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Stroke is very dangerous. If you recognize the first symptoms of a stroke, you can really save someone's life. Remember! Whether it's a hemorrhagic stroke or an ischemic stroke, every moment counts! What are the causes and symptoms of a stroke. How is stroke patients treated? And what should rehabilitation after a stroke look like?

Strokeis a sudden localdisturbance of blood circulation in the brain . In Poland, every year, a stroke reaches about 80,000. people, of which as much as 30 thousand. dies within a month. It is worth noting that approx. 5 percent. of these 80 thousand. she is at a young age. Although the vast majority of patients who have a stroke are elderly (mean age 60), strokes also happen in young people (aged 20 to 35).

Of those who survive the acute phase of stroke, 20% requires constant care, 30 percent help in some daily activities, and 50 percent. after a stroke, she regains almost full fitness, is independent, and can go back to work.

But recovery from a stroke depends on how quickly patients get specialist care. Ischemic neurons die at a rate of 1.8 million per minute. So a part of the brain dies every minute. So the life and he alth of our relatives often depends on whether the patient, and above all those around him, will be able to react properly and quickly in the moment of danger.

Stroke - types

  • ischemic stroke

Ischemic stroke , orcerebral infarction , is the most common form of stroke. It accounts for 70-80% of all his cases. It is caused by ischemia, orsudden stop of blood flow to the brain . An ischemic stroke occurs when a blood clot or plaque clogs the inside of a vessel that carries blood to the brain.

  • hemorrhagic stroke

Cerebral hemorrhagic strokeis caused by the rupture of a cerebral vessel, causing extravasation of blood within the brain. Blood outside the vessels completely destroys the tissues with which it comes into contact. It accounts for approximately 15% of stroke cases.

There are two types of hemorrhagic stroke:

a)intracerebral haemorrhage- occurs as a result of arterial ruptureb)subarachnoid haemorrhage- this is the spilling of blood into the space surrounding the brain

  • venous stroke

Is the result of thrombosis in the cerebral veins or venous sinuses of the dura mater. It occurs very rarely.

  • micro-impact (small stroke, mini-stroke)

Miniudar(aka small stroke, mini-stroke, transient ischemia) is a medical condition associated with a sudden failure of the blood supply to the brain.

Although symptoms resolve fairly quickly, even within an hour, they can occur several times and are usually a harbinger of a major stroke. It is estimated that one in five people after a mini-stroke may experience a true stroke within a few days or weeks.

Stroke - symptoms

Stroke symptomsnot everyone starts right away. Warning symptoms may occur first. This is called small stroke, also known as transient cerebral ischemia.The symptoms of minor strokeusually last 15-60 minutes, at most 24 hours, and resolve on their own. Every fifth patient has warning symptoms before he developsgross stroke .

The symptoms of a stroke include: ²

  • paresis, paralysis or hemiparesis (only on one side of the body)
  • speech disorders (slurred speech, gibbering, loss of speaking ability, difficulty understanding speech)
  • visual impairment - visual impairment in one eye or not seeing half of the field of view (right or left) is characteristic. Double vision may also appear
  • dizziness and headaches with a spinning sensation, accompanied by nausea, vomiting
  • imbalance

- The most common symptoms in the so-called in the acute phase of stroke aremotor symptoms , and therefore paresis of the limbs, arm or leg, or at the same time the upper and lower limbs, most often on the same side - says in an interview with the news agency Newseria Lifestyle dr hab. n. med. Jacek Rożniecki , head of the Department of Neurology, Strokes and Neurorehabilitation of the Medical University of Lodz. - A symptom of stroke is alsoasymmetry of the lower facein the area of ​​the mouth. The corner of the mouth is lowered on one side, the nasolabial fold is smoothed out, and this also causes more slurred speech.

- Another symptom that we are dealing with a stroke is speech disorders and communication problems - adds Dr. Rożniecki. - Less common symptoms such as double vision […] Sometimes dizziness, vertigo and gait disturbances may occur.

Strokethe brain - effects

The effects of a stroke are: ³

  • motor disability(25-50% of cases) - especially hemiparesis, as well as muscle tension disorders
  • cognitive disorders(30‒35% of cases)
    • memory impairment
    • dementia
    • attention deficit disorder
    • perception disorders
  • emotional disorders(25‒60% of cases) -
    • apathy or depression
    • forced laugh or cry
    • manic states
    • anxiety attacks or generalized anxiety
  • epileptic seizures(3‒30% of cases) - early or late seizures
  • systemic complications
    • urinary tract infections
    • bedsores
    • pneumonia
    • thromboembolic complications
  • limitation of social activity(depending on the degree of disability) - loss of current social status, lower living standard, isolation from the surrounding world

Stroke - first aid

Jif you notice the above-mentioned someone you love symptoms, ask them to:

  • smiled- if you see her lifting only half of her lips, the other part of her face may be paralyzed
  • she raised both hands above her head at the same time- When she cannot do it, you have proof that the paresis has affected half of the body
  • repeated the simple sentence , e.g. today is nice weather. If he speaks slurredly or cannot utter a word at all, it may be a stroke

Then follow the following statement:

1. call an ambulance, do not give the injured person neither drink nor food

2. if the injured is conscious, place him in a comfortable position

3. if the injured person is unconscious, place him in the recovery position

Stroke - causes and risk factors

Among the risk factors for stroke, there are those that are not modifiable (which we have no influence on) and risk factors that we have influence on.

