Stroke

A stroke is an acute cerebral circulation violation. This is a disease associated with a lack of blood flow and subsequent death of brain tissue, which can result in impaired muscle strength, coordination of movements, sensitivity, speech, mental functions, sometimes even coma and death.

Types

A stroke can occur both in the brain and in the spinal cord. There are 2 main types of it, depending on the causes:

• ischemic stroke, when a section of brain tissue dies due to insufficient blood circulation in it, which can be caused by: the growth of a thrombus on an atherosclerotic plaque (the so-called atherothrombotic subspecies); blockage of the vessel with an embolus, that is, a detached fragment of a thrombus (cardioembolic subspecies).
• hemorrhagic type of stroke, in which, as a result of the vessel wall rupture, a certain portion of the blood is entered directly into the brain tissue.

Factors

Accordingly, the main risk factors are:

• atherothrombotic stroke – increased cholesterol, contributing to the formation of atherosclerotic plaques;
• cardioembolic stroke – atrial fibrillation, against the background of which emboli often come off;
• hemorrhagic stroke – arterial hypertension, due to which the blood vessels become thinner and become ruptured.

Also, common causes are:

• smoking;
• overweight;
• birth control pills.

In 40% of cases, a stroke leads to profound disability. After such damage, a person, in most cases, is not able to socially adapt, he needs constant help.

Symptoms

Symptoms in which a stroke should be suspected:

• if the limbs do not move;
• a person feels sudden drowsiness and weakness;
• he/she loses sensitivity of body parts;
• vision, ability to speak and understand speech is reduced;
• loss of balance and orientation in space may occur;
• intense headache, accompanied by nausea.

Self-diagnosis

A simple and quick test to independently detect the first symptoms of a FAST stroke. It stands for: F (face) – A (Arm) – S (Speech) – T (time).

• Face – ask the patient to smile. With a stroke, asymmetry of the face will often be expressed;
• Arm – instruct the patient to raise both arms. With a stroke, it will often be possible to raise only one arm;
• Speech – ask the patient to pronounce the name, address, and date of birth. With a stroke, speech can often be impaired;
• Time – If at least one of the points gave a positive answer – time to immediately call an ambulance.

First aid

• First of all, it is necessary to calm the patient down, measure his blood pressure, in case of vomiting or excessive salivation – put on his side, with his hand under his head. The neck in this position should not be bent so that the blood flow through the vertebral arteries does not deteriorate;
• If breathing is disturbed, unbutton shirt or loosen your tie. Remove foreign objects from the mouth or vomit that interfere with oxygen flow;
• Provide fresh air access to the room;
• In case of loss of consciousness, make sure that the person does not get hurt during the fall.
• If the patient is conscious, you need to talk to him, try to maintain a conversation so that he does not lose his perceptive ability. Any tablets do not need to be taken, as they can provoke an allergic reaction. In any case, call an ambulance.
• After the ambulance arrives, the medical staff will bring the patient to a hospital in a neurological department. There, the patient will be prescribed infusion therapy (the introduction of medicinal solutions into the blood flow), aimed at restoring blood circulation and improving the nutrition of brain cells. Treatment will take at least 2 weeks.
• If a patient was admitted to the hospital unconscious with respiratory failure, then the medical staff will place him in the intensive care unit.

Stroke diagnosis

In order to make a forecast regarding the potential likelihood of a stroke or to prevent a relapse of the disease, doctors recommend passing:

• blood glucose test;
• coagulogram – a blood test for coagulability;
• lipid profile – a blood test to check cholesterol levels;
• doppler sonography of the vessels of the head and neck;
• daily (Holter) monitoring of pressure and cardiography;
• heart ultrasound.

To diagnose a stroke that has already happened it is required the following options:

• CT (computed tomography) is an X-ray diagnostic technique that determines the degree of damage to organs and systems. The doctor observes the desired body part in a three-dimensional image and in various “sections”. With a stroke, this method very quickly reveals a hemorrhage in the brain or a large focus of ischemic stroke;
• MRI (magnetic resonance imaging) – examination using electromagnetic waves. This diagnosis is more informative for monitoring soft tissues, therefore, it detects even the smallest foci of ischemic “microstrokes”.

Stroke treatment

Treatment methods for acute stroke are:

• thrombolysis is a method that prevents the brain tissue from completely dying, i.e. develop cerebral infarction if introduced 4.5 hours after symptoms’ onset;
• the operation to mechanically remove a blood clot – a thrombectomy – is an emergency method for removing a blood clot in order to prevent a stroke from developing during the so-called “therapeutic window” (9 hours), when there are already symptoms of a stroke, but the heart attack zone has not yet formed.

To restore the body after a stroke, a course of exercise therapy is necessary. With a formed heart attack or hemorrhage, brain tissue dies irrevocably. There are no ways to “build it up” again. The restoration of motor and mental functions can only occur if the neighboring nerve cells have retained the ability to “retrain” (neuroplasticity). Naturally, the retraining process is impossible without the practical training of lost skills, i.e. medical gymnastics, if the motor function is lost.