another extremely dangerous condition. It is characterized by a high mortality rate and is almost always accompanied by the development of additional problems.

Potential complications and consequences of subarachnoid hemorrhage:

• brain with the subsequent development of ischemia;
• accumulation of fluid in the brain;
• pathological processes in organs and systems as a result of damage to vital centers;
• headache and nausea, turning into epileptic seizures;
• memory impairment, impaired attention, lack of ability to focus on some moments;
• the risk of aneurysm formation and subsequent rupture.

Mortality with this type of stroke is observed in 60% of cases. If the assistance provided made it possible to bring the victim out of a critical condition, the probability of developing complications in him is 100%.

Early complications of stroke

Complications of ischemic stroke and hemorrhagic form of the disease develop according to the same scenario. The degree and aggressiveness of the manifestations depend on the size of the affected tissue area and the quality of the first aid provided. Many of these consequences pose an additional danger to the life and health of the patient.

Stupor and coma

Stupor - a state of deep depression - is characterized by severe depression of the patient. He does not make contact, his pupils do not react well to light. The person does not feel pain and is apathetic. Most often, the phenomenon is the result of damage to the right hemisphere of the brain.

If treatment is not started in time, coma develops. Vascular tone is disrupted, the victim loses consciousness and does not respond to stimuli. In case of severe damage to brain tissue, death occurs.

Brain swelling

Accompanied by vomiting and nausea, severe headache, gait disturbance, memory loss. Problems with articulation appear, tremors in the hands give way to convulsions and stupor. The patient loses consciousness and has difficulty breathing. The condition develops within two days after the impact, the peak of symptoms occurs on days 3-5. In the initial stages, the problem is solved by conservative treatment; in advanced cases, surgical intervention is required.

Pneumonia

There are two reasons for the development of complications. In the first case, due to impaired swallowing, pieces of food enter the respiratory tract and disrupt the natural course of processes. In the second, malfunctions in the work of the respiratory organs develop against the background of stagnation of blood due to the forced long position of the patient's body. Prevention of phenomena consists in observing the rules of feeding the patient and conducting breathing exercises.

Paralysis

Impairment of motor activity can be complete or partial. Most often, it affects the half of the body opposite the affected hemisphere of the brain. It is almost impossible to prevent such developments. Immediately after the patient's recovery from a critical condition, recovery measures begin.

Repeated stroke

During the recovery period after an ischemic stroke, a form of the disease may develop. These risks increase in case of high blood pressure, vascular hypertonicity, infectious diseases and heart pathologies in the victim. A person's careless attitude towards his health also poses a danger.

Bedsores

Lack of physical activity leads to the failure of biological processes in the human body. This can cause death of tissue, cartilage and bones. Prevention of pathology consists in a regular change in the position of the patient's body, treatment of problem areas with camphor alcohol and their light massage.

Mental disorders

Such problems often arise when the frontal lobes of the brain are damaged. They are expressed by capriciousness, aggressiveness, irritability or anxiety of the victim. Many patients after stroke suffer from sleep disturbances. In some, some character traits are sharpened, signs of dementia develop.

Stress disorders

A sharp increase in the level of stress hormones is fraught with the development of myocardial infarction and stomach ulcers. Many patients have a heart rhythm disturbance, which is exacerbated due to disruptions in mineral metabolism. Another consequence of the reactions is a decrease in the functionality of the immune system, which increases the likelihood of developing sepsis.

Delayed complications of stroke

Such complications after a stroke mainly have a negative impact on the quality of life of the victim. If conditions are ignored, there is a danger to human health and life. High-quality prevention and timely detection of pathologies is the key to reducing the risk of deep disability of the patient.

Thrombosis and thromboembolism

A slowdown in metabolic processes and a reduced intensity of blood flow lead to the formation of blood clots. These clots enter the bloodstream and can cause blockages in blood vessels. Blood stops flowing to the tissues of individual parts of the body, and necrosis develops. The initial stages of the condition do not have clinical signs, which increases the danger of the phenomenon. Prevention of thrombosis consists of diet, massage, physical activity (at least passive), and taking medications.

Depression and apathy

The depressed state of the patient negatively affects the quality of rehabilitation. In some cases, this is even fraught with the appearance of suicidal thoughts and inappropriate behavior.

Speech disorders

Occurs against the background of paralysis of the facial muscles. With the help of simple and available exercises this condition can be successfully combated. First, the work is carried out by a speech therapist, then classes continue at home.

Deterioration of memory and intelligence

Such phenomena can occur at any stage of the recovery period. They are dealt with with the help of medications, occupational therapy, art therapy, and work with a speech therapist. Systematic exercise slows down degenerative processes and reverses them.

The fight against the consequences and complications of a stroke continues for several months and even years after the stroke. Strict adherence to doctor’s recommendations increases patients’ chances of restoring the functionality of systems and organs. An integrated approach to rehabilitation under the supervision of professionals significantly reduces the risks of developing negative aspects.

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;
• 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 with 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 is due to the peculiarities of the location of nerve cells and pathways responsible for the functions of movement. The consequences of their defeat are “mirrored” paresis. So, if your left hand moves poorly after a stroke, it can be assumed that the right hemisphere was affected.

Complications after illness

Left-sided hemiparesis after stroke

An ischemic stroke is dangerous not only as a threat to life, but also because of the consequences that arise after the relief of an attack. Nervous tissue recovers slowly and is easily destroyed. Violation of the blood supply leads to the death of many cells, due to which the usual pathways for the brain signal are disrupted. Until these pathways are restored at the expense of neighboring cells, and according to some scientists of neurogenesis, the efficiency of performing certain cognitive tasks will be reduced. One of the worst consequences is dementia.

In addition, hemiparesis on the left side of the body may persist long time or constantly. The process of restoring the functions of movement is very long, the patient is required to take measures aimed at returning the 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 emotional sphere– their personality undergoes changes. The sense of tact is lost, the ability to empathize (empathy), emotional involvement is reduced. 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 don’t 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. Relapse is possible even after a year of remission, so follow healthy image life will always have to from now on. The long recovery period after discharge from the hospital can be whiled away in a sanatorium, where the patient will receive full care.

