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Consequences of ischemic stroke in the brain

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Cerebral infarction is a pretty scary diagnosis, but often this disease overtakes older people, which age jumped over the 60-year bar. The second name of the disease - ischemic stroke.

Surprising fact: the disease can be affected patients who in the past complained of arterial hypertension. With timely treatment to the clinic the prognosis may be quite favorable - known cases of complete recovery of patients.

Detailed study of ischemic stroke, symptoms and its causes, and methods of first aid, you may one day save not only his but also the lives of others.

Развитие ишемии

Classification and periodization

Classification of the disease is very extensive. We will go over the varieties of ischemia in passing, to draw a General picture of defeat. For the duration of the disease is divided into the following types:

  • transient ischemic attack is a neurological disorder is focal character);
  • "small stroke" (attacks inherent to a prolonged effect and reverse the neurological defect);
  • progressive ischemic stroke (develops gradually and can stretch to several days);
  • total ischemia (cerebral infarction accompanied by steadily regressing, or partial deficiency).

And here is the classification of disease with regard to its severity:

  • mild - neurological symptoms are insignificant, the regression is extended by approximately three weeks;
  • the average degree is simptomatic dominates, but the apparent disorder of consciousness can not be traced;
  • severe - cerebral disorders pronounced, focal neurological deficit has a rough shape.

Focusing on the pathogenesis, the doctors have identified several manifestations of cerebral infarction.

According to this classification, the stroke is divided into:

Закупорка сосуда в мозгу
  • atherothrombotic;
  • cardioembolic;
  • hemodynamic;
  • lacunar;
  • the rheological.

Localized ischemic stroke can be anywhere. Considering the blood pool, highlight several key areas of the lesion:

  • brain front (middle, rear) artery;
  • the main artery with branches and vertebral artery;
  • the internal carotid artery.

Ischemia is a complex multistep process.The disease can last for years and is divided into five periods:

  • the most severe takes place during the three days (first);
  • acute - 28 days (then comes the next stage);
  • early - lasts six months, is considered the beginning of recovery;
  • later stretched to 2-years, is part of the recovery period;
  • residual effects - are observed after two years.

Reasons

It often happens that the cerebral infarction occurs due to overlapping of blood flow by embolus or thrombus. Cerebral blood circulation is disturbed, and the patient is feeling the impact of the atherosclerotic process. Often from ischemia affects people who have had transient ischemic attack and is now prone to hypertension.

Томография мозга

There is a whole layer of chronic illnesses that can lead to ischemia. No wonder the angina pectoris, the treatment of which folk remedies has become widespread, it is considered a Wake-up call. Most of the problems lies in the field of cardiovascular system.

Here they are:

  • increased viscosity of blood;
  • congenital cardiovascular defects;
  • the slow blood flow;
  • defibrillation-a procedure that provokes the separation of the thrombi);
  • endocarditis (rheumatic active) - affects the left heart valves;
  • sewn pacemakers;
  • IBS;
  • dissecting aneurysm of the aorta;
  • heart failure;
  • myocardial infarction;
  • infringement of lipid exchange;
  • obesity and diabetes;
  • atrial fibrillation;
  • age (lower limit - 60 years);
  • small "ischemic stroke";
  • lack of exercise;
  • bad habits (tobacco, alcohol);
  • migraine;
  • oral contraceptives;
  • hematological disease paraproteinemia, coagulopathy).

How to recognize ischemia

The patient can feel the approach of the disease as ischemic stroke and its symptoms are felt typical ailments:

  • dizziness (eyes thoroughly dark);
  • short-term speech disorders;
  • periodic numbness in the extremities (weakness in the arm or leg, numbness of the whole side of the body);
  • vomiting and nausea;
  • blurred vision.
  • sudden loss of self-control;
  • the curvature of the tongue;
  • the inability to smile.

Sometimes the patient's face may be beveled, it is a clear sign that requires immediate medical intervention.

Symptoms

Speech disorders, which caused an ischemic stroke, is called "aphasia". There are some differences symptoms in left and right handers - it depends on what kind of hemispherebrain damaged.

List the common signs of sickness:

  • the smoothness of the right nasolabial triangle;
  • facial imbalance (the direction depends on the side of the lesion);
  • "parasit" right cheek;
  • paralysis of the limbs;
  • left-sided deviation of the tongue.

When struck by vertebrobasilar vascular pool, ischemic stroke and its symptoms become more varied:

  • disorders of coordination and statics;
  • dizziness (when tilting head and walking symptom increases);
  • visual and oculomotor pathology;
  • dysarthria (a type of aphasia where the patient cannot pronounce the individual letters);
  • soft speech;
  • hoarse voice;
  • dysphagia (difficulty swallowing);
  • paralysis, paresis, distortion, sensitivity usually affect the area opposite to the ischemic focus).

When blockage of the basilar artery blood ceases to flow in the respiratory and vasomotor centers, which leads to a number of bad symptoms:

  • loss of consciousness;
  • tetraplegia (paralysis of limbs);
  • periodic breathing;
  • dysfunction of the pelvic organs;
  • cyanosis of the face and the fall of cardiac activity.

The cerebellum is responsible for coordinating our movements. Therefore, his defeat has the following consequences:

  • instability (patient falls in the direction of the ischemic focus);
  • vomiting and nausea;
  • vertigo and acute migraine;
  • nystagmus (involuntary and sudden jerking of the eyeballs);
  • the lack of coordination of movements.

Complications

Ischemic stroke whose treatment was not properly carried out, is fraught with serious complications. Why the disease it is important to recognize in the early stages and prevent its further development.

