Symptoms and signs of onmk (ischemic type). Onmk by ischemic type, its symptoms and treatment

In abbreviated form, the classical name of the pathology in acute cerebrovascular accident looks like "CVA by ischemic type." If hemorrhage is confirmed, then - according to hemorrhagic.

In ICD-10, stroke codes may, depending on the type of violation, differ:

• G45 - established designation of transient cerebral attacks;
• I63 - recommended for statistical registration of cerebral infarction;
• I64 - a variant used for unspecified differences between cerebral infarction and hemorrhage, is used when a patient is admitted in an extremely serious condition, unsuccessful treatment and imminent death.

Ischemic strokes are 4 times more frequent than hemorrhagic strokes and are more associated with general human diseases. The problem of prevention and treatment is considered in programs at the state level, because 1/3 of patients who have had a disease die in the first month and 60% remain permanently disabled requiring social assistance.

Why is there a lack of blood supply to the brain?

Acute cerebrovascular accident of the ischemic type is more often a secondary pathology, occurs against the background of existing diseases:

• arterial hypertension;
• widespread atherosclerotic vascular disease (up to 55% of cases develop due to severe atherosclerotic changes or thromboembolism from plaques located in the aortic arch, brachiocephalic trunk or intracranial arteries);
• transferred myocardial infarction;
• endocarditis;
• heart rhythm disturbances;
• changes in the valvular apparatus of the heart;
• vasculitis and angiopathy;
• vascular aneurysms and developmental anomalies;
• blood diseases;
• diabetes mellitus.

Up to 90% of patients have changes in the heart and the main arteries of the neck. The combination of these causes dramatically increases the risk of ischemia.

Possible compression of the vertebral artery by the processes of the vertebrae

The most common causes of transient attacks are:

• spasm of the arterial trunks of the brain or short-term compression of the carotid, vertebral arteries;
• embolization of small branches.

The following risk factors can provoke the disease:

• elderly and senile age;
• excess weight;
• the effect of nicotine on blood vessels (smoking);
• experienced stress.

The basis of the influencing factors is the narrowing of the lumen of the vessels through which blood flows to the brain cells. However, the consequences of such a malnutrition can be different in terms of:

A combination of factors determines the form of the disease and clinical symptoms.

Pathogenesis of different forms of acute cerebral ischemia

Transient ischemic attack was previously called transient cerebrovascular accident. It is singled out in a separate form, since it is characterized by reversible disorders, the focus of the infarction does not have time to form. Usually the diagnosis is made retrospectively (after the disappearance of the main symptoms), after a day. Prior to this, the patient is treated as with a stroke.

The main role in the development of hypertensive cerebral crises belongs to elevated level venous and intracranial pressure with damage to the walls of blood vessels, exit into the intercellular space of fluid and protein.

Edema of the brain tissue in this case is called vasogenic

In development ischemic stroke the feeding artery is necessarily involved. The cessation of blood flow leads to oxygen deficiency in the focus, formed in accordance with the boundaries of the basin of the affected vessel.

Local ischemia causes necrosis of a portion of the brain tissue.

Depending on the pathogenesis of ischemic changes, there are types of ischemic strokes:

• atherothrombotic - develops when the integrity of the atherosclerotic plaque is violated, which causes a complete overlap of the internal or external supplying arteries of the brain or their sharp narrowing;
• cardioembolic - the source of thrombosis is pathological growths on the endocardium or heart valves, fragments of a thrombus, they are delivered to the brain with a general blood flow (especially when the foramen ovale is not closed) after attacks of atrial fibrillation, tachyarrhythmia, atrial fibrillation in patients in the post-infarction period;
• lacunar - more often occurs when small intracerebral vessels are damaged in arterial hypertension, diabetes mellitus, it is distinguished by a small focus (up to 15 mm) and relatively small neurological disorders;
• hemodynamic - cerebral ischemia with a general decrease in blood circulation rate and a drop in pressure against the background of chronic heart disease, cardiogenic shock.

With hemodynamic disorders, blood flow in the vessels of the brain can decrease to a critical level and below

It is worth explaining the variant of the development of strokes of unknown etiology. This often happens when there are two or more causes. For example, in a patient with carotid stenosis and fibrillation after an acute infarction. It should be taken into account that elderly patients already have stenosis of the carotid arteries on the side of the alleged violation caused by atherosclerosis, up to half the lumen of the vessel.

Stages of cerebral infarction

The stages of pathological changes are allocated conditionally, they are not necessarily present in every case:

• Stage I - hypoxia (oxygen deficiency) disrupts the permeability of the endothelium of small vessels in the focus (capillaries and venules). This leads to the transition of fluid and protein in the blood plasma into the brain tissue, the development of edema.
• Stage II - at the level of capillaries, pressure continues to decrease, which disrupts the functions of the cell membrane, nerve receptors located on it, and electrolyte channels. It is important that all changes are still reversible.
• Stage III - cell metabolism is disturbed, lactic acid accumulates, there is a transition to energy synthesis without the participation of oxygen molecules (anaerobic). This type does not allow maintaining the necessary level of life of neuron and astrocyte cells. Therefore, they swell, causing structural damage. Clinically expressed in the manifestation of focal neurological signs.

What is the reversibility of pathology?

For timely diagnosis, it is important to establish the period of reversibility of symptoms. Morphologically, this means the preserved functions of neurons. Brain cells are in the phase of functional paralysis (parabiosis), but retain their integrity and usefulness.

The zone of ischemia is much larger than the area of ​​necrosis, the neurons in it are still alive

In the irreversible stage, a zone of necrosis can be identified in which the cells are dead and cannot be restored. Around it is the zone of ischemia. Treatment is aimed at maintaining proper nutrition of neurons in this particular zone and at least partial restoration of function.

Modern research has shown extensive connections between brain cells. A person does not use all the reserves and opportunities in his life. Some cells are able to replace the dead and provide their functions. This process is slow, so doctors believe that the rehabilitation of a patient after an ischemic stroke should continue for at least three years.

Signs of transient circulatory disorders of the brain

In the group of transient disorders of cerebral circulation, clinicians include:

• transient ischemic attacks (TIA);
• hypertensive cerebral crises.

Features of transient attacks:

• by duration they fit in the period from several minutes to a day;
• every tenth patient after a TIA has an ischemic stroke within a month;
• neurological manifestations do not have a gross character of severe disorders;
• possible mild manifestations of bulbar paralysis (focus in the brain stem) with oculomotor disorders;
• blurred vision in one eye, combined with paresis (loss of sensation and weakness) in the limbs of the opposite side (often accompanied by incomplete narrowing of the internal carotid artery).

Features of hypertensive cerebral crises:

• the main manifestations are cerebral symptoms;
• focal signs are rare and mild.

The patient complains about:

• a sharp headache, often in the back of the head, temples or crown;
• state of stupor, noise in the head, dizziness;
• nausea, vomiting.

• temporary confusion;
• excited state;
• sometimes - a short-term attack with loss of consciousness, convulsions.

Signs of a cerebral stroke

Ischemic stroke means the occurrence of irreversible changes in brain cells. In the clinic, neurologists distinguish periods of the disease:

• the most acute - lasts from the onset of manifestations for 2–5 days;
• acute - lasts up to 21 days;
• early recovery - up to six months after the elimination of acute symptoms;
• late recovery - takes from six months to two years;
• consequences and residual effects - over two years.

Some doctors continue to distinguish small forms of stroke or focal. They develop suddenly, the symptoms do not differ from cerebral crises, but last up to three weeks, then completely disappear. The diagnosis is also retrospective. Examination revealed no organic abnormalities.

Cerebral ischemia, in addition to general symptoms (headaches, nausea, vomiting, dizziness), is manifested locally. Their nature depends on the artery, which is "turned off" from the blood supply, the state of the collaterals, the dominant hemisphere of the brain in the patient.

Consider the zonal signs of blockage of the cerebral and extracranial arteries.

With damage to the internal carotid artery:

• impaired vision on the side of the blockage of the vessel;
• the sensitivity of the skin on the limbs, the face of the opposite side of the body changes;
• in the same area there is paralysis or paresis of muscles;
• the disappearance of the function of speech is possible;
• the inability to be aware of one's disease (if the focus is in the parietal and occipital lobes of the cortex);
• loss of orientation in parts of one's own body;
• loss of visual fields.

Narrowing of the vertebral artery at the level of the neck causes:

• hearing loss;
• nystagmus pupils (twitching when deviating to the side);
• double vision.

If the narrowing occurred at the confluence with the basilar artery, then the clinical symptoms are more severe, since the cerebellar lesion predominates:

• inability to move;
• disturbed gestures;
• scanned speech;
• violation of the joint movements of the trunk and limbs.

If there is insufficient blood flow in the basilar artery, there are manifestations of visual and stem disorders (impaired breathing and blood pressure).

With damage to the anterior cerebral artery:

• hemiparesis of the opposite side of the body (unilateral loss of sensation and movement) more often in the leg;
• slowness of movements;
• increased tone of flexor muscles;
• loss of speech;
• inability to stand and walk.

Blockage of the middle cerebral artery is characterized by symptoms depending on the defeat of the deep branches (nourish the subcortical nodes) or long (suitable for the cerebral cortex)

Violation of patency in the middle cerebral artery:

• with complete blockage of the main trunk, a deep coma occurs;
• lack of sensitivity and movements in half of the body;
• inability to fix the gaze on the subject;
• loss of visual fields;
• loss of speech;
• the inability to distinguish the left side from the right.

Violation of the patency of the posterior cerebral artery causes:

• blindness in one or both eyes;
• double vision;
• gaze paresis;
• convulsions;
• large tremor;
• impaired swallowing;
• paralysis on one or both sides;
• violation of breathing and pressure;
• brain coma.

When blockage of the optic geniculate artery appear:

• loss of sensation in the opposite side of the body, face;
• severe pain when touching the skin;
• inability to localize the stimulus;
• perverted perceptions of light, knocking;
• thalamic hand syndrome - the shoulder and forearm are bent, the fingers are unbent in the terminal phalanges and bent at the base.

Impaired blood circulation in the zone of the visual tubercle, thalamus is caused by:

• sweeping movements;
• large tremor;
• loss of coordination;
• impaired sensitivity in half of the body;
• sweating;
• early bedsores.

In what cases can CVA be suspected?

The above clinical forms and manifestations require careful examination, sometimes not by one, but by a group of doctors of different specialties.

Violation of cerebral circulation is very likely if the patient has the following changes:

• sudden loss of sensation, weakness in the limbs, on the face, especially one-sided;
• acute loss of vision, the occurrence of blindness (in one eye or both);
• difficulty in pronunciation, understanding words and phrases, making sentences;
• dizziness, loss of balance, impaired coordination of movements;
• confusion;
• lack of movement in the limbs;
• intense headache.

An additional examination allows you to establish the exact cause of the pathology, the level and localization of the vascular lesion.

Purpose of diagnosis

Diagnosis is important for choosing a treatment method. For this you need:

• confirm the diagnosis of stroke and its form;
• identify structural changes in the brain tissue, the focus area, the affected vessel;
• clearly distinguish between ischemic and hemorrhagic forms of stroke;
• on the basis of pathogenesis, establish the type of ischemia to start specific therapy in the first 3-6 to get into the "therapeutic window";
• evaluate the indications and contraindications for medical thrombolysis.