Acute cerebrovascular accidents include transient cerebrovascular accidents and cerebral strokes, among which a group of small strokes is distinguished.

Transient cerebrovascular accidents

Transient cerebrovascular accident is an acute disturbance of blood circulation in the brain with the development of rapidly passing symptoms of damage to the central nervous system. This group includes only those cases of the disease in which clinical manifestations persist for no more than 24 hours. Therefore, the diagnosis of transient cerebrovascular accident is always retrospective, and until the end of the first day after the onset, the disease is regarded as a cerebral stroke. Transient cerebrovascular accidents include transient ischemic attacks and hypertensive cerebral crises.

The duration of neurological disorders in transient ischemic attacks ranges from several minutes to a day, but more often - 10-15 minutes. About 10% of transient ischemic attacks within a month after the onset are accompanied by the development of ischemic stroke.

Transient ischemic attacks are diverse in clinical manifestations and depend on the location and duration of hemodynamic disorders. Usually, transient ischemic attacks are manifested by a mild neurological deficit, consisting of general cerebral and focal neurological symptoms. Transient ischemia of the brain stem may be accompanied by symptoms of bulbar palsy, oculomotor disorders. Transient ischemic attacks also include suddenly developing transient visual impairment in one eye (typical for retinal artery embolism), visual impairment in one eye in combination with contralateral hemiparesis (alternating optopyramidal syndrome, pathognomonic for lesions of the internal carotid artery).

Hypertensive cerebral crises are acutely developing disorders of cerebral hemodynamics as a result of a breakdown in autoregulation with the development of cerebral edema, which are accompanied by cerebral and focal symptoms that disappear within a day. In the pathogenesis of hypertensive cerebral crises, the main place is given to an increase in venous and intracranial pressure, damage to the blood-brain barrier with access to the extracellular space of a protein-rich fluid. Vasogenic cerebral edema develops.

In the clinical picture, with the development of a hypertensive cerebral crisis, general cerebral symptoms come to the fore: a sharp headache, localized mainly in the occipital or parietotemporal region, a change in consciousness in the form of stupor, confusion, psychomotor agitation. Sometimes a short-term loss of consciousness is possible. In some cases, meningeal symptoms are detected. Often, at the height of the headache, nausea, vomiting occurs, and quite often dizziness, usually of a systemic nature. Against this background, focal symptoms of varying degrees of severity can be determined.

In case of transient cerebrovascular accidents, there are no acute changes in the brain substance during computed tomography and magnetic resonance imaging.

Brain strokes

Cerebral stroke is an acute circulatory disorder in the brain with the development of persistent symptoms of damage to the central nervous system caused by a heart attack (acute cerebrovascular accident of the ischemic type, ischemic stroke) or hemorrhage in the medulla or in the intrathecal space (acute cerebrovascular accident of the hemorrhagic type , hemorrhagic stroke). In the structure of strokes, the ischemic type (80%) clearly predominates over the hemorrhagic type (20%).

Minor stroke. It develops acutely and is characterized by the development of focal and cerebral symptoms, which should be completely relieved with or without therapy within 3 weeks. (21 days). Computed tomography or magnetic resonance imaging often shows no acute damage to the brain tissue. The diagnosis of minor stroke is retrospective.

Ischemic stroke. Ischemic stroke (acute ischemic cerebrovascular accident) is an acute brain injury that develops as a result of insufficient supply of brain tissue with oxygen and metabolic substrates. Ischemic stroke has always been classified as a disease of old age, but the onset of stroke before the age of 50 is not uncommon.

With ischemic stroke, 30% of patients die within the first month, and by the end of the year – about another 20%. Of the patients who have suffered a cerebral stroke, more than 60% remain disabled and require medical and social support for the rest of their lives, and labor activity no more than 15% can return.

The onset of stroke refers to the first clinical manifestations (neurological symptoms) of an acute cerebrovascular accident.

The following periods of ischemic stroke are distinguished:

– the most acute period – up to 2–5 days after the onset of the disease;

– acute period – from 2–5 to 21 days;

– early recovery period – from 21 days to 6 months;

– late recovery period – from 6 months. up to 2 years;

– period of residual effects – after 2 years.

When a new ischemic focus appears in the same basin (area of ​​blood supply to the main vessel of the head), cerebrovascular accidents are diagnosed within 28 days after the onset of stroke, a recurrent stroke is diagnosed, in more late dates- recurrent stroke.

In the clinical picture of ischemic stroke, as a rule, focal neurological symptoms prevail, although in some cases it can begin with headache, vomiting, loss of consciousness, and epileptic seizures. The nature and severity of focal symptoms depend on the area of ​​the switched off artery, the state of collateral circulation and the depth of ischemic damage.

Occlusion of the internal carotid artery may manifest itself as monocular visual impairment on the side of occlusion (due to impaired blood circulation in the orbital artery) in combination with contralateral hemiparesis or hemiplegia (alternating opticopyramidal syndrome), hemihypesthesia; aphasia with damage to the dominant hemisphere; anosognosia, autotopagnosia with damage to the subdominant hemisphere; paresis of gaze; hemianopia may develop.

Occlusion of the middle cerebral artery, depending on its degree and location (Fig. 84, 85), it manifests itself in various clinical symptoms. Complete blockage of the trunk to the origin of the deep branches causes extensive damage and is manifested by a deep disturbance of consciousness up to coma, hemiparesis or hemiplegia (usually of the brachiofacial type), hemianesthesia, gaze paresis, hemianopsia, aphasia (with damage to the dominant hemisphere), anosognosia and autotopagnosia (with damage to the subdominant hemisphere).

Anterior cerebral artery occlusion manifested by the following symptoms: hemiplegia or hemiparesis with predominant damage to the leg, a significant increase in muscle tone, deep reflexes, the appearance of a grasping reflex; hemihypesthesia with a predominant loss of sensitivity in the leg; motor aphasia, usually transient, with damage to the dominant hemisphere. When the anterior parts of the limbic region and hypothalamus are damaged, mental, memory, and emotional disorders develop. Possible loss of coordination such as astasia-abasia.

