Stroke: types, signs, first aid and rehabilitation

What is a stroke and why is it dangerous?

Stroke is a circulatory disorder in the brain [1]. It can occur due to a ruptured vessel or blockage by a blood clot. In this case, the nerve cells do not receive the required amount of oxygen, glucose and other nutrients, which can lead to their death.

There are several factors that increase the risk of stroke, including: excess weight, high cholesterol, diabetes, hypertension, alcohol and drug use, and smoking. In addition, doctors take into account genetic predisposition and age: the disease most often affects those over 45 years old.

Stroke can be ischemic or hemorrhagic. Subarachnoid hemorrhage is also isolated, which is rare, but in 50% of cases is accompanied by death. He is characterized by acute pain in the back of the head, convulsions, vomiting and loss of consciousness are possible.

Ischemic stroke, or cerebral infarction, is the most common type of cerebrovascular accident. The immediate cause of ischemic stroke is blockage of a vessel supplying the brain. This may occur due to the formation of a blood clot or its entry into the lumen of the vessel. People with atherosclerosis, cardiac arrhythmias, or heart valve disease have an increased risk of developing blood clots. Ischemic stroke can occur when you take medications on your own without a doctor's prescription (for example, diuretics or combined oral contraceptives).

Symptoms of an ischemic stroke develop over a short period of time and are not accompanied by headaches, since there are no pain receptors in the brain. Most often this happens at night when a person is sleeping, and in the morning when waking up he discovers that an arm or leg is not working or speech is impaired.

In a hemorrhagic stroke, the wall of a vessel ruptures and blood permeates the brain tissue. Frequent causes of hemorrhagic stroke are increased blood pressure, taking drugs that reduce blood clotting, disruption of the structure of the vessel wall (aneurysm) or congenital abnormalities of the vascular bed - arteriovenous malformations. Hemorrhagic stroke develops quickly and is often accompanied by headache. If blood soaks into the choroid of the brain, where there are pain receptors, a person may lose consciousness. This subtype of stroke has a high rate of death, but if the person survives, he recovers well.

First aid for stroke

It is advisable that a person with a stroke be taken to hospital as soon as possible - within three hours of the onset of the first symptoms. Therefore, it is important to properly organize assistance for a person with suspected stroke.

Call an ambulance. If you experience symptoms of a stroke, ask for help and have someone else call the doctor. Provide brief information about the patient (age, what happened). Leave your contact information so we can contact you. Be prepared to meet the physician and provide access to the patient.
Help the patient find a safe position: it is best to lie on his side with his head slightly elevated.
While you are waiting for an ambulance, try to find out from the patient when the symptoms began, what chronic diseases does he suffer from and what medications does he take? This information will save doctors time and allow them to quickly make decisions.
If a person is unconscious and not breathing, cardiopulmonary resuscitation must be performed. However, to properly provide it, it is necessary to undergo specialized training courses [2], [3].
If the patient has difficulty breathing, remove restrictive clothing (tight collar, tie or scarf) and open the windows.
If a person is cold, cover him with a warm blanket.
While the ambulance is traveling, do not under any circumstances try to give the patient something to drink, feed, or force him to stand up. The person may have difficulty swallowing and may choke. And when trying to stand up due to high blood pressure or lack of coordination, there is a high risk of falling and receiving additional injuries.
Monitor the person closely for any changes in their condition. Be prepared to tell the emergency operator or doctor about their symptoms and when they started. Be sure to indicate whether the person fell or hit their head.
In some cases, it is advisable to transport the patient to the nearest hospital yourself if you are not confident in the efficiency of the team. Discuss this decision with the emergency operator.

It is good if several people provide assistance. For example, one will be responsible for resuscitation, the second will monitor pulse and blood pressure, and the third will talk on the phone with doctors. Call neighbors and others for help if the sick person is on the street or in a public institution.

Signs and symptoms of stroke

Depending on the severity of the stroke, symptoms may be mild or severe. You need to know what to look for. To check for warning signs of a stroke, you can use the Western mnemonic FAST, which means [4]:

F - face - “face”

A - arm - “hand”

S - speech - “speech”

T - time - “time”

The first symptom is facial asymmetry. If you ask a person to smile, he will not be able to do it; one corner of his mouth will remain downturned. When the patient sticks out his tongue, it may deviate to one side. As soon as you have performed a small operational test, you must immediately call an ambulance. Often the victim does not respond to requests, cannot speak coherently and cannot raise both hands at the same time; sometimes he is in a state of disorientation, the pupils are dilated or there is no reaction to light.

Transient ischemic attack can be difficult to identify based on symptoms alone [5]. They resolve completely within 24 hours and often last less than five minutes. The attack causes temporary circulatory failure and may be followed by a more severe stroke, so it is important to see a doctor as soon as possible.