It is practically important to use diagnostic methods on an emergency basis. But not all hospitals have enough medical equipment for round-the-clock work. The use of echoencephaloscopy and the study of cerebrospinal fluid give up to 20% errors and cannot be used to resolve the issue of thrombolysis. The most reliable methods should be used in the diagnosis.

Foci of softening on MRI allow differential diagnosis of hemorrhagic and ischemic strokes

Computed and magnetic resonance imaging allows:

• distinguish stroke from volume processes in the brain (tumors, aneurysms);
• accurately determine the size and localization of the pathological focus;
• determine the degree of edema, violations of the structure of the ventricles of the brain;
• identify extracranial localization of stenosis;
• to diagnose vascular diseases that contribute to stenosis (arteritis, aneurysm, dysplasia, vein thrombosis).

Computed tomography is more accessible, has advantages in the study of bone structures. And magnetic resonance imaging better diagnoses changes in the parenchyma of brain tissues, the size of the edema.

Echoencephaloscopy can only reveal signs of displacement of midline structures with a massive tumor or hemorrhage.

Cerebrospinal fluid rarely gives ischemia a slight lymphocytosis with an increase in protein. Most often no change. If the patient has a hemorrhage, then an admixture of blood may appear. And with meningitis - inflammatory elements.

Ultrasound examination of the vessels - the method of Dopplerography of the arteries of the neck indicates:

• development of early atherosclerosis;
• stenosis of extracranial vessels;
• sufficiency of collateral connections;
• the presence and movement of the embolus.

With duplex sonography, the condition of atherosclerotic plaque and artery walls can be determined.

Cerebral angiography is performed if there are technical possibilities for emergency indications. Usually, the method is considered more sensitive in determining aneurysms and foci of subarachnoid hemorrhage. Allows you to clarify the diagnosis of the pathology detected on the tomography.

Ultrasound of the heart is performed to detect cardioembolic ischemia in heart disease.

Survey algorithm

The examination algorithm for suspected stroke is carried out according to the following plan:

1. examination of a specialist in the first minutes after the patient's admission to the hospital, examination of the neurological status, clarification of the anamnesis;
2. blood sampling and examination of its coagulability, glucose, electrolytes, enzymes for myocardial infarction, hypoxia level;
3. in the absence of the possibility of an MRI and CT scan, an ultrasound of the brain;
4. lumbar puncture to exclude hemorrhage.

Treatment

The most important in the treatment of cerebral ischemia belongs to the urgency and intensity in the first hours of admission. 6 hours from the onset of clinical manifestations is called the "therapeutic window". This time is the most effective application thrombolysis techniques for dissolving a thrombus in a vessel and restoring impaired functions.

Regardless of the type and form of stroke in the hospital, the following are carried out:

• increased oxygenation (filling with oxygen) of the lungs and normalization of respiratory function (if necessary, by translation and mechanical ventilation);
• correction of impaired blood circulation (heart rhythm, pressure);
• normalization of the electrolyte composition, acid-base balance;
• reduction of cerebral edema by the introduction of diuretics, magnesia;
• relief of excitation, convulsive seizures with special neuroleptic drugs.

To feed the patient, a semi-liquid table is prescribed, if swallowing is impossible, parenteral therapy is calculated. The patient is provided with constant care, prevention of bedsores, massage and passive gymnastics.

Rehabilitation starts from the first days

This allows you to get rid of negative consequences as:

• muscle contractures;
• congestive pneumonia;
• DIC;
• thromboembolism of the pulmonary artery;
• damage to the stomach and intestines.

Thrombolysis is a specific therapy for stroke of the ischemic type. The method allows preserving the viability of neurons around the necrosis zone, returning to life all weakened cells.

The introduction of anticoagulants begins with Heparin derivatives (in the first 3-4 days). This group of drugs is contraindicated in:

• high blood pressure;
• peptic ulcer;
• diabetic retinopathy;
• bleeding;
• the impossibility of organizing regular monitoring of blood clotting.

After 10 days, they switch to indirect anticoagulants.

Drugs that improve metabolism in neurons include Glycine, Cortexin, Cerebrolysin, Mexidol. Although they are not listed as effective in the evidence-based medicine database, the appointment leads to an improvement in the condition.

Decompression trepanation of the skull is performed in case of increasing edema in the region of the brain stem

Patients may need symptomatic treatments, depending on the specific manifestations: anticonvulsants, sedatives, painkillers.

Antibacterial agents are prescribed to prevent infection of the kidneys and pneumonia.

Forecast

Prognosis data are available only for ischemic infarction, other changes are precursors indicating an increased risk of stroke.

Atherothrombotic and cardioembolic types of ischemia have the most dangerous mortality rate: from 15 to 25% of patients die during the first month of the disease. Lacunar stroke ends fatally in only 2% of patients. The most common causes of death:

• in the first 7 days - cerebral edema with compression of vital centers;
• up to 40% of all deaths occur in the first month;
• after 2 weeks - pulmonary embolism, congestive pneumonia, cardiac pathology.

Patient survival time:

After this period, 16% per year die.

Only 15% of patients return to work

The presence of signs of disability have:

• in a month - up to 70% of patients;
• six months later - 40%;
• by the second year - 30%.

Most of all, the rate of recovery is noticeable in the first three months by increasing the range of motion, while the functions of the legs return faster than the hands. Remaining immobility in the hands after a month is an unfavorable sign. Speech is restored years later.

The rehabilitation process is most effective with the willful efforts of the patient, the support of loved ones. Complicating factors are elderly age, heart disease. Seeing a doctor in the phase of reversible changes will help to avoid serious consequences.

My husband was given a stroke doctor, stayed in the hospital for a month, then was treated at home for a month. Paresis on the right side, moved on crutches. After 2 months, paralysis of the left side was treated for 10 days. An MRI showed that there was no stroke at all. Did the course of treatment for STROKE - LEFT PARALYSIS harm the arms and legs?

Three months after stroke, he lost his speech and cannot swallow. They put him back in the hospital. Feed through a tube. What can be the prognosis? And are they discharged from the hospital with a probe?

In 2011, she suffered an ischemic stroke on the left side, the functions recovered, but now the left side of the head is numb. In 2014, she had an MRI, blood flow to the brain was 30%, constant headaches, the pressure rises to 140 to 85. The stroke was at a pressure of 128 to 80, working pressure 90 over 60, I'm 65 years old.

CVA by ischemic type, its symptoms and treatment

CVA or acute cerebrovascular accident is a group of clinical syndromes that are the result of impaired blood flow to the brain. Pathology can be caused by a thrombus formed in the blood vessels of the brain or their damage, which leads to the death of a large number of blood and nerve cells. Allocate:

1. CVA by ischemic type (ischemic stroke).
2. CVA by hemorrhagic type (hemorrhagic stroke). This diagnosis is made when a cerebral hemorrhage is confirmed.

The above classification is very important for right choice treatment method.

A stroke provoked by damage to the brain tissue and critical disorders of the blood supply to its areas (ischemia) is called ischemic stroke.

The main reason for the manifestation of pathology is a decrease in the amount of blood entering the brain. The following factors and diseases can lead to this:

• Persistent increase in blood pressure.
• Damage to the main arteries of the brain and neck vessels in the form of occlusion and stenosis.
• atherosclerotic changes.
• Inflammation of the connective tissue lining of the heart.
• Inflammatory processes or injuries of the carotid arteries, which significantly reduce blood flow through the vessels.
• Hemorheological changes in the cellular composition of the blood.
• Cardiogenic embolism.
• Change in the rhythm of heart contractions.
• Myocardial infarction.
• Various changes in the heart, as well as in the main arteries of the cervical region (observed in 91% of patients).
• Diabetes.
• Immunopathological vascular inflammation.
• Pathological violation of the tone of blood vessels.
• Thrombotic formations on the walls of blood vessels.
• The presence of artificial valves in the heart.
• Smoking.
• Overweight.
• Everyday stress.

At risk are the elderly (however, there are cases of illness in children) and patients suffering from osteochondrosis of the cervical spine, as this leads to significant squeezing of blood vessels.

The disease has a wide variety of symptoms. The general symptoms of stroke of the ischemic type include sudden headaches, deterioration of speech and vision, impaired reflexes and coordination, nausea, vomiting, dizziness and disorientation of the patient in space, pain in the eyeballs, paralysis of the face and limbs. Psychomotor agitation and short-term loss of consciousness, convulsions are also possible.

There are zonal signs of cerebral artery thrombosis. It is characterized by the following types of violations.

If the internal carotid artery is affected, the patient's vision deteriorates (fields of vision fall out), skin sensitivity and speech are disturbed, muscle paralysis and loss of orientation in one's own body occur.

Patency disorders in the middle cerebral artery cause sensory disturbances in half of the body, the inability to focus on a specific object, loss of visual fields and loss of speech. The patient is unable to distinguish the right side from the left.

If disturbances have occurred in the posterior cerebral artery, blindness, seizures, complete or partial paralysis, respiratory failure, large tremors, and deterioration in swallowing function may occur. In the worst case, a cerebral coma occurs.

With damage to the anterior cerebral artery, one-sided loss of sensitivity, loss of speech is observed. The patient's movements slow down or there is no ability to walk and stand at all.

If the slightest symptoms of pathology are detected, it is necessary to carry out timely treatment of stroke.

The purpose of diagnosis is to determine the necessary method of treatment. It is very important to conduct an examination with a specialist in the first hour after the patient arrives. The following procedures are followed:

• Blood sampling to determine blood clotting: viscosity, hematocrit, fibrinogen, electrolytes and antiphospholipid antibodies.
• CT and MRI. This is the most reliable method for detecting acute cerebrovascular accidents. It allows you to correctly determine the type of stroke, exclude tumors and aneurysms, determine the size and location of the focus, and diagnose vascular diseases.
• echoencephaloscopy. This technique is not very informative in the first hours of a stroke.
• X-ray examination of the vessels of the brain.
• ECG changes in blood pressure.
• brain ultrasound. It is used if there is no possibility of carrying out computer and magnetic resonance imaging.

The main task is the emergency and intensive treatment in the first minutes of the patient's admission, since at this time the thrombolysis technique is effective. This will preserve the vitality of neurons near the zone of necrosis, as well as weakened cells. Further, in the hospital, upon confirmation of a stroke in a patient, the treatment is carried out in the following order:

1. 1. A general complex is being carried out to maintain the vital functions of the body.
2. 2. If necessary, antihypertensive agents, anticoagulants (if the patient has high blood pressure, ulcers, diabetes or bleeding), vasoactive and decongestants, antiplatelet agents and others are prescribed.
3. 3. To normalize breathing and saturate the lungs with oxygen, breathing exercises are performed. In extreme cases, perform artificial ventilation of the lungs.
4. 4. Restore blood circulation.
5. 5. With the help of diuretics, swelling of the brain is reduced.
6. 6. Antipsychotic drugs are prescribed to exclude the possibility of recurrent seizures.
7. 7. In case of violation of the swallowing function of the body, the patient is prescribed semi-liquid nutrition or parenteral therapy is carried out.