Rice. 84. Magnetic resonance imaging of the brain, T2-weighted image. Post-ischemic changes in the brain substance of the right frontal, temporal and parietal lobes - consequences of ischemic stroke in the territory of the right middle cerebral artery

Rice. 85. Non-contrast three-dimensional time-of-flight magnetic resonance angiography of cerebral vessels. Absence of an MP signal from the blood flow in the area of ​​the M1 segment of the right middle cerebral artery and its distal parts – thrombosis of the middle cerebral artery

Vertebral artery occlusion leads to the development of a syndrome, the structure of which is determined by the degree of involvement of its various branches. Most often, symptoms are caused by damage to the medulla oblongata, cerebellar or spinal cord infarction. Damage to the brain stem leads to the development of various alternating syndromes. The possibilities of collateral blood flow are optimal in case of occlusion of the extracranial region. In this case, collateral blood flow is possible from the opposite vertebral artery, branches of the external carotid and subclavian arteries. With occlusion of the intracranial region, the possibilities of compensation are limited and the depth of the lesion is more severe.

Basilar artery occlusion characterized by the development of bilateral focal symptoms. Extensive occlusion of the basilar artery is particularly severe and leads to the development of an infarction, spreading to both halves of the pons, with damage to the corticonuclear and corticospinal tracts. Clinically, it is manifested by the development of “locked-in” syndrome (locked-in syndrome). Such a heart attack is characterized by the loss of all motor functions (tetraplegia in combination with pseudobulbar syndrome) while maintaining only individual movements, most often of the eyeballs, while the patient is conscious.

Posterior cerebral artery occlusion leads to the development of homonymous hemianopia (often with preservation of central vision), visual agnosia (with damage to the outer parts of the dominant hemisphere), memory impairment (with damage to the posterior limbic region in the mediobasal parts of the temporal lobe); alexia, mild sensory or amnestic aphasia (with damage to the temporal region of the dominant hemisphere); thalamic Dejerine-Roussy syndrome (hemianesthesia, spontaneous pain, hyperpathy, “thalamic arm”, hemiataxia, pseudoathetosis); hemiplegia; upward gaze paresis, pupillary disorders; large-scale tremor. Damage to both posterior cerebral arteries leads to the development of cortical blindness through a period of “tunnel” vision.

Hemorrhagic stroke- this is an intracranial hemorrhage that occurs as a result of rupture of pathologically altered cerebral vessels (Fig. 86, 87). The relevance of hemorrhagic stroke is associated primarily with a high mortality rate (up to 80%). Depending on the location of the hematoma, parenchymal, subarachnoid, ventricular, parenchymal-subarachnoid, parenchymal-ventricular hemorrhages are distinguished.

Most common cause hemorrhagic stroke is arterial hypertension in combination with atherosclerotic lesions of the cerebral arteries (about 70% of cases). In second place in frequency are cases of hemorrhage that developed against the background arterial hypertension without atherosclerotic lesions of the cerebral arteries (about 15% of cases). Aneurysm rupture causes hemorrhage in approximately 10% of cases.

In the pathogenesis of hemorrhages in arterial hypertension, the main role is played by hypertensive crises, which result in morphological changes in intracerebral vessels and violations of their integrity. As a rule, these are only tears in the wall with the formation of miliary aneurysms, less often - complete ruptures. Atherosclerotic changes in arteries without arterial hypertension do not lead to hemorrhages.

Hemorrhagic strokes also include spontaneous cerebral hematomas. They occur at a young age (20–30 years) in almost all healthy people. Intracerebral hematomas are localized mainly in the white matter. The cause of hematoma development is arteriovenous malformations, which are a congenital defect of the vascular system.

Rice. 86. Computed tomography of the brain. Hemorrhagic stroke in the left occipital lobe with breakthrough of blood into the ventricular system of the brain

Rice. 87. Computed tomography of the brain. Extensive hematoma of the right hemisphere of the brain with a breakthrough of blood into the lateral ventricles - parenchymal-ventricular hemorrhage

As a rule, intracranial hemorrhage develops suddenly, against the background of complete health. Less commonly, it is preceded by headaches similar to a migraine attack or intracranial hypertension, and sometimes epileptic seizures occur. Hemorrhage most often develops during the day, during vigorous activity, and is often preceded by severe exercise stress, psycho-emotional stress.

Acute form intracerebral hemorrhage clinically debuts as coma with dysfunction of vital systems (cardiovascular and respiratory). Repeated vomiting is common. With incomplete loss of consciousness, psychomotor agitation is observed. Severe autonomic disorders are characteristic: hyperemia (sometimes pallor) of the skin of the face and neck, profuse sweating, acrocyanosis. The pulse is tense and rare. Blood pressure can reach very high numbers, be persistent and difficult to correct with medications, which is a poor prognostic sign. Already on the first day, central hyperthermia up to 41 °C can develop. About 80% of patients die on the first day. Subacute form observed in 25% of patients and is characterized by a less rapid development of neurological symptoms. Chronic course hemorrhagic stroke is observed in 10% of patients with lateral hematomas. This form is characterized by a slow (over several weeks) increase in neurological symptoms, the course of the disease is slowly progressive or wave-like, periods of deterioration are followed by periods of improvement in the general condition, reminiscent of the course of a brain tumor. Although it is believed that the chronic course is more favorable, the mortality rate reaches 60%.