However, it is worth remembering that only a small part of the brain is responsible for movement and sensitivity, therefore, if blood circulation is disrupted in other parts of the brain, a variety of symptoms may occur: impaired speech, swallowing, vision, dizziness, lack of coordination, confusion and loss of consciousness, epileptic seizures, sudden memory loss or inappropriate behavior of the patient and others. The main task is to call a doctor if someone feels unwell: unusual symptoms appear that were not there before. It’s better to be on the safe side than to miss time, which is the most important factor determining the prognosis for a stroke.

What is a stroke, its types

A stroke is a disorder of cerebral circulation leading to brain damage.

The pathology is widespread. In the Russian Federation alone, there are 3 cases of stroke per 1000 inhabitants. In the post-mortem extract, it is listed as the cause of death in 23.5% of people.

Even if patients do not die after suffering a vascular accident, more than 80% of them remain disabled. Often neurological disorders are so severe that the patient is unable to care for himself. Stroke is the third leading cause of death.

There are 2 types of stroke: ischemic and hemorrhagic. The mechanism of their development and the features of treatment have nothing to do with each other. There is also a special type of hemorrhagic vascular damage - subarachnoid hemorrhage.

Ischemic

Ischemic stroke is a cerebral circulatory disorder accompanied by an acute onset. Pathology develops due to disruption or complete cessation of blood supply to the brain. This leads to softening of its tissues and infarction of the affected area. It is cerebral vascular ischemia that is one of the main causes of death worldwide. Such a stroke occurs 6 times more often than hemorrhagic lesions.

It can be of 2 types:

Thrombotic . Develops due to blockage of blood vessels in the brain by a blood clot.
Embolic . Occurs when blood vessels located far from the brain become blocked. The most common source of embolism is the heart muscle (cardioembolic stroke).

In 80% of cases, the pathological focus is localized in the middle cerebral artery. Other vessels account for the remaining 20%.

Reasons that can provoke ischemic damage to cerebral arteries and veins:

Myocardial infarction.
High or low blood pressure.
Atrial fibrillation.
Diabetes.
Lipid metabolism disorders.

Risk factors include: old age, hereditary predisposition to vascular accidents, as well as lifestyle features.

Symptoms of ischemic stroke do not increase as quickly as symptoms of hemorrhagic brain damage.

Its manifestations:

Drowsiness, dazedness.
Brief fainting.
Headache, dizziness.
Nausea and vomiting.
Pain in the eyes that gets worse with movement.
Cramps.
Sweating, hot flashes, dry mouth.

Depending on which part of the brain is affected, the neurological manifestations of ischemia differ. The lower and upper extremities are affected to a greater or lesser extent, paresis of the tongue and face is observed, and visual and/or auditory function deteriorates.

Hemorrhagic

Hemorrhagic stroke is bleeding into the cranial cavity. The most common cause of blood vessel rupture is high blood pressure.

Other provoking factors include:

Aneurysm.
Malformation of cerebral vessels.
Vasculitis.
Systemic connective tissue diseases.
Taking certain medications.
Amyloid angiopathy.

The onset of the pathology is acute; most often the manifestation occurs against the background of high blood pressure. A person experiences severe headaches, dizziness, accompanied by vomiting or nausea. This state is quickly replaced by stupor, loss of consciousness, and even the development of coma. Convulsions are possible.

Neurological symptoms manifest themselves in the form of memory loss, deterioration of sensitivity and speech function. One side of the body, which is on the opposite side of the lesion, loses the ability to function normally. This applies not only to the muscles of the torso, but also to the face.

A stroke with blood escaping into the ventricles of the brain is difficult to endure. The victim develops symptoms of meningitis and has seizures. He quickly loses consciousness.

The next 3 weeks after a stroke are considered the most difficult. At this time, cerebral edema progresses. It is he who is the main cause of death of patients. Starting from the fourth week, in surviving people, the symptoms of the lesion begin to reverse. From this time on, the severity of brain damage can be assessed. They are used to determine what degree of disability to assign to the victim.

Subarachnoid hemorrhage

Subarachnoid hemorrhage is understood as a condition that develops as a result of a breakthrough of blood vessels into the subarachnoid space of the brain. This pathology is a type of hemorrhagic stroke.

The subarachnoid space contains cerebrospinal fluid, the volume of which increases due to blood flow. The patient's intracranial pressure increases and meningitis of aseptic nature develops. The situation is aggravated by the reaction of cerebral vessels. They spasm, which leads to ischemia of the affected areas. The patient develops an ischemic stroke or transient ischemic attack.

The following reasons lead to hemorrhage into the subarachnoid space::

Traumatic brain injuries with damage to the integrity of blood vessels.
Aneurysm rupture.
Dissection of the carotid or vertebral artery.
Myxoma of the heart.
A brain tumor.
Amyloidosis.
Diseases associated with blood clotting disorders.
Uncontrolled use of anticoagulants.

The pathology manifests itself as a severe headache. Possible loss of consciousness. In parallel, symptoms of meningitis develop, with neck stiffness, vomiting, and photophobia. A distinctive sign is an increase in body temperature. In severe cases, there is a disorder of respiratory function and cardiac activity. With prolonged fainting and coma, one may suspect that blood has entered the ventricles of the brain. This occurs during its massive outpouring and threatens with serious consequences.