Acute cerebrovascular accident of the ischemic type can lead to the following complications:

• paralysis or paresis of one side of the body;
• violations of pain sensitivity of any part of the body;
• loss of taste, hearing, sudden blindness or double vision;
• problems with speech (when talking, it is difficult for the patient to select and pronounce words);
• violations of complex, purposeful movements (apraxia);
• violations of the swallowing function of the body;
• loss of visual fields;
• spontaneous fainting;
• involuntary urination.

It should be noted that with proper treatment and regular rehabilitation sessions, it is possible to completely eliminate the above complications, as well as complete recovery of the patient's body. And after some time, a person can completely return to normal life.

If you have the slightest suspicion of stroke, you should immediately call an ambulance. The patient at this time should not be unreasonably disturbed (but it is best to isolate him) and put him in such a position that the upper body and head are raised. Next, you need to allow the patient to breathe freely. To do this, you need to perform a massage of the cervical-collar zone and provide fresh air access to the room.

If a person has gag reflexes, turn his head to the side and clean his mouth with a tissue or gauze. This will eliminate the risk of getting vomit into the respiratory tract.

Quite often, with stroke, an epileptic seizure occurs, which is accompanied by loss of consciousness and convulsions. In this case, the main thing is not to get confused. The patient should be placed on his side and a pillow placed under his head. Next, a pencil or pen should be placed in the mouth, for example, to prevent biting the tongue. In no case should you restrict the patient's movements (hold him by the arms and legs or press him down with your body), as this will only increase convulsions and the risk of fracture or dislocation.

A common mistake is to use ammonia, which can lead to respiratory arrest. If a person's heartbeat or breathing has disappeared, direct heart massage and artificial respiration can help.

Every year the number of people suffering from this terrible and deadly disease is increasing. This is facilitated by a modern sedentary lifestyle, as well as malnutrition, leading to obesity. Therefore, it is recommended to exercise regularly (spontaneous exercise can lead to a jump in blood pressure and cause rupture of blood arteries and veins), lead an active lifestyle and follow a proper diet. The implementation of these simple recommendations will significantly reduce the risk of stroke.

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What is stroke, what types of disorders exist and how each type of pathology is diagnosed

Elderly people are familiar with such a disease, the name of which ONMK - acute cerebrovascular accident Or just a stroke. Almost every older person has experienced this disease on himself. It is very important to understand the causes of stroke and the proper treatment of the disease.

What it is?

A stroke is a clinical symptom manifested by sharp failures in the normal operation of the existing options of the brain of the head, the duration of which is more than one day.

The main symptoms of CVA are:

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

An unexpectedly appeared violation of the speech apparatus, loss of body sensitivity and problems with coordination of movement pass over the next day. Then they talk about transistor ischemic attack. This is not such a dangerous disease as a stroke, but also applies to stroke.

If the disease refers to disorders in the functioning of the circulatory system, then it is characterized as "stroke by the type of ischemia." In the case when bleeding is confirmed by a specialist, then the disease has the characteristic "CVA by hemorrhagic type".

A stroke that ends in a stroke is the stage when blood flow 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 - ICD-10 code

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 ends in death in a third of cases. Sixty percent of patients who have had the disease turn out to be disabled, who cannot do without social assistance.

Causes of stroke

CVA, related to the ischemic type, develops as a result of already existing pathologies in the patient's body.

These diseases include:

• Hypertonic disease;
• Atherosclerotic vascular lesions;
• Myocardial infarction, transferred to the patient earlier;
• Inflammatory disease of the inner lining of the heart;
• Disorder of the rhythm of contractions of the heart muscle;
• Change in the work of the heart valve;
• Inflammatory processes in the walls of blood vessels of a systemic nature;
• Disorder of the tone of blood vessels;
• Expansion and abnormal development of blood vessels;
• Pathology of the circulatory system;
• The occurrence of blood clots;
• Diabetes.

ACVE is found not only in the adult category of the population, but also in children. This is due to the fact that the vessels of the child's brain have any anomalies in their development. A high risk of developing stroke is observed in children who have congenital heart disease.

When stroke occurs, only 30% of children recover completely. About fifty percent have incurable disorders in the work of the neurological system. Twenty percent of cases of acute cerebral circulatory disorders in children end in death.

In what cases can CVD be suspected?

The diagnosis of stroke is made if the patient has the following disorders in 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. Clouding of consciousness.

An accurate diagnosis can be established only after the diagnosis.

Stages of cerebral infarction

ONMK has several stages of development. Let's consider each of them in more detail.

Ischemic stroke

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

Causes of ischemic stroke

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

Risk group

CVA is most often manifested in the category of the population that have the following pathologies:

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

Symptoms of the disease

1. mild headache;
2. Vomiting;
3. High blood pressure over a long period;
4. Increased tone of the neck muscles;
5. From the very beginning, the disease is accompanied by impaired motor function;
6. Disorder in the work of the speech apparatus;
7. In the laboratory diagnosis of cerebrospinal fluid, it has a colorless tint;
8. There is no hemorrhage in the retina.

Neurologists distinguish several intervals in the 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. Eliminate traces. Over 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 the internal carotid artery is affected, then the following symptoms appear:

• Disorder of the visual system in the direction where the blockage of the vessel occurred;
• The sensitivity of the extremities disappears on the opposite side of the focus of the disease;
• 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 view.

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 double in the eyes.

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

• Severe disturbances in the functioning of the motor apparatus;
• Problems with gestures;
• Jerky articulation of speech;
• Upset in joint work motor apparatus of the body and limbs;
• Malfunctions in the respiratory system;
• Violation of blood pressure.

In case of damage to the anterior artery of the brain:

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

If failures prevent the normal patency of the middle cerebral artery:

• The result of a complete blockage of the main trunk is a state of severe coma;
• In half of the body there is a loss of sensitivity;
• Refuses the motor apparatus;
• The inability to fix the gaze on the subject;
• Fields of vision fall out;
• There is a failure of the speech apparatus;
• The patient is unable to distinguish the right limb from the opposite.

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

• Loss of vision in one or both eyes;
• Doubling of objects in the eyes;
• Inability to jointly move the eyeballs;
• The patient has convulsive movements;
• A strong tremor is characteristic;
• Inability to swallow food and saliva normally;
• Paralysis of the body on any one side or on both sides at once;
• Disorders in the work of the respiratory system;
• Coma of the brain.

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

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

The defeat in the area of ​​​​the visual tubercle is characterized by the following symptoms:

• The movements of the patient have a wide scope;
• There is a strong tremor;
• There is a loss of coordination;
• Half of the body loses sensation;
• Severe sweating is characteristic;
• Bedsores occur.

The most severe case of stroke is the process of breaking through an intracerebral hematoma. Hemorrhage occurs in the cerebrospinal fluid, fills 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 lies in the unhindered flow of blood into the patient's brain.

Treatment of stroke by ischemic type

The above symptoms may appear unexpectedly in native person. It is very important to provide the first first aid sick.

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

1. Put the patient on the side so that vomiting freely leaves the victim's oral cavity;
2. The head should be slightly raised;
3. If there is a tonometer, then it is necessary to measure blood pressure. If a sharp increase in pressure to critical values ​​\u200b\u200bis 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. Release the patient's neck from any squeezing things.

Treatment in a hospital

After arriving at the 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 the necessary trace elements. Nutrition is adjusted so that fatty, spicy, salty foods are not observed in the diet.

Mayonnaise and other seasonings should also be excluded. Vegetables and fruits are limited only during the acute stage of the disease. If the patient's consciousness is absent, then food intake is carried out through a medical probe no earlier than two days later.

After confirmation of stroke, inpatient treatment continues for a month. The consequences after the transfer of this disease are extremely severe.

A severe decrease in strength in the muscle tissue on the opposite side of the brain, the area of ​​\u200b\u200bwhich has been affected. A certain category of patients practically learns to walk again and perform normal movements;

Violations in the work of mimic muscles. The decrease in strength occurs only in the area of ​​the mouth, cheeks and lips. The patient is unable to properly eat and drink fluids;

Quite often there is a disturbed work of the speech apparatus. It's caused by defeat speech center in the human brain. The patient either completely loses speech, or does not perceive the words of another person;

Disorder of coordination of movements is caused by a lesion in 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;

Failures in the work of the visual system are of a different nature and depend on the size and localization of the lesion with a stroke. Usually they are expressed in the loss of visual fields;

Violation of sensitivity is expressed in the loss of pain, sensations of heat and cold.

Rehabilitation

A very important stage on the path of recovery after stroke.

Quality therapy includes the following categories of treatment:

1. Physiotherapy. It is necessary to return the patient to normal movement of the limbs. A set of exercises is selected by the attending physician;
2. Visiting a speech pathologist. It is prescribed if the patient has speech and swallowing disorders;
3. Physiotherapy. The most affordable type of therapy, which is in every clinic;
4. Therapy with medicines. The main stage in the recovery process. Drugs mitigate complications after the disease and prevent the risk of relapse;
5. Mind training. It is desirable for the patient to read as much literature as possible, to memorize poems or excerpts from works.

CVA by hemorrhagic type

Components that have a nutritional effect, which include oxygen, enter the brain through the carotid arteries. Being in the box of the skull, they form a network of vessels, which is the root of the blood supply to the central nervous system. When arterial tissues are destroyed, the blood flow rushes to the brain.

Causes

A stroke of the hemorrhagic type occurs in the event of a 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 the brain tissue. Also, blood from a burst vessel can penetrate into the area surrounding the brain.

Risk group

Particular attention should be paid to the state of their health of the following category of citizens:

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

Symptoms

1. Acute headache;
2. Constant vomiting;
3. Frequent loss of consciousness over 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. Violation of the motor system;
8. Disorder of the visual system;
9. Strong nervous excitement;
10. When analyzed, a small amount of blood is observed in the cerebrospinal fluid;

Treatment of stroke by 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.

Medications can cause stroke recurrence, so it is advisable to eliminate the problem by surgical intervention. First of all, the neurosurgeon removes the lesion, and then eliminates the failure in the vessel.

Reversibility of pathology

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

If the stage is irreversible, then the brain cells have died and cannot be restored in any way. This area is called the ischemia zone. But therapeutic treatment in this case is possible.

Its meaning is to provide neurons with all the nutrients in the ischemic zone. With proper treatment, cell functions can be partially resuscitated.

It was found 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 the work can replace the dead cells and ensure their full functioning. The process is rather slow, so full rehabilitation lasts for three years.

Transistor ischemic attack (TIA)

This disease is also a stroke, but unlike ischemic and hemorrhagic stroke is temporary. For some period of time, there is a sharp violation 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. The symptoms of TIA - transistor ischemic attack last for days and are similar to the symptoms of a stroke.

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

Symptoms

Consider the symptoms of a transistorized ischemic attack:

• There is a decrease in sensitivity in one of the sides of the face, body, lower or upper extremities;
• Weakness in the body, which is mild or moderate;
• Violations in the work of the speech apparatus up to the complete absence of speech or problems with understanding the words of the opponent;
• Dizziness and incoordination;
• Sudden noise in the ears and head;
• Headache and heaviness.