Clinical picture of hemorrhagic stroke consists of cerebral, focal and meningeal symptoms. The most common symptom is hemiplegia, usually combined with central paresis of the facial muscles and tongue. Typically, paretic disorders in the arm are more pronounced than in the leg. Monoplegia is rare. Tetraplegia is observed in 10% of patients. In this case, the disease begins especially acutely, a deep coma quickly develops, and most patients die. An autopsy reveals large hematomas with breakthrough of blood into the ventricles of the brain, dislocation of the trunk with pinching in the foramen magnum. In this case, multiple small secondary hemorrhages occur in the brain stem. In the first hours of hemorrhage, muscle hypotension develops in the paralyzed limbs, which is subsequently replaced by muscle hypertension. A cerebral hemorrhage is characterized by a paroxysmal increase in muscle tone, called hormetonia by S. N. Davidenkov. Hormetonic convulsions are observed with hemispheric hemorrhages with a breakthrough of blood into the ventricles of the brain. It is possible to identify sensory disturbances (most often hemihypesthesia) only in patients with preserved consciousness. Seizures are observed in approximately 1% of patients with intracranial hematoma. Meningeal symptoms appear within a few hours after the hemorrhage. Kernig's symptom is determined with great constancy, while neck stiffness may be absent.

Subarachnoid hemorrhage

Subarachnoid hemorrhage develops as a result of damage to the vessels of the brain and (or) its membranes in many diseases: hypertension and atherosclerosis, infectious diseases, exogenous and endogenous intoxications, but in most cases (50–60%) the cause of spontaneous subarachnoid hemorrhage is aneurysms or arteriovenous malformations .

There are three periods in the clinical course of ruptured aneurysms: pre-hemorrhagic, hemorrhagic, post-hemorrhagic.

Pre-hemorrhagic period has a number of features that you should pay attention to. Approximately half of the patients exhibit the following clinical manifestations:

- local headaches (especially in the forehead, nose and orbit), often radiating to the eyeball, and in some patients combined with meningeal symptoms lasting up to 2-3 days;

- migraine attacks (especially ophthalmoplegic and associated) with a late onset in patients older than 40 years;

- epileptic seizures - primary generalized and partial, which began without an apparent external cause, especially in patients older than 35 years;

- attacks of non-systemic dizziness in young people, not accompanied by fluctuations in blood pressure;

- transient (lasting from several hours to several days) focal neurological symptoms of unknown origin.

Hemorrhagic period includes the first three weeks after the aneurysm ruptures. An aneurysm ruptures suddenly. The factors provoking it are physical or psycho-emotional stress, alcohol intoxication, etc. In some cases, it is not possible to establish a provoking factor.

The clinical picture consists of cerebral, meningeal, to a lesser extent - focal symptoms in combination with characteristic changes in the cerebrospinal fluid.

Of the general cerebral symptoms, the most common and constant is intense headache, which can be diffuse or local. In the latter case, it is concentrated mainly in the forehead, temple, and back of the head, often radiating into the eye and bridge of the nose. A severe headache usually lasts for the first 7–8, less often – 10–12 days. The headache is persistent and difficult to relieve with analgesics. Subsequently, the headache gradually subsides and disappears completely by the end of the third week. Some patients experience persistent pain in the back of the neck and spine, caused by irritation of the roots of the spinal cord from the escaping blood. Headache is often accompanied by nausea and vomiting.

Vomiting has the typical nature of so-called “brain” vomiting, that is, it develops out of connection with food intake and does not bring relief. Most patients experience disturbances of consciousness of varying duration. Psychomotor agitation, severe disorientation in place, time and self, confusion, and memory loss are considered characteristic symptoms of subarachnoid hemorrhage. Epileptic seizures often develop.

Meningeal symptoms appear early. Direct meningeal symptoms (stiffness of the neck muscles, Kernig, Brudzinsky, etc.) are detected in 74% of patients. The degree of their severity may vary. More often (86%) indirect signs of irritation of the meninges are observed (hyperesthesia of the sensory organs, pain on percussion of the zygomatic arches, etc.).

The severity, frequency and nature of focal neurological symptoms are determined, first of all, by the location and type of vascular pathology - saccular aneurysm or arteriovenous malformation.

Focal symptoms of rupture of a saccular aneurysm are represented mainly by isolated damage to the roots of the cranial nerves, primarily the oculomotor nerve, which is observed only when the aneurysm of the supraclinoid part of the internal carotid or posterior communicating artery ruptures. Damage to the brain substance is not typical for subarachnoid hemorrhage caused by aneurysm rupture, and occurs only in the presence of concomitant intracerebral hematomas or ischemic disorders (as a result of the development of vasospasm). In patients with aneurysm ruptures and subarachnoid hemorrhage syndrome, damage to the hypothalamus is often observed, leading to dysfunction of the hypothalamic-pituitary-adrenal system.

The predominance of disturbances of consciousness is characteristic of massive subarachnoid hemorrhages, more often with rupture of an aneurysm of the anterior communicating artery. Isolated meningeal syndrome is observed mainly with limited basal and convexital hemorrhages. The combination of meningeal symptoms with focal neurological symptoms is usually observed in patients with rupture of a vessel of an arteriovenous malformation (67%) and very rarely with a saccular aneurysm (4%). The detection of this syndrome in patients with rupture of a saccular aneurysm indicates the development of foci of ischemia caused by regional vasospasm. Epileptic syndrome is observed in 18% of patients with ruptured aneurysm and only 3% with arteriovenous malformation.

Clinical manifestations of hypothalamic disorders are represented by increased blood pressure (up to 240/110 mm Hg and above), tachycardia, hyperthermia, changes in diencephalic breathing (frequent, more than 40 per minute, correct breathing), the occurrence of hyperglycemia and azotemia, the development of trophic disorders characterized by the appearance of macerations, quickly turning into ulcerations and bedsores, which can occur both in typical places and on areas of the skin not subject to pressure. There is a progressive general exhaustion of the patient.

The fate of a patient with a ruptured intracranial aneurysm is largely determined by the presence and severity of arterial vasospasm. Angiospasm develops as a result of damage to the wall, as well as the influence of humoral factors released as a result of cascade reactions of organic proteolysis (catecholamines, serotonin, prostaglandins, fibrin breakdown products), causing, in particular, persistent swelling of the vessel wall with a narrowing of its lumen. In the area of ​​vasospasm, vascular resistance sharply increases, perfusion pressure decreases, and cerebral ischemia develops, which can lead to severe damage to brain tissue and the occurrence of a heart attack.