Here are the most common complications are:

  • deep vein thrombosis (affects the region of the Shin);
  • infectious complications (suffer urinary system, develop bedsores and pneumonia);
  • swelling of the brain;
  • pulmonary thromboembolism;
  • voiding and bowel movement;
  • cognitive dissonance;
  • epilepsy (20 per cent);
  • mental disorders (irritability, mood variability, depression);
  • motor dysfunction (bilateral and unilateral), paralysis, weakness;
  • pain.

Diagnosis

Early diagnosis is a crucial factor that can identify ischemic stroke and differentiating it from similar diseases(subarachnoid hemorrhage, hemorrhagic stroke).

Key methods of diagnosis in the early stages are:

  • Physical examination. The patient's condition is evaluated on several criteria, including breathing and circulatory disorders, the difference of heart rate and blood pressure.
  • Transcranial Doppler. This survey indirectly detects the flow velocity in the intracranial arteries.
  • Angiography. Is the most effective method of diagnosis because it detects aneurysms, narrowing and other diseases.
  • Echocardiography and ECG. Is considered a mandatory diagnostic procedure to exclude cardiac pathology.
  • X-ray examination. Does not always apply, since his main goal is to identify pulmonary complications (pulmonary embolism, aspiration pneumonia).
  • Blood tests. Physicians interested in biochemical, clinical, and gas analysis, and coagulation.

Computed tomography and MRI

Acute ischemic stroke is visualized using magnetic resonance imaging. In comparison with computed tomography is more accurate method of diagnosis. Tomograms capture ischemic changes already in the first days of the formation of occlusion. If the lesion develops in less than 12 hours, half of the tomograms did not reveal any catastrophic changes.

Contrast CT images can differentiate microscopic cerebral infarcts (lacunar and affecting an area of the brain stem).

Differential diagnosis of

In some cases, the patient may need a lumbar puncture. Before applying it, the physician should confirm the absence of contraindications. Ischemic stroke involves transparency of the cerebrospinal fluid. The content of cellular elements and protein will be normal. To differentiate cerebral infarction will have two similar movements:

  • subarachnoid hemorrhage;
  • a brain hemorrhage.

Treatment

Therapy will depend on the amount, localization and condition of the patient. Ischemic stroke and its treatment can be divided into specific and basic therapy. The basic treatment is based on a set of measures for the prevention of somatic illnesses. The objectives of this therapy are:

  1. To adjust the AD to support the functioning of vascular and the heart.
  2. To normalize respiratory function.
  3. To stabilize the temperature of the patient.
  4. To adjust homeostasis (acid-base balancefluid and electrolyte balance, glucose levels).
  5. Symptomatic treatment.
  6. Prevention of uropeltis, pulmonary embolism, bedsores, pneumonia, peptic ulcers and of fractures of the limbs.

Specific therapy involves the use of thrombolysis, fibrinolytic agents, anticoagulants and antiplatelet agents.

First aid

Faced with a man who was struck by a stroke, don't panic. To help him you can easily, the main thing - to follow step-by-step instructions.

The steps are:

  1. Lay the patient back and provide access to it of oxygen. It will have to undo the gate. Find a pillow (will fit a small cushion to put under the victim's head.
  2. When saliva (or mucus), the patient's head should turn sideways and put down the napkin.
  3. Reassure the patient. This is done by 1 gram of glycine (the drug is placed in the mouth).
  4. Randomize the pressure of the drugs the patient was given, injections are also not recommended. If we decided to bring down the pressure, do not go too far (max 10-15 units). A number of medicines are generally contraindicated (nikoshpan, papaverine, nicotinic acid, no-Spa).
  5. Call an ambulance or make yourself an intramuscular injection of piracetam (10 ml will prevent the death of the brain). Also helpful would be Cerebrolysin.

Folk remedies

If your family member was struck by angina treatment of folk remedies do not seem nonsense, and will be one of the options for man's salvation. This harsh truth applies to cerebral infarction. Traditional medicine has the following objectives:

  • the decrease in blood pressure;
  • the restoration of paralyzed limbs;
  • cleaning of vascular from cholesterol plaques.

To restore the normal functioning of the limbs, to engage in the manufacture of ointments, which are based on vegetable oil and Bay leaf. A good option would be a Bay leaf, mixed with juniper and butter. For internal use it is recommended tincture of a peony.

Also a good help will be honey liqueur created from onion juice, honey and citrus. The famous garlic tincture also have the way. All these means are permissible during the rehabilitation period, when the danger disappeared, and the patient is recovering from illness.

Prevention

Primary prevention involves the influence on diseases of the underlying ischemia. With hypertension doctors fight anti-hypertensive drugs. 24 hours, the patient needs to stabilize the pressure. Patients included in the risk group, are under constant surveillance.

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This applies to:

  • of diabetes;
  • hypertension;
  • primary strokes.

Secondary prevention is based on three factors:

  • the use of antiplatelet agents (anticoagulants);
  • stabilization of blood pressure;
  • diet (cholesterol must be completely eliminated from the diet).

Get ready to drink the following drugs:

  • cardiomagnyl;
  • aspecard;
  • aggrenox;
  • hypolipidemic drugs (statins and atorvastatin);
  • trombone;
  • simvastatin (simvastin, Liprimar, vabadin, torvacard, Foraker).

There are more sophisticated maintenance procedures (up to sessions with a speech therapist). Cerebral infarction is better to push than to put yourself in danger. Try to minimize consumption of cholesterol, more move and weight.