These symptoms appear abruptly and disappear after 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 conditions:

1. Persistent increase in blood pressure, which is chronic;
2. Chronic cerebrovascular disease;
3. Changes in blood clotting;
4. sudden drop in blood pressure;
5. The impossibility of the normal flow of blood through the artery, caused by a mechanical obstruction;
6. Pathology of the structure of cerebral vessels.

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

Risk group

• Those who use excessive amounts of products of the tobacco and alcohol industry;
• Suffering from high blood pressure of a chronic nature;
• Having high levels of cholesterol in the blood;
• Suffering from diabetes;
• Those who are overweight;
• Leading a sedentary lifestyle.

Transistor ischemic attack is no less dangerous than a stroke. Up to 8% of patients who have had a TIA in the future suffer from a stroke that occurred within a month after the attack. In 12% of patients, a stroke occurs within a year and in 29% within the next five years.

Treatment of transistorized 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 assigned 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. Regular blood pressure checks.

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;
• Vasodilating agents;
• Lowering cholesterol levels in the blood;
• Designed to normalize 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 the diet by reducing the amount of fatty, salty and spicy foods;
3. Reduce the use of alcohol and tobacco products;
4. Monitor your body weight.

Survey algorithm

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

It is necessary to undergo a series of diagnostic studies.

Examination by a specialist immediately after the patient enters a medical institution;

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

Computed tomography in this case allows you to get more complete information about the disease. In the first 24 hours after an ischemic disorder, it is not possible to find out the localization of the affected area.

This problem can be solved by conducting 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, an aneurysm and a pathological connection between the veins and arteries of the brain can be diagnosed.

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

The collection of cerebrospinal fluid for laboratory testing poses a threat to the patient's life, but this study allows you to determine what type of stroke belongs to.

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

Forecast

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

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.

Acute cerebrovascular accident (ACV) occurs suddenly, but there are situations that can act as triggers, these are:

• high blood pressure;
• cholesterol;
• obesity;
• smoking;
• stress.

What is ischemia?

Cerebral ischemia occurs when there is insufficient blood flow to a specific area of ​​the brain. When there is not enough blood, the nerve cells in this zone are deprived of oxygen and nutrients because they do not work in the correct format.

If the blood flow is not immediately restored, the cells of the affected area begin to die, and this can lead to injury and damage, which can provoke corresponding changes.

The extent of these effects will depend on several factors, such as the victim's previous health status, the timing of the cessation of blood flow, or the area of ​​the brain where the injury occurred.

Risk factors

Cerebral ischemia or stroke usually occurs suddenly. There are people more predisposed than others to suffer from this, and it largely depends on their state of health and lifestyle. We detail the aspects that need to be taken into account to prevent these dangerous episodes:

• Blood pressure control: Hypertension is the most important risk factor. Having high blood pressure can increase your risk of ischemia, or cerebral hemorrhage, by up to 5 times.
• Controlling Your Cholesterol: Helps keep our arteries healthy and therefore prevents stroke. Follow a diet, preferring foods rich in fiber and vitamins, and limiting animal fats.
• Prevention of diabetes: This is an important risk factor because it accelerates the aging process of the vessels, affecting all vessels in the body. Try to maintain a healthy weight and limit refined foods.
• Exercise: This protects the arteries of the brain and heart. With 25 minutes of moderate physical activity, you can significantly reduce your risk of suffering from cerebral ischemia.
• No smoking: Quitting smoking and controlling alcohol use should be one of the first priorities to protect yourself from stroke and other cardiovascular diseases.
• Hormonal contraceptives: There are medications that make people more likely to suffer from cerebral ischemia, especially if they are added to other risk factors. Hormones in birth control pills can cause clots to form and therefore increase the chance of ischemia. The risk is low, it is better to limit their use in women over 30 who also have hypertension, obesity and bad habits.

signs

To combat stroke, the most important thing is to act quickly, because every minute counts. Learning to recognize the symptoms of a stroke is essential in order to be able to act quickly and thus reduce the effects of the disease.

You may be aware of what is happening to you, but to those around you, your condition may remain a mystery. At the first signs, you need to act as soon as possible by notifying the emergency service.

Here are some of the symptoms and signs to watch out for.

lack of strength

We may feel weakness and lack of strength in the leg or arm. This symptom is the most common and can be seen in both limbs or on one side of the body. You may also notice tingling and decreased sensation. Similar sensations can also be seen on the face.

asymmetrical smile

It is often the case that during a stroke, you may see that the mouth is slightly crooked and it is difficult for the person to smile. He may have difficulty drinking liquid because it will overflow on one side.

Other signs

If the disease affects the back of the brain (vertebrobasilar area), it can cause double vision and difficulty speaking.

If you feel dizzy, it may be that an ischemic cerebrovascular accident is affecting the area of ​​the brain that is responsible for balance. In this case, you may also notice that it is difficult for you to coordinate movements.

Another of the symptoms that should make us suspect that we are facing cerebral ischemia is sudden change in vision. Sometimes it can be double vision, and other times it can be a sudden loss of it. This loss can be total, although it most often affects only one of the areas of vision. It may occur in one or both eyes.

Sudden difficulty in speaking or understanding may also indicate a stroke. If you are talking, and suddenly you have trouble formulating words or making sentences, this may be a symptom of an ailment. Similarly, if you feel like you cannot understand the words, as if they were speaking to you in a different language, this may be a sign of vascular disease.

sudden headache

Feeling a severe headache, a stroke may suddenly appear, especially a cerebral hemorrhage. However, it is important not to worry because it could also be a headache due to another reason. You should be concerned if the pain is accompanied by some other suspicious symptom, such as tingling or difficulty moving a body part.

A stroke is a situation in which blood does not reach the brain. This can happen for two different reasons: because of a blood clot, that is, something that clogs the veins or arteries, or because of a rupture in one of these veins through which the blood "moves".

Ischemic stroke, also known as CVA for the ischemic type, occurs when blood flow is cut off due to a clot that clogs a blood vessel in the brain. This is also known as thrombosis or embolism. We talk about thrombosis when a blood clot or embolus forms in the wall of a cerebral artery, and we talk about embolism when this clot originates elsewhere in the body (such as the heart) and travels through the bloodstream until it reaches the vessels of the brain.

A hemorrhagic stroke, also known as a hemorrhage, occurs when a lack of blood supply to the brain is caused by a ruptured vessel, followed by internal bleeding that it causes.

The onset of symptoms can be very rapid. The main symptoms of cerebral ischemia are:

• blurred vision;
• difficulty controlling muscles
• speech disorders.

There are two types of cerebral ischemia:

• Focal cerebral ischemia. It occurs when a blood clot closes off a cerebral vessel that reduces blood flow to a specific area of ​​the brain, increasing the risk of cell death in that particular area. This may be due to thrombosis or embolism.
• Global GMS of the brain. This happens when blood flow to the brain stops or is greatly reduced. It is often caused by cardiac arrest. If sufficient circulation is restored within a short period of time, the symptoms may be temporary.

A person suffering from focal cerebral ischemia will still have some degree of blood flow to part of the brain, however, a patient with global ischemia will not have any blood flow to any area of ​​the brain.

Risk factors

Cerebral ischemia can be caused various diseases and anomalies, including:

• Vascular anomalies. Blood vessels can form clots that block circulation, causing a stroke. They can also rupture or cause vascular malformations, where blood vessels grow abnormally.
• Trauma in the brain. A severe head injury can also cause ischemia or rupture of blood vessels and prevent blood from reaching certain areas of the brain.
• Ventricular tachycardia. It generates a series of irregular heartbeats that can lead to cardiac arrest by completely cutting off the flow of oxygen.
• Plaque buildup in the arteries (atherosclerosis). Even a small buildup of plaque can cause arteries to narrow, making clots more likely to form.
• Blood clots. Large blood clots can also cause ischemia by blocking blood flow.
• Low blood pressure after a heart attack. Hypotension, in other words, extremely low blood pressure, usually results in inadequate tissue oxygenation.
• Congenital heart defects. People with congenital heart defects may also be prone to blood clots.
• Tumors. They cause constriction of blood vessels.
• Sickle cell anemia. This can cause cerebral ischemia associated with defective blood cells. Cardiac blood cells coagulate more easily than ordinary cells blood, blocking blood flow to the brain.

Even short-term interruptions in blood supply can cause cerebral ischemia and potentially lead to a situation called ischemic stroke, where brain cells with insufficient blood supply necrotize and release toxins that damage surrounding cells, causing them to become damaged and release toxins.

Complications

When cerebral ischemia involves areas responsible for regulating functions such as respiration, heart rate, and metabolism, it can lead to autonomic manifestations.

Interruption of blood flow to the brain for several minutes usually results in permanent brain damage. The brain stem cannot recover from severe damage. Mild brain damage can lead to a worsening condition that requires the use of a ventilator for breathing.

Treatment

If prompt treatment is provided, chances of recovery are possible. Other patients may suffer from brain damage and need therapy to learn some skills. In some cases, the damage can be repaired with therapy and the patient will have a permanent disability.

Prevention

A transient ischemic attack is a brief episode in which there is a temporary cessation of blood flow in a vessel in the brain. Recognition and treatment of a transient ischemic attack when it occurs is important because the patient may be at risk for future myocardial paralysis or stroke.

Cerebral ischemia or ischemic stroke occurs when there is a decrease or absence of blood flow to the brain, which reduces the amount of oxygen that reaches the organ and characterizes the picture of cerebral hypoxia. Cerebral hypoxia can lead to complications if not identified and treated as soon as the first symptoms appear, such as drowsiness, paralysis of the arms and legs, speech and vision changes.

Cerebral ischemia can occur at any time during physical activity or even sleep, and is more common in people with diabetes, atherosclerosis, and sickle cell anemia. Diagnosis can be made based on imaging tests such as MRI and CT.

There are 2 types of cerebral ischemia:

• In which a clot blocks a brain vessel and prevents or slows down the flow of blood to the brain, which can lead to cell death in the area of ​​the brain that has been blocked.
• Where the entire blood supply to the brain is blocked, which can lead to permanent tissue damage if it is not detected and repaired quickly.

Symptoms of cerebral ischemia can last from seconds to longer periods and can be:

• weakness in arms and legs;
• dizziness;
• tingling;
• difficulties with speech;
• headache;
• increased pressure;
• problems with coordination;
• weakness on one or both sides of the body.

Symptoms of cerebral ischemia should be identified as soon as possible in order to begin treatment, otherwise permanent brain damage may occur.

In transient cerebral ischemia, symptoms are temporary and last less than 24 hours, but must also be treated clinically.

What is transient cerebral ischemia?

Transient cerebral ischemia, also called a mini-stroke, occurs when there is a short-term decrease in blood flow to the brain, usually lasts about 24 hours, and requires immediate attention as it may be a sign of more severe cerebral ischemia.

Transient ischemia should be treated according to medical advice, usually with vasodilators. Changes in eating and living habits are important, including physical exercise and reducing fat and alcohol consumption, as well as avoiding smoking.

Possible consequences of cerebral ischemia

Cerebral ischemia can cause complications such as:

• permanent brain damage;
• paralysis of the entire or one side of the body;
• loss of coordination;
• difficulty swallowing;
• difficulties with speech;
• emotional problems such as depression;
• vision problems;
• fragility of bones;
• weakness or paralysis of an arm, leg, or face.