The most important and common risk factor for stroke ishypertension . Setting blood pressure within the limits of the ideal (120/80 mm Hg) lowers the risk of stroke by as much as 30-40%.

Risk factors beyond our controlRisk factors we can influence
  • age(over 55 - this does not mean that young people do not have a stroke, but that the incidence of strokes increases with age)
  • gender (more often in women than in men)
  • race(black people get sick more often)
  • genetic factors
  • hypertension
  • heart disease
    • atrial fibrillation
    • heart defects
  • smoking
  • diabetes
  • vascular diseases (especially advanced atherosclerosis)
  • lipid disorders
  • obesity or very overweight
  • sleep apnea syndrome
  • alcohol abuse

It's good to know that there arerisk factors for stroke that are common to women . Researchers at the Brigham and Women's Hospital in Boston (USA)1examined potential risk factors for stroke that are unique to women: ¹

  • hormone levels, specifically low levels of dehydroepiandrosterone (DHEA)
  • hormone replacement therapy
  • hormonal contraception - taking oral estrogen or combined oral contraceptives
  • early age of first menstruation (less than 10 years old)
  • early age of menopause (under 45)
  • pregnancy complications
    • gestational diabetes
    • pre-eclampsia
    • hypertension during or immediately after pregnancy

Scientists point out that not every woman with one or more factors will have a stroke. However, in their opinion, doctors should pay special attention to such patients.

Stroke - diagnosis

A patient with a stroke should see a neurological ward with a CT scanner as soon as possible so that he can receive specialist help within a few hours. A CT scan is extremely important as it allows you to see the area of ​​the brain affected by the disease and determine its type. If the tomography cannot be performed, a lumbar puncture is performed, i.e. the cerebrospinal fluid is collected with a special needle.

Doppler ultrasound allows you to assess the condition of the carotid arteries that may be blocked by embolism. The level of blood clotting is also checked.

If the patient is conscious, a neurological examination is also performed (checking the correctness of reflexes, assessing the strength and efficiency of the muscles, examining the pupil's reaction to light). All this allows you to precisely determine the area of ​​brain damage.

Stroke - treatment

In the event of a hemorrhagic strokethere are few effective treatments, but in the case of ischemic stroke there is a good chance of recovery if the patient is promptly hospitalized.

In the event of a strokebrainis given a drug that dissolves the clot. Quick and effective intervention gives the patient a chance to regain speech and muscle strength in the affected limbs. Brain damage can be largely prevented if the patient is hospitalized within approx.2 hours after the onset of stroke . There is still a chance forto open the closed brain vesseland to restore circulation in an area that is ischemic but still alive. After 5-6 hours, permanent and irreversible changes occur in the ischemic area of ​​the brain. If the patient receives the drug within about 3 hours of the onset of stroke symptoms, there are large sessions to minimize the neurological complications of the disease, mainly paresis and speech disorders.

Usually the patient stays in the hospital for 3 weeks. This is the time that determines the future, i.e. intellectual and physical fitness. It is also the period when the body regenerates the fastest. After that, all changes go back much slower.

Adequate post-stroke dietis also important. Studies show that some patients with a history of stroke have featuresmalnutrition , which significantly increases the risk ofcomplications after stroke , such as, for example, infections and bedsores. The loss of muscle mass makes it difficult to undertake effective rehabilitation and prolongs the patient's stay in the hospital. Malnutrition reduces the chances of recovery from a stroke and increases the risk of death.

Modern methods of treating stroke

In Poland, more and moremodern methods of treating strokeare used, because it affects as many as 70,000 in our country. people per year. The first step in treating a stroke is to restore circulation to the person who has had it. One method by which this is accomplished ismechanical thrombectomy . About modern methods of treating stroke talksdr hab. n. med. Adam Kobayashi from the Institute of Psychiatry and Neurology in Warsaw .

Stroke - rehabilitation after stroke

Rehabilitation after strokebegins in the neurological or stroke ward, often on the day of admission to the hospital and continues in the rehabilitation ward, outpatient clinic or - if necessary - in sick home. Rehabilitation is a chance for many stroke patients to return to a normal and active life.

Stroke - prevention

1.Blood pressure control- it is recommended to keep blood pressure below 140/90 mm Hg, and in people with diabetesand kidney diseases up to 130/80 mm Hg

2.Do not smoke or drink alcohol

3. For people who drink alcohol, it is recommendedto limit alcohol consumption to a maximum of 2 drinks a day for men and 1 for women .

4.Increase physical activity- it reduces the incidence of cardiovascular diseases, including stroke. Regular, moderately intense physical effort is recommended for min. 30 minutes a day (brisk walking, jogging, cycling, aerobics).

5.Follow a diet low in sodium and high in potassium(helps to reduce hypertension), eat fruit and vegetables frequently and reduce animal fats.

6.Keep your body weight normal . If you are overweight or obese, lose weight - especially since being obese or overweight is associated with other risk factors such as hypertension, hyperlipidemia, diabetes.

7.Control your blood sugar

8.Reduce stress

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Category:

Neurology