Mixed stroke

In most cases, a mixed type of stroke is understood as an ischemic stroke followed by hemorrhagic transformation of the ischemic focus (intracerebral hemorrhage). Treatment tactics are determined depending on the predominance of the ischemic or hemorrhagic component of the stroke.

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Due to frequent surges in blood pressure and various work-related problems of cardio-vascular system, including a violation of the structure of the walls of large or small blood vessels, a person may experience an acute ischemic cerebrovascular accident, which is a type of stroke.

This is when in one of the areas of the brain there is a cessation, a disruption of normal blood circulation, that is, in the area of ​​pathology, cells die due to lack of oxygen. It is impossible to treat them, however, the functions for which they were previously responsible can be revived if more daily attention is paid to the victim of acute stroke during the rehabilitation period.

Based on this, it has also been proven that every year the number of deaths of stroke victims is constantly increasing, as well as the number of people who become disabled. This may be due not only to related diseases, but also to polluted air, which is especially common in cities with large populations. Plus everything poor nutrition and bad habits further aggravate the condition of many people.

Symptoms of ischemia in stroke

Stroke is one of the diseases that belongs to the type of neuralgia. She never comes alone, but is always accompanied by a number of ailments. It is mainly important to note that the patient may feel the symptoms of acute ischemic stroke precisely during deep sleep or in the early morning.

As a rule, poor health begins to gradually increase, thereby increasing the person’s restless state every hour, so, over the course of a day or several days.

At this very time, patients may experience the following ailments:

• Cutting pain in the head.
• Lethargy in movements.
• Decreased sensitivity in the body, on any side.
• The picture before my eyes becomes less clear.

• Distortion of speech functions.
• There are periods when, after a cerebral ischemic stroke, patients deny the presence of lethargy and low functionality of the arms and legs.

Together with the listed symptoms, the doctor can also identify decreased pain threshold, unilateral decreased vision and severe speech impairment.

This includes distortion of one half of the nasolabial line, deterioration of reading processes and swallowing functions; also, due to poor cerebral circulation, the patient experiences a violation of the logic of judgment when solving arithmetic problems. Which can sometimes manifest itself as the victim’s inability to adequately assess his condition in the period after a stroke.

What can increase the risk of an acute period?

Ischemic stroke has never been an independent disease, on the basis of which in a number of situations stroke of the type of ischemia always overtook people at the most unexpected moments as a result of many ailments caused by the following reasons:

• Regular pain in the heart area.
• Disproportionate consumption of sugar, fat and flour products.
• A high body mass index is the main reason for the development diabetes mellitus and blockage of blood vessels.
• Ischemic stroke is a common problem among drinkers and smokers.
• As a rule, many young women, fearing their pregnancy, begin to take hormonal drugs on their own, without warning their loved ones about it, including without consulting a doctor.

• Hemoglobin in the blood may be high due to insufficient oxygen supply to the brain. In this case, a cerebrovascular accident may result in a cerebral ischemia stroke.
• Old age of a person.
• Consequences after head injuries.

Perhaps not all the reasons are listed here, however, even in this case, you should always pay attention to the daily menu, namely, what products are most often present in the diet, fresh herbs and fruits, or sweet rolls with carbonated drinks. This also includes bad habits, when people who choose a healthy active lifestyle instead of a healthy one can get many problems leading to impaired cerebral circulation.

Necessary restorative actions during acute medical complications

A person who has experienced acute illness during an ischemic stroke cannot determine in advance at what stage he will be able to fully recover. At the same time, he has no way of knowing what might happen to him in the future after his illness, how he will live in the future, and will remain stuck for the rest of his life. wheelchair or die within the first 24 hours.

Therefore, in order to prevent subsequent deterioration of the patient’s condition, doctors immediately during hospitalization begin to reduce the influence of pathology through drug treatment or in an extremely acute period of ischemic type, the patient may be referred to the surgery department.

After treatment of ischemic stroke in the acute period, when the patient has improved, stability in blood pressure and cholesterol levels, doctors can proceed to the next stage of the patient’s recovery, for example, the use of physiotherapeutic procedures. In this case, also, depending on certain consequences, rehabilitation courses of exercise therapy, massage and ergotherapeutic procedures are prescribed to restore mental and motor activity.

Pathological causes of brain stroke

Poor circulation during an ischemic stroke leads to very serious consequences. When, in almost the same proportions, patients can die or become completely incapacitated people. But, despite the danger of a brain stroke, 5-7% of the victims fully begin to take care of themselves and walk without assistance during the first rehabilitation stage.

But what a patient will ultimately expect after a stroke will depend entirely on a number of the following reasons:

1. Occlusion in the large arteries of the hemispheres and cervical spine, accompanied by blood obstruction due to sudden blockage of the lumen due to the high content of platelets in the blood.
2. The presence in the patient's body of a focus of the inflammatory process.
3. The postoperative period on the heart, when due to the formation of a blood clot, an immediate, acute circulatory disorder occurs.
4. Due to dissection of the main artery.
5. The formation of a transparent dense mass in the internal environment of the connective tissues of the human body.
6. Blood clotting disorder, this phenomenon occurs mainly during manifestations of infections internal organs protracted nature.

It is also important to note that it will contribute to the development of ischemic cerebral stroke and various types of inflammation of the cervical spine, especially if the carotid arteries were affected in the process, there is such a possibility, but, by the way, it extremely rarely causes a stroke.

Therefore, great importance should be given to those people who already have a history of osteochondrosis of the upper spine, when there is a possibility that circulatory disorders may occur in the area where blood passes from the neck to the brain.

In connection with this, in order to improve blood permeability, such people need to constantly massage using an ointment or cream with a warming effect, due to which the blood permeability will be better, due to increasing the lumen in the vessels.