The consequences of cerebral ischemia vary greatly from one person to another and depend on the time taken to start treatment, and it is often necessary to go to a physical therapist, speech therapist or occupational therapist to improve quality of life and prevent complications.

The causes of cerebral ischemia are closely related to a person's lifestyle. Thus, people suffering from atherosclerosis, diabetes and high blood pressure, which are diseases associated with eating habits, are at greater risk of cerebral ischemia.

In addition, people who have sickle cell anemia are also more likely to suffer from reduced brain oxygenation because the red blood cells are shaped like they don't carry oxygen properly.

Problems associated with coagulation, such as platelet retention and impaired coagulation, also contribute to the occurrence of cerebral ischemia, since there is a greater likelihood of obstruction of the cerebral vessel.

How is cerebral ischemia treated and prevented?

Treatment of cerebral ischemia is based on the size of the clot and the possible consequences for the individual, and the use of clot-melting drugs such as Alteplase may be indicated. Treatment must be carried out in a hospital so that blood pressure and intracranial pressure can be controlled while avoiding possible complications.

• nutrition;
• fatty foods should be avoided;
• salt;
• perform physical exercises;
• stop drinking alcoholic beverages;
• stop smoking.

There are some home remedies that can prevent stroke because they have properties that cause the blood to become too thick and form clots.

Terms: ischemic infarction, apoplexy and others are indicated on different languages the word "stroke", which is a critical condition with an acute onset, the severity of the stroke depends on the vastness of the affected area and the functions controlled by this area.

A stroke may be an ischemic infarction (white infarct) due to the absence of bleeding and may be thrombotic (25%) or embolic (70%) in nature. Red heart attack - hemorrhagic stroke (15-20%) - the term is used for intracerebral bleeding, less often subarachnoid or meningeal forms (cerebral aneurysms, severe hypertensive crisis, amyloid angiopathy).

Classification of stroke depending on the affected vascular area:

• Posterior infarction in the pathology of the vertebral arteries.
• The infarction is lacunar, it occurs in one peripheral and deep artery, affecting the thalamus, internal capsule, or brainstem.

The brain is involved in such vital functions as breathing, metabolic homeostasis, sleep rhythm, swallowing, chewing, eye movements, hearing, maintaining balance, speech articulation, facial sensitivity in case of illness, certain functions may be impaired.

The trunk is also a kind of crossroads of neural pathways that regulate movement and its regulation, muscle tone and all the different types of sensation, while, as far as vision is concerned, disturbances of the visual field (Mesencephalic) should be taken into account, but also acute episodes of loss visibility. Often this symptomatology is called "drunk".

Deep infarctions affecting the internal capsule give symptoms of contralateral hemiparesis, more or less extensive, with or without sensation (of all or part of the internal capsule).

Midbrain lesions give a significant stroke that affects almost the entire hemisphere, accompanied by contralateral paralysis with loss of speech, motor or sensory aphasia. People do not understand what is being said and seem crazy if the affected hemisphere is dominant, which makes it impossible to see the field of view on one side of the hemiparesis or leads to hemiplegia (lack of strength).

Strokes caused mainly by vascular pathologies include risk factors that are divided into:

• constant factors: age, gender, race.
• modifiable factors: smoking, alcoholism, obesity, use of oral contraceptives, hypertension and hypertensive heart disease with left ventricular hypertrophy, embolic heart disease such as valvular stenosis, bacterial endocarditis, predisposition to deep vein thrombosis, Marfan syndrome, blood viscosity, hypercholesterolemia, diabetes, coagulation changes, migraine with aura, vasculitis associated with diseases such as lupus, Sjögren's syndrome, arteritis, Cogan's syndrome, etc.

Obviously, primary prevention (i.e. measures that must be implemented before the onset of the disease) is to prevent diseases through a lifestyle that leads to the avoidance of smoking, alcohol, stress, the use of contraceptives or, if necessary, periodic control of coagulation factors. and any thrombotic injury. Inactivity, excess of salt, sugar, potatoes, red meat and sausages are unfavorable, preference should be given to river fish, vegetables, fresh fruits.

Adequate treatment of existing diseases such as:

• diabetes;
• kidney failure;
• hypertension;
• chronic obstructive bronchopathy;
• dental caries;
• recurrent angina;
• tonsillitis.

Diseases such as congenital or acquired heart defects, deep venous insufficiency, clotting defects that may predispose not only to thrombosis but also to bleeding, folic acid deficiency with hyperhomocysteinemia, hemolytic anemia.

Cerebral ischemia is not a simple disease. It is a cardiovascular disease that can occur in two ways.

This is cerebral ischemia, which occurs due to a decrease in the blood supply to the brain and hemorrhagic stroke, which is the ingress of blood due to damage to the brain vessels into the brain tissue.

cerebral ischemia may be different types: one of them is when a stroke occurs due to some disease, for example, diabetes or problems with uncontrolled hypertension. Here the walls of the cerebral artery are damaged, they begin to overgrow with platelets, forming what is called a thrombus, and then the so-called thrombosis occurs.

This is a clot in one of the branches of the internal carotid artery, which is located inside the brain. The plaque completely impedes blood circulation at a certain point. If this persists, this decrease in blood flow leads to a heart attack or permanent brain injury.

This obstruction can occur with a plaque, which is nothing more than a blood clot located at a remote site from the damaged artery. It can be located at the level of the heart or the large vessels of that organ, and for a moment it separates, travels with the blood and interferes with the blood flow in the more distant vessels of the brain.

Another ailment that can cause ischemic damage is hypoxia, that is, a decrease in the concentration of oxygen in the blood that reaches the brain, and the cause of this may be a decrease in blood pressure or hypotension, which is secondary to myocardial infarction.

In this case, cardiac output and cerebral circulation may decrease. If this is observed for a long time, permanent ischemic brain damage will occur.

Patients with higher risk factors are smokers, as well as those people who have poor eating habits, suffer from cholesterol, triglycerides as well as patients with heart injuries.

As for the consequences that ischemia can cause, it all depends on the size of the clogged vessel.

A large occluded vessel that has several branches can cause a massive cerebral infarction. In this case, over time, it will lead to long-term disability.

When it comes to small vessels that can be fed by collateral circulation, the consequences will be minimal.

The effects depend on the area of ​​the brain affected. If the ailment affects the area that is associated with speech, the person may become speechless, if it touches areas such as movement, sensitivity, hearing, vision, the patient is left with certain dysfunctions, loses the ability to express ideas or understand them.

There are degenerative diseases of the arteries that can accompany childhood pathology, but the disease is associated most of all in elderly patients.

Manifestations that tend to occur and are sometimes felt but go unnoticed include, among others, food intolerance, dizziness, dyspepsia, chest pain, and high blood pressure.

Experts say that an excess of certain types of food, such as fatty and smoked foods, or habits such as smoking or drinking alcohol, can lead to such a disease.

When there is a case of cerebral ischemia, physicians tend to take general measures to control the underlying cause and restore oxygen to the affected tissue. They may also offer surgical treatment in cases of atherosclerotic occlusive diseases. However, according to the characteristics of each patient, your doctor may recommend certain procedures and tests.

Knowledge of pathophysiological mechanisms makes it possible to understand the changes in neuroimaging at different stages of cerebral ischemia and the mechanisms of action on which many therapeutic aspects are based.

The pathophysiology of cerebral ischemia differs in the gray and white matter of the brain. In gray matter, obstruction of a blood vessel causes ischemic stroke. In the peripheral zone, functional changes in neurons occur, but with the preservation of their structural integrity for some time. The penetration of calcium into cells leads to the launch of a number of biochemical processes that end in the death of neurons. In white matter, the loss of energy capacity changes the direction of ion exchange pumps, leading to the entry of calcium into the tissues. The release of GABA activates specific receptors that protect nerve fibers from the consequences of such a phenomenon.

Conclusions. Acute cerebral stroke accompanying ischemia has a dual mechanism: it is initially cytotoxic and then vasogenic. Both factors contribute to the increase in neurological damage caused by cerebral ischemia.

Cardiovascular disease is the most common cause of neurological disability. Most vascular lesions of the brain are secondary to atherosclerosis and arterial hypertension.

The main types of brain diseases are:

• Cerebral insufficiency due to transient changes in blood flow.
• Cerebral infarction caused by embolism or thrombosis of intracranial or extracranial arteries.
• Hypertensive parenchymal cerebral and subarachnoid hemorrhage due to congenital aneurysm.
• An arteriovenous malformation that can cause symptoms due to a mass effect, infarction, or hemorrhage.

Neurological signs and symptoms of cerebrovascular disease reflect the area of ​​brain damage. Ischemic stroke and cerebral hemorrhage tend to appear suddenly, with the hemorrhage usually having a more acute onset.

Ischemic syndrome

According to the latest statistics, in our country there are more than a hundred thousand new cases of the disease a year, as a result of which tens of thousands of people are in need of state assistance.

Stroke is now the leading cause of death among women and second among men, and is also the leading cause of adult disability and dementia.

A third of stroke patients develop dementia within the next three months. In particular, out of every three people who have a stroke, one is left with a severe disability that makes them completely dependent on someone else, and the rest, although they do not need constant help, may suffer the consequences.

This is a problem that appears suddenly and in most cases without any preceding symptoms, so it is important to control your living habits.

The public should be aware of the symptoms of the disease that will prompt them to visit their doctor soon, such as loss of strength, difficulty speaking or understanding, sudden loss of vision, double vision, feeling dizzy, or intense and unusual pain in the head.

Etiology: Intracerebral thrombosis or embolism formed from atheroma plaque due to arteritis, valvular disease, endocarditis, or atrial fibrillation often causes ischemic arterial occlusion.

Sympathomimetic drugs such as cocaine and amphetamines can cause ischemic strokes.

Vertebral osteophytes can contribute to compression of the arteries with the risk of cerebral ischemia, in addition, the artery may have stenosis due to plaque in the lumen.

Factors that favor the pathology include atherosclerosis, heart disease, diabetes mellitus, and polycythemia.

In both situations, thrombosis or embolism, if the deprivation of oxygen and nutrients in the brain continues, provokes a heart attack, which can lead to brain damage and neurological injury. They may be permanent.

Western people's diet of processed red meat, grains, and refined sugars may be associated with an increased risk of cerebral infarction.

People who suffer from migraine with aura are four times more likely to have a stroke or heart disease before the age of 45. According to recent research, there should be a general predisposition to migraine and heart disease, regardless of risk factors such as alcohol, smoking, or oral contraceptive use.

The use of three or more glasses of alcoholic beverages per day increases the likelihood of cerebral ischemia, embolism by 45%.

More than 20% of the adult population suffers from sleep apnea, and there is an association between these repeated stops during the night if a cerebral infarction has occurred. In fact, the frequency of apnea is directly proportional to the risk of complications after a cerebral infarction.

Treatment for a stroke depends on the cause and type of the disease. In cerebral infarction, which is the most common type, medications are indicated that prevent blood clotting and facilitate blood circulation, only in selected cases.

Statins have been shown to be effective in the onset of myocardial infarction and stroke in diabetic patients. Patients with diabetes II and receiving atorvastatin have a 48% lower risk of stroke.

Other alternatives aim to kill intra-arterial clots with thrombolytic agents that activate tissue plasminogens such as rt-PA in the first three hours and in selected cases.

Surgery is limited to very specific situations, such as intervention in the carotid arteries, provided that they show a certain degree of obstruction and that no important consequences remain.

Any cerebral ischemic process prevents the disappearance of symptoms and neurological signs that vary in their expression depending on the area of ​​the affected brain. To be able to manage the disease, the cause of cerebral ischemia must be known and treatment must be initiated to prevent recurrence of the episode.

If the risk of new episodes of ischemia persists, driving is not recommended.

Patients on anticoagulants should be aware of the increased risk of bleeding from small impacts, so they should exercise caution when driving. It is recommended that the driver not perform forced lateral movements that reduce cerebral blood flow. Panoramic mirrors are useful for facilitating maneuvers.

Cerebral ischemia can occur unexpectedly in men and women. Despite the severity of the disease, it provides for treatment and prevention.

Ischemia occurs when there is an interruption or deficiency in atherosclerosis—thickening and hardening of the arterial wall—or a clot from the heart. In this case, there are difficulties in the movement of the body, a sudden loss of the ability to speak. Possible weakness of the arms and legs. Symptoms appear instantly.

What are the consequences?

It depends on the area of ​​the brain affected. The disease can paralyze one side of the body, impair speech, or affect vision. These effects will be temporary or permanent depending on the recovery, i.e. the faster the ischemia disappears, the more likely there are to be no complications.

Treatment is with medications that dissolve the clot or reduce its blockage. However, drugs should be taken by mouth, especially in the first three hours after the problem occurs. After this time, the chances of improvement decrease.

How to prevent the disease?

Control of blood pressure, diabetes and increased blood cholesterol levels are the highlights. Also, by practicing physical exercises, avoiding obesity and performing the treatment indicated by the doctor, one can hope for a favorable prognosis.

Acute cerebral ischemia is a complete or partial reduction in blood flow in a certain area of ​​​​the brain as a result of a thrombus (a blood clot that forms inside an artery or vein) or an embolus (solid, liquid or consisting of gaseous bacteria, fatty droplet, air bubble). An embolus can become lodged in a smaller artery or vein and obstruct blood circulation.

This decrease in blood flow means that oxygen and glucose do not reach the neurons. This may explain the cognitive and behavioral changes caused by acute cerebral ischemia.

When the blood supply to the brain is interrupted, neurons survive only three minutes, no more. If this irrigation is not restored, the neurons begin to die. Risk factors for this disease primarily occur in the sixth decade of life and include hyperlipidemia (high levels of fat in the blood) and hypertension (high blood pressure).

It has also been observed that frequent use of alcohol and tobacco, drug abuse in general, and the use of contraceptives can contribute to the formation of blood clots and, as a result, cause an acute cerebral ischemic attack.

Also, when a person suffers a heart attack, the heart stops pumping enough blood to the brain, leading to an ischemic process that can lead to cerebral vascular stroke.

As already mentioned, this disease usually appears at the age of 60 years and, although it is rare in young people, people with obesity, hyperlipidemia and hypertension are susceptible to it.

Several signs or symptoms portend the imminent occurrence of an acute cerebral ischemic attack. The main thing is that a person has problems with speech, because he loses control over his speech.

The unexpected presence of a nervous tic of the eyelid can also be alarming. Possible disorientation, trembling. The duration of treatment aimed at reducing the damage from acute cerebral ischemic attack is very short: three hours. In fact, the only drug used in the clinic today is prescribed only for the three hours counted from the onset of a stroke, because after three hours the drug, instead of helping, can harm the person.

Just three minutes

Acute cerebral ischemia is the third and fifth cause of death in men and women aged 60 and over. According to global epidemiological studies, most of those who survive are left with problems with walking, speech, hearing, and cognitive problems (i.e., attention, thought, and memory), depending on the area of ​​the brain that has lost its blood supply.

Once the blood supply to the brain is interrupted, neurons survive only three minutes, no more. If blood flow is not restored, neurons begin to die. It turns out that the prognosis depends on the speed of assistance.

Healthy diet and exercise

After an acute cerebral ischemic attack, some people enter a vegetative state; others cannot walk or move on their own, or speak or write, are dyslexic, or have memory and personality alterations; but others do recover remarkably quickly.

The reaction of the body to a cerebral vascular complication is very variable and is associated with the area of ​​the affected brain and the general condition of the person.

The severity of acute cerebral ischemic stroke is lower in a person who has followed healthy eating, low-fat diet and practiced exercise, compared with people who are overweight or obese, have hypertension and never practice exercise.

Video "What is ONMK"

This video explains what acute cerebrovascular accident (ACV) is, what are its symptoms and consequences.

And some secrets...

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Education: FGBU Clinical Hospital, Moscow. Occupation: general surgery…

Hello, dear guests and readers of the information resource dedicated to rehabilitation after a stroke.

As a doctor, every day I meet with a lot of questions regarding this vascular complication, and today I will present all the important information on this topic here.

Acute cerebrovascular accident.

« Stroke" (from the Latin insulto) - literally "jump, jump", meaning "attack, blow, onslaught", The diagnosis of stroke is acute cerebrovascular accident (ACV).

This is a condition accompanied by a cessation of blood flow in any of the structures of the brain due to acute vascular insufficiency in one of the cerebral vessels. This leads to a permanent disorder of neurological function due to the death of a section of brain tissue.

A disease with a high mortality rate 20% of all deaths from diseases in Russia

At least 50% of those who have undergone acute cerebrovascular accident become disabled. The prevalence in Russia is from 1 to 5 for every 1000 people, depending on the region, while the urban population gets sick more often.

I. leads to disability, according to the statistics of the national stroke registry, in at least 50% of all cases. Mortality is around 30 % within the first 30 days after And., and within a year about a half of all sick people die.

Lack of blood flow, leading to energy and oxygen starvation in any human tissue (the brain is no exception) is called the term "ischemia". If the blood supply is not restored, then the tissue dies, leaving in its place a piece of dead tissue, called a heart attack.

A heart attack is an area of ​​dead tissue in the human body that has died as a result of ischemia. Therefore, a heart attack is not only a “heart attack”, but also any organ whose tissue can die due to an acute lack of blood circulation.

Acute cerebrovascular accident

I. is based acute cerebrovascular accident (ONMK) - this is how the diagnosis sounds in medical practice, characterizing this vascular catastrophe.

Examples of medical diagnoses, as an outcome of I.:

Diagnosis: “CVD. CVA by ischemic type in the pool of the left middle cerebral artery from 01.01.01” – ischemic I.

Diagnosis: “CVD. CVA of the hemorrhagic type with the formation of an intracerebral hematoma in the left temporal lobe from 01/01/01 - hemorrhagic I.

Each tissue in the human body has its own need for oxygen and nutrients that come with the blood through the arteries.Nervous tissue in the human body has a high-intensity metabolism.

The intensity of blood circulation in the brain is one of the highest in the body, due precisely to the high demand for oxygen and nutrients. When this access is terminated, the function is first lost in nerve cells (neurons), and then they die (if blood circulation has not been restored).

The time interval after a stroke, when it is still possible to save a part of the brain substance and prevent the brain cells from completely dying, is no more than 4-5 hours.

The area of ​​the dead nervous tissue is, in fact, the substrate of I. The dead brain tissue does not perform the functions assigned to it.

The nature and extent of their loss determine the clinical picture of neurological consequences. The larger the area, the more grossly the functions are violated. About what this is fraught with in the case of stroke, what it is and everything about their consequences, read more in.

The most common consequences of CVA are:

• speech disorders ()
• blurred vision
• decreased strength and mobility in the limbs
• sensory disturbance
• a disorder of coordination of movements, as a result of which unsteadiness when walking and dizziness may appear
• memory impairment due to

A feature of such disorders that distinguish And. among other vascular diseases of the brain is their resistance - they persist for more than 24 hours.

There are situations when a sudden speech disorder or a decrease in strength and / or sensitivity in half of the body went away on its own within a few hours, and sometimes a few minutes.

In this situation, we are talking about a transient violation of cerebral circulation and it contains one very important feature for people who have been spared the trouble of a stroke, read more about it in the article about the diagnosis. Diagnosis: transient ischemic attack is not I., although it is also an acute violation of cerebral circulation.

Diagnosis of ischemic and hemorrhagic stroke

Ischemic I.(ONMK by ischemic type, hereinafter II) - in which acute cerebrovascular accident occurred as a result of obstruction of blood flow to any part of the brain, resulting in acute ischemia in any structure of the brain.

Cause of AI. is a blockage of blood flow by a thrombus or a cholesterol plaque, this type of circulatory disorder of the cerebral vessels accounts for about 80% of all stroke

Hemorrhagic I.(ONMK by hemorrhagic type) - acute violation of cerebral circulation, the cause of which was intracerebral hemorrhage from a damaged blood vessel. As a result, an intracerebral hematoma limited to brain tissue or hemorrhage into the space surrounding the brain. Hemorrhagic And., as well as ischemic, a separate article is devoted to.

That is, to put it simply, in the first case there was a "blockage" of the vessel, in the second - it "burst".

About complications and consequences

The condition of the majority of people who have undergone stroke is assessed as severe. In the brain there are vital centers, in case of violation of which, a person often dies or is left with gross violations of the functions of the body, sometimes disabling him.

After I., a recovery period is needed, which is no less important than the treatment process itself. What needs to be done for rehabilitation - what it is and what the rehabilitation process is, read more in the continuation of the article on recovery.

Treatment and rehabilitation

Treatment with confirmed stroke is carried out in a hospital setting. In urban areas, these are vascular centers, emergency hospitals, urban general hospitals and research institutes. In the provinces, these are the Central District Hospital and numerous small rural hospitals.

In the first days of the disease, the priority task is to prevent re-I. and stabilize the human condition.

In the first 7-10 days, the condition is the least stable and can easily worsen due to cerebral edema and other complications.

The duration of treatment in the hospital, on average, from 2 weeks. Two weeks is the time for a small and uncomplicated I. If it is moderate or severe, then the course of treatment is delayed for months, especially if in its most acute period there was an episode of coma and treatment in intensive care.

After discharge from the hospital, there are rarely cases of complete recovery. In more than half of the cases, persistent consequences remain that require qualified assistance in restoring and returning a person to his former life.

Unfortunately, in most cases, it is not possible to fully restore the lost functions after undergoing treatment in the hospital. Often, a rehabilitation course is not carried out at all, although it may be necessary.

In the vast majority of cases, this is due to the fact that relatives and friends simply were not informed about this, and if they were, they did not know where to go for rehabilitation and how to do it.

Rehabilitation treatment is carried out in the field of treatment in an emergency hospital. The duration of the course can vary from 2-3 weeks to several months. It depends on the depth of the consequences, in which you need to return the lost functions.

Risk factors

1. High blood pressure(arterial hypertension). This is the most common cause of acute cerebrovascular accident. Most And. happen against the background of high arterial pressure. In the case of an ischemic nature, increased blood pressure narrows the lumen of the cerebral vessels due to the spasm that accompanies this.