Possible consequences after a difficult rehabilitation stage

During the period of a cerebral stroke, patients can suffer from very serious to very mild consequences, which after some time can recover and return to their normal environment. If, during the recovery process, the disruption of blood flow has managed to affect larger areas of the brain matter, then most likely the patient may develop the following ailments as a result:

• In certain areas of the body, the patient will have a low sensitivity threshold.
• As a rule, in the post-stroke period, patients cannot fully feel their paralyzed arms and legs.
• Impaired swallowing function, when the patient requires intravenous feeding or by introducing food through a gastric tube.
• Patients may not be able to taste food, since the taste buds on the tongue will also have low sensitivity on the paralyzed part.
• Partial or complete loss of hearing and vision after ischemic cerebral stroke.
• A frequent sign of poor blood circulation in the brain is a disturbance in the perception and reproduction of speech.

• When starting rehabilitation, the patient may often experience signs of severe dizziness.
• The patient’s thoughts become less objective and reasonable, so he is unable to do even the most simple words put together a sentence.
• Disorders of urination and defecation.
• Due to low blood circulation during the illness, in most cases, coma for a long time.
• Patients lack the ability to control their body position in space.

However, if you spend more time with the patient from the beginning of the first and subsequent days, and preferably from the first second when he had a stroke, then the chances for his rehabilitation will be much greater. Compared to the moment when help was provided to the patient not immediately, but several hours later.

What basically happens when the patient himself does not pay more attention to his own health. But, most importantly, everything will depend on the specific area in which problems with blood circulation in the brain were recorded, and how quickly further complications were eliminated.

Elderly people are familiar with this disease, the name of which is ACVA - acute cerebrovascular accident or simply a stroke. Almost every older person has experienced this illness. It is very important to understand the causes of stroke and proper treatment diseases.

What it is?

Stroke is a clinical symptom manifested by sudden disruptions in the normal functioning of the existing brain options of the head, the duration of which is more than one day.

The main symptoms of stroke are:

1. Inability of the patient's body to move normally;
2. Disorders of organs responsible for sensitivity;
3. Violations of the proper functioning of the speech apparatus;
4. The patient's inability to swallow;
5. Frequent headache;
6. Loss of consciousness.

An unexpected disturbance in the speech apparatus, loss of body sensitivity and problems with coordination of movement disappear over the next 24 hours. Then they talk about transistor ischemic attack. This is not as dangerous a disease as stroke, but also refers to stroke.

If the disease relates to disturbances in the functioning of the circulatory system, it is characterized as “CVA of the ischemia type.” In the case when a specialist confirms bleeding, the disease is characterized as “CVA of the hemorrhagic type.”

A stroke that ends in a stroke is a stage when the flow of blood to some part of the brain stops. This phenomenon is caused by a decrease in the tone of the walls of the arteries of the brain and is accompanied by a disorder of the neurological system, which is a consequence of the destruction of part of the nerve tissue.

ONMK - code according to ICD-10

In the tenth international classification of diseases, stroke has several codes that differ from each other according to the disorders that caused the disease.

Prevention and treatment of this disease are considered at the state level, since stroke is fatal in a third of cases. Sixty percent of patients who have suffered from the disease turn out to be disabled people who cannot do without social assistance.

Causes of stroke

ACVA, related to the ischemic type, develops as a result of existing pathologies in the patient’s body.

Such diseases include:

ACVA occurs not only in the adult population, but also in children. This is due to the fact that the vessels of the children’s brain have some anomalies in their development. A high risk of developing stroke is observed in children who have congenital heart disease.

When acute stroke occurs, only 30% of children recover completely. About fifty percent have incurable disorders of the neurological system. Twenty percent of cases of acute cerebrovascular accident in children are fatal.

In what cases can one suspect stroke?

The diagnosis of stroke is made if the patient has the following disturbances in the functioning of the body:

1. A sharp lack of sensitivity in the limbs;
2. Loss of vision up to blindness;
3. Inability to recognize the opponent's speech;
4. Loss of balance, problems with coordination;
5. Very severe headaches;
6. Confusion of consciousness.

An accurate diagnosis can only be made after diagnostics.

Stages of cerebral infarction

ACVA has several stages of development. Let's look at each of them in more detail.

Stage number	Stage symptoms
First stage	A lack of oxygen occurs, which leads to disruptions in the permeability of flat cells located on the surface of blood vessels. As a result, fluid and protein from the blood cells enter the brain tissue. Edema formation occurs;
Second stage	At the capillary level, blood pressure continues to fall, which leads to disruption of the cell membrane. Nerve receptors and electrolyte channels also stop functioning properly. At this stage, the disease is preventable;
Third stage	Disturbances in cell metabolism occur, and lactic acid accumulates in tissues. Energy synthesis occurs, in which oxygen molecules do not participate. The anaerobic regime does not allow the tissues of neurons and astrocytes to maintain a normal level of vital activity. These cells increase in volume, causing malfunctions in the structure. The clinical picture represents focal signs of a neurological nature.

Ischemic stroke

This type of stroke is accompanied by a complete cessation of blood flow to specific areas of the brain tissue, which is accompanied by the destruction of brain cells and the cessation of its basic functions.

Causes of ischemic stroke

This type of stroke is caused by obstruction of blood flow to any brain cell. As a result, normal brain activity stops. A plaque consisting of cholesterol can also become an obstacle to the normal flow of blood. This causes more than 80% of all diseases.

Risk group

ACVA most often manifests itself in the population that has the following pathologies:

• Vascular disorders of an atherosclerotic nature;
• A sharp increase in blood pressure;
• Previous extensive myocardial infarction;
• Stretching of the artery;
• Heart defects that are acquired or congenital in nature;
• Increased blood thickness caused by diabetes:
• Reduced blood flow rate, which is a consequence of cardiac failure;
• Excess body weight;
• Transistor ischemic attacks previously suffered by the patient;
• Excessive consumption of alcohol and tobacco products;
• Reaching the age of sixty;
• The use of oral contraceptives, which contribute to the occurrence of blood clots.

Symptoms of the disease

Neurologists distinguish several periods of development of ischemic stroke according to the severity of the disease:

1. The sharpest. Lasts up to five days;
2. Spicy. The duration is 21 days;
3. Recovery at an early stage. From the moment the acute symptoms are eliminated, it takes six months;
4. Late recovery. The rehabilitation period lasts for two years;
5. Eliminating traces. More than two years.