If hemorrhagic And. - a high mechanical pressure is created on the vessel wall and sooner or later it cannot withstand it and breaks in this place.

In order for the vessel to break, more reasons are needed that will thin its wall and reduce its elasticity. These reasons include:

• cerebral atherosclerosis,
• systemic inflammatory diseases with damage to the vessel wall
• oncological diseases
• anomalies in the structure of blood vessels with a violation of the structure and loss of strength of the vessel wall
• chronic exogenous intoxication (alcoholic, narcotic)

2. Hypodynamia- low level of physical activity. This factor plays a very important role in increasing the risk of stroke. With regular moderate physical activity, it is possible to reduce the influence of several risk factors at once:

• lowering the level of hell
• a decrease in the level of glucose and lipoproteins in the blood, which can be deposited in the vessel wall and promote the growth of atherosclerotic plaque
• maintaining the elasticity of the vascular wall

3. Smoking. At smokers risk And. exceeds by 5 times that at non-smokers.

Smoking increases blood pressure; in smokers, it is, on average, 10-20 mm Hg higher than in those who do not smoke.

• in smokers, the vascular wall loses its elasticity faster and cholesterol plaques grow faster on it
• cells of the substance of the brain are more in a state of prolonged hypoxia (lack of air)

4. D asynchronosis and overwork- disruption of sleep and wakefulness. Cases of strokes occurring after episodes of lack of a period of sleep adequate to the preceding period of wakefulness are common. Such I. are often recorded in a group with an unclear cause of development.

5. Alcoholism.

Probability of Recovery

At the mere mention of this diagnosis, many who heard feel, if not panic, then some kind of anxiety and inner discomfort. Indeed, in the vast majority of the population, this diagnosis is associated with disability or even death.

Let's take a closer look at whether this is actually the case.

There are many cases of recovery, if not complete, then almost complete.

In fact, the state of affairs is such that in the same neurological department, a person can be treated for stroke and a person, physical activity is limited only by doctor's orders and bedridden, unable to move independently even within the hospital ward.

In the first case: the patient of the hospital walks calmly without support and auxiliary items. Even the stairs can walk without support for the handrails. Speech is preserved, fully oriented in time and space. Coordination of movements is also not disturbed. Outwardly, there are no signs of a serious illness. The loss of neurological function is minimal and its manifestations can be detected only on a neurological examination.

Second case: a person cannot move independently - there are forces only in the left arm and leg, the coordination of movements in them is disturbed. Is in a hospital bed. He can only turn slightly in bed to one side. Raising the head of the bed causes dizziness. Speech is not intelligible - only some of its fragments are understandable. Verbal communication - responds with gestures and facial expressions, selectively - to individual questions.

As you can see, the difference between stroke cases can be enormous. Moreover, both in its acute period - the first 21 days, and a year later, as it happened.

This difference is due, first of all, to the size of the focus in the substance of the brain. This is one of the most important factors affecting the depth of impairment of neurological consequences.

The size of the dead tissue as a result of a hemispheric stroke is not more than 20-30 mm. in diameter and localized outside the zone of passage of large nerve tracts (pyramidal, optic radiance) are favorable in terms of the volume of neurological dysfunctions and their recovery.

Foci more than 30-40 mm in diameter, localized in the places of passage of large nerve tracts or in the region of the brain stem, are unfavorable prognostic in terms of the depth of neurological disorders and recovery after them.

Of great importance for recovery is the location of the focus of the stroke. More pronounced symptoms of brain damage will be when the focus is located near the conductive nerve pathways or in their area, even if they are small in size. This also applies to the stem localization of stroke. With equal sizes of the dead nervous tissue, the depth of function loss will be greater when localized in the trunk area.

This happens because of the high density of the nerve conductors located here. The danger of this localization is due to the location in this area of ​​a large number of vital nerve centers, including those responsible for blood circulation, respiration, digestion and other vital functions of the human body.

Situation today

So, acute cerebrovascular accident is a serious problem of maintaining the health and vitality of the population. Most of the victims are being treated in hospitals for emergency reasons.

In the last decade, regional vascular centers have appeared. There may be several in large cities. What is special about such a centre? In the fact that it is “sharpened” for helping patients with stroke, there is the possibility of thrombolysis (dissolution of a blood clot, if it was the cause of stroke, during the first 4 hours).

Other mandatory conditions for the work of the vascular center is the availability of all the specialists necessary for early rehabilitation. These include: a speech therapist, a doctor and an exercise therapy instructor (kinesiotherapist), an ergotherapist (not everywhere he is).

In medicine, this is called a multidisciplinary team. Necessarily, such centers should be equipped with CT (computed tomography) devices to detect the focus of stroke and its differentiation into ischemic and hemorrhagic. There should be a neuro-resuscitation unit and/or an intensive care unit (ICU). Not always everything is exactly as it is written in the orders for the organization of such centers.

The time of assistance is an extremely important point, a timely diagnosis and treatment reduce the severity of the consequences, and sometimes make persistent dysfunction minimal. Unfortunately, the creation of vascular centers did not significantly affect this “golden time”. Cases of care in such centers after 5 hours or more - when it has already happened acute cerebrovascular accident and a persistent focus of necrosis (heart attack or necrosis) has formed in the brain - quite a lot. The reason for this is the late treatment of the patients themselves and the congestion of hospitals.

Hospitals are overloaded in large cities and sometimes it takes quite a lot of time for examination and diagnosis. The issue is organizational and, unfortunately, not fully resolved. However, there are still some positive developments.

The diagnosis of stroke in medicine is a “red flag” for any physician. A lot of health problems that have arisen in subsequent years after suffering a stroke are associated with it. Unfortunately, often, unreasonably.

The main unresolved issue today is rehabilitation - this applies to the patients themselves and their relatives. There are still not enough centers and the queues for existing ones often drag on for years. People are not informed about what a stroke is, this diagnosis causes fear and anxiety. Much remains unclear about the methods and timing of recovery, which does not add to the share positive results recovery after hospital.

Elderly people are familiar with such a disease, the name of which CVA - acute cerebrovascular accident Or just a stroke. Almost every older person has experienced this disease on himself. It is very important to understand the causes of stroke and the proper treatment of the disease.

What it is?

A stroke is a clinical symptom manifested by sharp failures in the normal operation of the existing options of the brain of the head, the duration of which is more than one day.

The main symptoms of CVA are:

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

An unexpectedly appeared violation of the speech apparatus, loss of body sensitivity and problems with coordination of movement pass over the next day. Then they talk about transistor ischemic attack. This is not such a dangerous disease as a stroke, but also applies to stroke.

If the disease refers to disorders in the functioning of the circulatory system, then it is characterized as "stroke by the type of ischemia." In the case when bleeding is confirmed by a specialist, then the disease has the characteristic "CVA by hemorrhagic type".

A stroke that ends in a stroke is the stage when blood flow 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 ends in death in a third of cases. Sixty percent of patients who have had the disease turn out to be disabled, who cannot do without social assistance.

Causes of stroke

CVA, related to the ischemic type, develops as a result of already existing pathologies in the patient's body.

These diseases include:

ACVE is found not only in the adult category of the population, but also in children. This is due to the fact that the vessels of the child's brain have any anomalies in their development. A high risk of developing stroke is observed in children who have congenital heart disease.

When stroke occurs, only 30% of children recover completely. About fifty percent have incurable disorders in the work of the neurological system. Twenty percent of cases of acute cerebral circulatory disorders in children end in death.

In what cases can CVD be suspected?

The diagnosis of stroke is made if the patient has the following disorders in 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. Clouding of consciousness.

An accurate diagnosis can be established only after the diagnosis.

Stages of cerebral infarction

ONMK has several stages of development. Let's consider each of them in more detail.

Ischemic stroke

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

Causes of ischemic stroke

A stroke of this plan is caused by obstruction of blood flow to any brain cell. As a result, the normal functioning of the brain stops. 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

CVA is most often manifested in the category of the population that have the following pathologies:

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

Symptoms of the disease

Neurologists distinguish several intervals in the 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. Eliminate traces. Over 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 struck then the following symptoms appear:

• Disorder of the visual system in the direction where the blockage of the vessel occurred;
• The sensitivity of the extremities disappears on the opposite side of the focus of the disease;
• 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 view.

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 double in the eyes.

If the defeat happened on the junction 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 the musculoskeletal tissue;
• Lack of speech;
• The patient cannot stand or walk.

If failures interfere with normal patency of the middle artery of the brain:

• The result of a complete blockage of the main trunk is a state of severe coma;
• In half of the body there is a loss of sensitivity;
• Refuses the motor apparatus;
• The inability to fix the gaze on the subject;
• Fields of vision fall out;
• There is a failure of the speech apparatus;
• The patient is unable to distinguish the right limb from the opposite.

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 from the opposite side of the face and body;
• If you touch the patient's skin, then he experiences severe pain;
• Incorrect perception of light and knock;
• Forearms and shoulder joints are bent. The fingers are also bent at the base.

Defeat on the site thalamus are characterized by the following symptoms:

• The movements of the patient have a wide scope;
• There is a strong tremor;
• There is a loss of coordination;
• Half of the body loses sensation;
• Severe sweating is characteristic;
• Bedsores occur.

The most severe case of stroke is the process of breakthrough intracerebral hematoma. Hemorrhage occurs in the cerebrospinal fluid, fills 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 lies in the unhindered flow of blood into the patient's brain.

Treatment of stroke by ischemic type

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

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

1. Put the patient on the side so that vomiting freely leaves the victim's oral cavity;
2. The head should be slightly raised;
3. If there is a tonometer, then it is necessary to measure blood pressure. If a sharp increase in pressure to critical values ​​\u200b\u200bis 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. Release the patient's neck from any squeezing things.

Treatment in a hospital

After arriving at the 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 the necessary trace elements. Nutrition is adjusted so that fatty, spicy, salty foods are not observed in the diet.

Mayonnaise and other seasonings should also be excluded. Vegetables and fruits are limited only during the acute stage of the disease. If the patient's consciousness is absent, then food intake is carried out through a medical probe no earlier than two days later.

After confirmation of stroke, inpatient treatment continues for a month. The consequences after the transfer of this disease are extremely severe.

Severe loss of strength in muscle tissue on the opposite side of the brain, the area of ​​which was damaged. A certain category of patients practically learns to walk again and perform normal movements;

. The decrease in strength occurs only in the area of ​​the mouth, cheeks and lips. The patient is unable to properly eat and drink fluids;

Quite often there is a disrupted work of the speech apparatus. 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 a lesion in 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 are of a different nature and depend on the size and localization of the lesion with a stroke. Usually they are expressed in the loss of visual fields;

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

Rehabilitation

A very important stage on the path of recovery after stroke.

Quality therapy includes the following categories of treatment:

1. Physiotherapy. It is necessary to return the patient to normal movement of the limbs. A set of exercises is selected by the attending physician;
2. Visiting a speech pathologist. It is prescribed if the patient has speech and swallowing disorders;
3. Physiotherapy. The most affordable type of therapy, which is in every clinic;
4. Therapy with medicines. The main stage in the recovery process. Drugs mitigate complications after the disease and prevent the risk of relapse;
5. Mind training. It is desirable for the patient to read as much literature as possible, to memorize poems or excerpts from works.