In addition to general symptoms, ischemic stroke of the brain is characterized by local symptoms. It depends on the area in which the disease occurred.

And so, if you are amazed then the following symptoms appear:

• Disorder of the visual system in the side where the blockage of the vessel occurred;
• The sensitivity of the limbs disappears on the opposite side of the lesion;
• In the same area, paralysis of muscle tissue occurs;
• There are disorders in the work of the speech apparatus;
• The inability to recognize your illness;
• Problems with body orientation;
• Loss of field of vision.

With narrowing of the artery of the spine, another symptomatology is noticeable:

• Hearing loss;
• Twitching of the pupils when moving in the opposite direction;
• Objects appear double.

If defeat happened on area of ​​combination with an unpaired blood vessel, then the symptoms manifest themselves in a more severe form:

In case of defeat anterior cerebral artery:

• Loss of sensation in the opposite side, usually in the leg area;
• Slowness in movement;
• Increased tone of muscle-flexor tissue;
• Lack of speech;
• The patient cannot stand or walk.

If failures prevent normal patency of the middle cerebral artery:

• The consequence of complete blockage of the main trunk is a state of severe coma;
• There is a loss of sensitivity in half the body;
• The motor system fails;
• Inability to fix your gaze on an object;
• Fields of vision disappear;
• There is a failure of the speech apparatus;
• The patient is unable to distinguish the right limb from the opposite one.

In case of violation patency of the posterior cerebral artery The following clinical picture is observed:

Obstruction of the optic geniculate artery accompanied by the following symptoms:

• Lack of tactile sensations on the opposite side of the face and body;
• If you touch the patient’s skin, he experiences severe pain;
• Incorrect perception of light and knocking;
• The forearms and shoulder joints are bent. The fingers are also bent at the base.

Defeat on the site thalamus characterized by the following symptoms:

• The patient's movements have a wide range;
• There is a strong tremor;
• Loss of coordination occurs;
• Half the body loses sensation;
• Characterized by severe sweating;
• Bedsores occur.

The most severe case of stroke is the process of breakthrough of an intracerebral hematoma. Hemorrhage occurs in the cerebrospinal fluid pathways, filling the cerebral stomachs with blood. This disease is called “ventricular tamponade”.

This case of stroke is the most severe and in almost all cases ends in death. The explanation for this is the unimpeded flow of blood to the patient's brain.

Treatment of stroke of ischemic type

The above symptoms may appear unexpectedly in loved one. It is very important to provide first first aid to the patient.

After calling an ambulance, it is necessary to alleviate the patient’s condition using the following techniques:

1. Place the patient on side so that vomit leaves the victim’s mouth without hindrance;
2. The head should be slightly raised;
3. If you have a tonometer, you need to measure your blood pressure. If a sharp increase in pressure to critical values ​​is noticed, then a drug should be placed under the patient’s tongue to reduce it;
4. Provide the patient with the necessary amount of fresh air;
5. Free the patient's neck from any constricting objects.

Treatment in hospital

After arriving at a medical facility, the victim is placed in the intensive care unit. Next, the patient is prescribed a special diet, which focuses on the balance of all necessary microelements. Nutrition adjustments are made so that the diet does not contain fatty, spicy, salty foods.

Mayonnaise and other seasonings should also be excluded. Vegetables and fruits are limited only during the acute stage of the disease. If the patient is unconscious, then food is supplied through a medical tube no earlier than two days later.

After confirmation of stroke, inpatient treatment continues for a month. The consequences of suffering from this disease are extremely severe.

Severe decrease in strength in muscle tissue on the opposite side of the brain, the area of ​​which was damaged. Some patients practically learn to walk and perform normal movements again;

. The decrease in strength occurs only in the area of ​​the mouth, cheeks and lips. The patient cannot eat or drink fluids properly;

Disturbed functioning of the speech apparatus is quite common.. This is caused by damage to the speech center in the human brain. The patient either completely loses speech or does not perceive the words of another person;

Movement coordination disorder It is caused by damage to the parts of the central nervous system that are responsible for the normal functioning of the human motor system. In severe cases, disturbances may persist for several months;

Malfunctions of the visual system They are of different nature and depend on the size and location of the stroke lesion. Usually they are expressed in loss of visual fields;

Sensory impairment expressed in loss pain, sensations of heat and cold.

Rehabilitation

Very important stage on the path to recovery after stroke.

Quality therapy includes the following treatment categories:

1. Physiotherapy. It is necessary to return the patient to normal movement of the limbs. The set of exercises is selected by the attending physician;
2. Visit to a speech therapist. Prescribed if the patient has problems with speech and swallowing;
3. Physiotherapy. The most accessible type of therapy, which is located in every clinic;
4. Medication therapy. The main stage in the recovery process. The drugs mitigate complications after the disease and prevent the risk of relapses;
5. Training for the mind. It is advisable for the patient to read as much literature as possible, memorize poems or excerpts from works.

stroke of hemorrhagic type

Components that have a nutritional effect, which includes oxygen, enter the brain through the carotid arteries. Located in the skull box, they form a network of vessels, which is the root of the blood supply to the central nerve system. When arterial tissue is destroyed, blood flows into the brain.

Causes

A stroke of the hemorrhagic type occurs in the case of hemorrhage into the brain from a vessel whose integrity has been compromised. As a result, a hematoma occurs in the patient’s brain, which is limited to brain tissue. Also, blood from a burst vessel can enter the area surrounding the brain.

Risk group

Particular attention should be paid to the health status of the following categories of citizens:

• Suffering from congenital dilatation of blood vessels;
• Having anomalies in the development of arteries and veins;
• Suffering from inflammatory diseases of the walls of blood vessels;
• With connective tissue pathologies of a systemic nature;
• Having lesions of blood vessels, accompanied by disturbances in protein metabolism;
• Abuse of drugs that stimulate the nervous system.