CVA by hemorrhagic type

Components that have a nutritional effect, which include oxygen, enter the brain through the carotid arteries. Being in the box of the skull, they form a network of vessels, which is the root of the blood supply to the central nervous system. When arterial tissues are destroyed, the blood flow rushes to the brain.

Causes

A stroke of the hemorrhagic type occurs in the event of a 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 the brain tissue. Also, blood from a burst vessel can penetrate into the area surrounding the brain.

Risk group

Particular attention should be paid to the state of their health of the following category of citizens:

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

Symptoms

1. Acute headache;
2. Constant vomiting;
3. Frequent loss of consciousness over 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. Violation of the motor system;
8. Disorder of the visual system;
9. Strong nervous excitement;
10. When analyzed, a small amount of blood is observed in the cerebrospinal fluid;

Treatment of stroke by 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.

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

Reversibility of pathology

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

If the stage is irreversible, then the brain cells have died and cannot be restored in any way. This area is called the ischemia zone. But therapeutic treatment in this case is possible.

Its meaning is to provide neurons with all the nutrients in the ischemic zone. With proper treatment, cell functions can be partially resuscitated.

It was found 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 the work can replace the dead cells and ensure their full functioning. The process is rather slow, so full rehabilitation lasts for three years.

Transistor ischemic attack (TIA)

This disease is also a stroke, but unlike ischemic and hemorrhagic stroke, it is temporary. For some period of time, there is a sharp violation 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. The symptoms of TIA - transistor ischemic attack last for days and are similar to the symptoms of a stroke.

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

Symptoms

Consider the symptoms of a transistorized ischemic attack:

• There is a decrease in sensitivity in one of the sides of the face, body, lower or upper extremities;
• Weakness in the body, which is mild or moderate;
• Violations in the work of the speech apparatus up to the complete absence of speech or problems with understanding the words of the opponent;
• Dizziness and incoordination;
• Sudden noise in the ears and head;
• Headache and heaviness.

These symptoms appear abruptly and disappear after 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 conditions:

1. Persistent increase in blood pressure, which is chronic;
2. Chronic cerebrovascular disease;
3. Changes in blood clotting;
4. sudden drop in blood pressure;
5. The impossibility of the normal flow of blood through the artery, caused by a mechanical obstruction;
6. Pathology of the structure of cerebral vessels.

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

Risk group

Transistor ischemic attack is no less dangerous than a stroke. Up to 8% of patients who have had a TIA in the future suffer from a stroke that occurred within a month after the attack. In 12% of patients, a stroke occurs within a year and in 29% within the next five years.

Treatment of transistorized 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 assigned 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. Regular blood pressure checks.

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;
• Vasodilating agents;
• Lowering cholesterol levels in the blood;
• Designed to normalize 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 the diet by reducing the amount of fatty, salty and spicy foods;
3. Reduce the use of alcohol and tobacco products;
4. Monitor your body weight.

Survey algorithm

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

It is necessary to undergo a series of diagnostic studies.

Examination by a specialist immediately after the patient enters the medical facility;

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

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

This problem can be solved by conducting 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, an aneurysm and a pathological connection between the veins and arteries of the brain can be diagnosed.

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

Collection of cerebrospinal fluid for laboratory research is a threat to the patient's life, but this study allows you to determine what type of stroke belongs to.

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

Forecast

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

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.

Cardiologist

Higher education:

Cardiologist

Kabardino-Balkarian State University named after A.I. HM. Berbekova, Faculty of Medicine (KBSU)

Level of education - Specialist

Additional education:

"Cardiology"

State Educational Institution "Institute for the Improvement of Doctors" of the Ministry of Health and Social Development of Chuvashia

With a stroke in the vertebrobasilar basin, the area of ​​\u200b\u200bthe brain that is fed by the vertebral and basilar vessels is affected. More specifically, the cerebellum and the occipital part of both hemispheres suffer. The manifestations of the disease can be varied, so a neurologist can make a reliable diagnosis after receiving MRI or CT images.

The mechanism of the development of the disease

The vertebrobasilar system provides nutrients to the posterior parts of the brain, the optic tubercle, the Varolian bridge, the cervical spinal cord, the quadrigemina and the brain stem, 70% of the hypothalamic region. There are many arteries in the system itself. They have not only a different size and length, but also differ from each other in structure. There are several types of the disease, and they all depend on the localization of the lesion:

• right-sided variant of ischemia;
• left-sided variant of ischemia;
• damage to the basilar artery;
• damage to the posterior cerebral artery.

The mechanism of the development of the disease is quite simple. As a result of some congenital pathology or an altered blood composition, the arteries that feed a certain segment of the brain narrow. The patient has associated symptoms. If the visual tubercle does not receive enough nutrition, then the patient will see worse, if the cerebellum area is affected, then the person’s gait becomes shaky. Very often, people with cervical osteochondrosis suffer from this disease.

Causes of stroke in the vertebrobasilar basin

Formally, all factors influencing the development of stroke can be divided into congenital and acquired. Congenital pathologies include those pathologies that are present in the human body from the beginning of his life. They also include a genetic tendency to atherosclerosis and the accumulation of cholesterol.

Acquired factors are completely dependent on a person's lifestyle. The presence of excess weight provokes the formation of excess cholesterol, which leads to blockage of blood vessels. Visceral fat has a similar effect. It is deposited not only around the organs of the body, but also near the spine. As a result, excess weight begins to physically interfere with normal blood flow. The main causes of this type of stroke are:

• arrhythmia;
• embolism;
• atherosclerosis;
• thickening of the blood;
• mechanical clamping of the arteries;
• dissection of the arteries.

These factors most often provoke various circulatory disorders. The cause of the disease greatly affects the treatment plan. If the problem is overweight, then it is enough for the patient to go on a diet, but with atherosclerosis, this approach will practically not help. But in all cases, to speed up recovery, the patient will have to take specialized medications.

Seizure symptoms

The symptoms of ischemic stroke in the vertebrobasilar basin are similar to many other brain lesions. This is the main problem in diagnosing neurological diseases. Without a hardware examination, it will not be possible to make a diagnosis to the patient. Circulatory disturbance is always acute. The symptoms are most pronounced at the beginning of the attack, but within 3-4 days they disappear. With transient ischemic attacks, the patient complains of the following:

• vision loss;
• lack of sensation in any particular part of the body;
• problems with coordination and control of limbs;
• dizziness;
• erratic breathing rhythm;
• strange movements of the eyeball, unregulated patients.

How does vertebrobasilar stroke manifest in children?

Previously, it was believed that brain circulatory diseases occur only in older people, but numerous studies refute this information. VBB deficiency occurs in children from 3 years of age. The most common cause of pathology is congenital anomalies vascular structures. They can occur while still in the womb or as a result of trauma during childbirth. Also, this disease is provoked by vertebral injuries during sports. There are certain signs due to which diagnosing a stroke or insufficiency of the vertebral basin will not be a friend. The symptoms of the disease include:

• constant sleepiness;
• posture problems;
• fainting and nausea in stuffy rooms;
• tearfulness.

There are certain medical conditions that lead to stroke. In any case, at the first sign of illness, parents should take the child for a medical examination. If this disease is detected as a result of the diagnosis, then medical treatment should be started. There is no need to think that without drug therapy, circulatory disorders of the brain will pass. The blood flow in the arteries will not be able to recover on its own.

Methods for diagnosing the disease

A stroke of this type, like the insufficiency of the vertebrobasilar basin itself, is very difficult to diagnose. This is due to the fact that different people the disease manifests itself in different ways. In addition, some patients cannot distinguish specific manifestations of the disease from subjective discomfort. As a result, when collecting an anamnesis, the doctor cannot understand what specific disease he should look for. In addition, the general symptoms of brain diseases are similar. The following diagnostic methods are used:

• MRI or CT. Magnetic resonance imaging allows you to get a more detailed picture of the brain structures, but it cannot be done if the patient has implants in his mouth. For such cases, there is a computed tomography. Thanks to her, you can see bleeding and all the changes in the brain that appeared right after the attack.
• Angiography. Contrast is injected into the vessels, and then pictures are taken. This diagnostic method allows obtaining extended information about the state of the vascular system and the considered pool as a whole. Any narrowing of the diameter of the vessels will be displayed on the images.
• X-ray of the spine. Needed to assess the general condition of the vertebrae.
• Infrared thermography. Allows you to get information about the thermal characteristics of a particular part of the body.
• functional tests. They will help determine if I have any area of ​​the brain that is severely affected after a circulatory disorder.
• Blood testing in the laboratory.

Treatment of vertebrobasilar stroke

A patient who has experienced an attack of acute circulatory disorders must necessarily be hospitalized in a hospital. There they begin to give the patient drugs that improve blood microcirculation. The danger of the disease lies in the fact that attacks become more frequent over time. If a person tries to be treated according to any method found somewhere, he risks becoming disabled due to extensive brain hemorrhage. With a stroke, the following groups of drugs are prescribed:

• analgesics;
• nootropics;
• anticoagulants;
• angioprotectors;
• sedatives;
• histamine mimetics;
• antigregants.

Analgesics are needed to relieve pain. It is impossible to use narcotic drugs to eliminate pain in patients with a stroke. Nootropics stimulate the brain. Doctors prescribe them so that the metabolism inside the brain improves. Numerous studies have confirmed that nootropics help to avoid a second stroke.

Anticoagulants are prescribed for patients with viscous blood and a tendency to thrombosis. They can directly affect thrombin in the blood or disrupt the synthesis of this element in the liver. Antigregants have similar properties. After a stroke, patients often cannot sleep properly, so they are prescribed mild sedatives.

Histaminomimetics are prescribed for damage to the cerebellum. They make histamine receptors work more actively, which leads to the normalization of the functions of the vestibular apparatus. You cannot prescribe medicines on your own. This is what the doctor does. As for traditional medicine, prescriptions should be used as an additional therapy, and not instead of nootropics or angioprotectors.

Prevention

Preventing a stroke is much easier than recovering from an attack. It is advisable to start preventive measures immediately after circulatory failure has been detected. Also, people who have a hereditary tendency to vascular pathologies should take care of their health. To prevent further deterioration of cardio-vascular system, necessary:

• To refuse from bad habits.
• Normalize the daily routine.
• Try to eat less fatty and salty foods.
• Do sports every day.
• Try to visit more often fresh air.
• Walk 6-7 km per day.
• Monitor blood cholesterol levels.
• Treat in a timely manner all diseases that affect the state of blood vessels and blood pressure.

When it comes to bad habits, doctors aren't just talking about smoking and drinking. The lack of a nutritional culture is another problem for patients at risk. People not only eat too much fatty foods, but they constantly overeat. This is also harmful to health. As for daily sports, here light stretching exercises and exercises are meant. After hard and professional training, a person must give time to the muscles to recover.

Walking in the fresh air will help to avoid hypoxia. They help remove toxins from the body and help cells renew themselves. As for the distance, it is desirable that it be at least 5 km. Ideally, to maintain good cardiovascular health, a person should walk at least 8 km a day.