Symptoms

1. Acute headache;
2. Constant vomiting;
3. Frequent loss of consciousness for a long period;
4. In almost all cases, there is an increase in blood pressure;
5. Increasing sensations of weakness in the limbs;
6. A disorder in the functioning of the organs responsible for sensitivity or a complete loss of sensitivity;
7. Disturbance in the functioning of the motor system;
8. Visual system disorder;
9. Strong nervous excitement;
10. When analyzed, a small amount of blood is observed in the cerebrospinal fluid;

Treatment of stroke of hemorrhagic type

Drug therapy consists in the use of drugs whose action is aimed at stopping bleeding, reducing the size of cerebral edema, and calming the nervous system. Antibiotics and beta blockers are used.

Medicines can cause relapse of stroke, so it is advisable to eliminate the problem through surgery. First of all, the neurosurgeon removes the lesion, and then eliminates the malfunction in the vessel.

Reversibility of pathology

During diagnostic studies It is essential whether the symptoms of stroke are reversible. When the stage is reversible, brain cells exist in the paralysis phase, but their integrity and full-fledged work are not impaired.

If the stage is irreversible, then the brain cells are dead and cannot be restored in any way. This area is called the “ischemic zone”. But therapeutic treatment in this case is possible.

Its purpose is to provide neurons with all nutritional components in the ischemic zone. With proper treatment, cell functions can be partially restored.

It was revealed that a person does not use all the resources of his body in the process of his life, including not all brain cells are involved. Cells that are not involved in work can replace dead cells and ensure their full functioning. The process is quite slow, so complete rehabilitation continues for three years.

Transistor ischemic attack (TIA)

This disease is also a stroke, but unlike ischemic and hemorrhagic stroke, it is temporary. Over a period of time, there is a sharp disruption of blood flow in the large vessels of the brain, as a result of which its cells suffer from a lack of oxygen and nutrients. Symptoms of TIA - transistor ischemic attack last for 24 hours and are similar to the symptoms of a stroke.

If more than 24 hours have passed, but the disease has not subsided, then most likely an ischemic or hemorrhagic stroke has occurred.

Symptoms

Consider the symptoms of transistor ischemic attack:

• There is a decrease in sensitivity in one side of the face, body, lower or upper extremities;
• Weakness in the body that is mild or moderate in nature;
• Disturbances in the functioning of the speech apparatus, up to a complete absence of speech or problems with understanding the opponent’s words;
• Dizziness and loss of coordination;
• Sudden noise in the ears and head;
• Headache and heaviness.

These symptoms appear abruptly and disappear within 3-4 hours. The deadline that distinguishes a transistor ischemic attack from a stroke is no more than a day.

What diseases can cause TIA?

TIA can be caused by the following diseases:

1. Persistent increase in blood pressure, which is chronic;
2. Chronic cerebrovascular disease;
3. Changes in blood cell clotting;
4. Sudden decrease in blood pressure;
5. Impossibility of normal blood flow through the artery caused by a mechanical obstruction;
6. Pathologies of the structure of cerebral vessels.

Transistor ischemic attack can and should be treated! Despite the fact that its symptoms pass rather quickly, this disease already signals a malfunction of the body and, in case of relapse, can result in a stroke!

Risk group

Transistorized ischemic attack is no less dangerous than a stroke. Up to 8% of TIA patients suffer a future stroke within a month of the attack. In 12% of patients, a stroke occurs within a year and in 29% within the next five years.

Treatment of transistor ischemic attack

It is carried out in a hospital.

Diagnostic studies include the following procedures:

1. Visiting a cardiologist, angiologist and ophthalmologist. The patient is prescribed a consultation with a medical psychologist;
2. To conduct a laboratory analysis, the patient must pass a general blood and urine test, as well as blood for a biochemical analysis;
3. Electrocardiography;
4. Computed tomography of the brain;
5. X-rays of light;
6. Constantly checking your blood pressure.

The victim is allowed to go home only if the recurrence of TIA is excluded or the patient has the opportunity to be immediately hospitalized in case of a second attack.

The treatment of transistorized ischemic attack is to take the following oral medications:

• The action of which is aimed at thinning the blood;
• Vasodilators;
• Reducing blood cholesterol levels;
• Aimed at normalizing blood pressure.

It is good to combine drug therapy with balneotherapy and physiotherapy.

Prevention

To avoid the occurrence and recurrence of a transistor ischemic attack, a set of preventive measures should be observed:

1. Go in for sports, having previously drawn up a lesson plan together with your specialist;
2. Adjust your diet by reducing the amount of fatty, salty and spicy foods;
3. Reduce the consumption of alcohol and tobacco products;
4. Monitor your body weight.

Examination algorithm

It is possible to diagnose stroke by characteristic symptoms, but in order to determine the degree of the course of the disease, to which type of stroke it refers

It is necessary to undergo a series of diagnostic tests.

Examination by a specialist immediately after the patient’s admission to a medical facility;

Taking blood for laboratory analysis, in order to assess the state of glucose levels, coagulation, enzymes;

CT scan in this case, it allows you to obtain more complete information about the disease. In the first 24 hours after an ischemic disorder, it is not possible to determine the location of the affected area.

This problem can be solved by performing magnetic resonance imaging;

Angiography of cerebral vessels helps to determine with reliable accuracy the area where the lesion occurred or the level of narrowness of the artery. With this study, it is possible to diagnose an aneurysm and a pathological connection between the veins and arteries of the brain.

But the results obtained do not allow us to correctly assess the amount of nerve tissue destruction. The solution to this problem is to combine vascular angiography with other diagnostic methods;

Cerebrospinal fluid sampling for laboratory tests poses a threat to the patient’s life, but this study allows us to determine what type of stroke it is.

This diagnostic method is mainly used in medical institutions, which lack more advanced equipment.

Forecast

A favorable outcome after the disease has a category of citizens who have experienced a small form of acute stroke. With minor restrictions, these patients can normalize their activities.

Statistics show that 40% of deaths occur within the first month after illness. 70% show signs of disability in the first month. Over the next 6 months, 40% become disabled. After two years, signs of disability are noticeable in 30% of patients.

Video: ONMK. Signs of a stroke.