Bibliography

Hemorrhagic stroke in adults: clinical recommendations of the Ministry of Health of the Russian Federation, 2021. Developers: Association of Neurosurgeons of Russia. - Electronic text. - URB: (access date 08/18/2020).
Efremova M.D. Stroke as an urgent socio-psychological problem / M.D. Efremova – electronic text//Skif. Questions of student science.- 2021 - No. 2(24) URB: (date of access 08/17/2021) Access mode: Cyberleninka electronic library system. — Text: electronic.
Ischemic stroke and transient ischemic attack in adults: clinical recommendations of the Ministry of Health of the Russian Federation, 2021 developers: All-Russian Society of Neurologists, National Association against Stroke, Association of Neurosurgeons of Russia, Association of Neuroanesthesiologists and Neuroreanimatologists, Union of Rehabilitologists of Russia. - Electronic text. - URB: ( access date 08/18/2020).
Machinsky P.A. Comparative characteristics of incidence rates of ischemic and hemorrhagic stroke in Russia / P.A. Machinsky, N.A. Plotnikova, V.E. Ulyankin [and others] – Direct text.// News of higher educational institutions. Volga region. Medical Sciences.- 2021.- “2(50)-P.112 – 132 DOI 10.21685/2072-3032-2019-2-11.
Monitoring the implementation of the federal project “Combating Cardiovascular Diseases” - Presentation Department of Organization of Medical Care and Sanatorium Affairs of the Ministry of Health of the Russian Federation URB: (date of access 08/17/2021).
Order of the Ministry of Health of the Russian Federation dated November 15, 2012 N 928n “On approval of the Procedure for providing medical care to patients with acute cerebrovascular accidents.” — URB: (access date 08/17/2021) Access mode: Electronic library system “Garant”. — Text: electronic.
Order of the Ministry of Health of the Russian Federation dated July 31, 2021 No. 788n “On approval of the Procedure for organizing medical rehabilitation of adults.” – URB: (date of access 08.17.2021).- Access mode: Electronic library system “Garant”. — Text: electronic.
Prevention of cerebrovascular accidents: textbook. manual / Compiled by: L.B. Novikova, A.P. Akopyan. – Ufa: Publishing house of the State Budgetary Educational Institution of Higher Professional Education BSMU of the Ministry of Health of Russia, 2015.-58 p.
Stakhovskaya L.V. Analysis of epidemiological indicators of recurrent strokes in the regions of the Russian Federation (based on the results of the territorial-population register 2009-2014) / L.V. Stakhovskaya, O.A. Klochikhina, M.D., Bogatyreva, etc.]. CONSILIUM MEDICUM, 2021, vol. 5, no. 9, p. 8-11.
Shamalov N. A. Analysis of the dynamics of the main types of stroke and pathogenetic variants of ischemic stroke / N. A Shamalov, L. V Stakhovskaya, O. A Klochikhina [and others]. Direct text. // Journal of Neurology and Psychiatry named after. S.S. Korsakov. Special issues. 2019;119(3-2):5-10. doi.org/10.17116/jnevro20191190325.
1RRE Electronic edition. Updated daily Stroke Day is celebrated on October 29, 2021 URB: (accessed 08/17/2021).

Author:

Pugonina Tatyana Alekseevna, Therapist

Signs and symptoms of stroke

A stroke manifests unexpectedly for a person, although sometimes it is preceded by certain symptoms. If you interpret them correctly, you can avoid a terrible vascular catastrophe.

Warning signs of an impending stroke include:

Prolonged headaches. They do not have a clear localization. It is not possible to cope with them with the help of analgesics.
Dizziness. It occurs at rest and can intensify when performing any actions.
Ringing in the ears.
Sudden attack of atrial fibrillation.
Difficulty swallowing food.
Memory impairment.
Numbness of arms and legs.
Loss of coordination.
Insomnia.
Increased fatigue.
Decreased overall performance.
Rapid heartbeat and constant thirst.

The listed signs may have varying intensities. You should not ignore them; you should consult a doctor.

Symptoms of ischemic stroke increase slowly. With hemorrhagic brain damage, the clinical picture unfolds rapidly.

You can suspect a brain catastrophe based on the following symptoms::

General cerebral symptoms . The patient experiences unbearable headaches. Nausea ends with vomiting. Consciousness is impaired, and both stupefaction and coma may occur.
Focal symptoms . They directly depend on where exactly the lesion is localized. The patient may have decreased or completely lost muscle strength on one side of the body. Half of the face is paralyzed, causing it to become distorted. The corner of the mouth lowers, the nasolabial fold smoothes out. On the same side, the sensitivity of the arms and legs decreases. The victim’s speech deteriorates and he has difficulty oriented in space.
Epileptiform symptoms . Sometimes a stroke provokes an epileptic attack. The patient loses consciousness, has convulsions, and foam appears at the mouth. The pupil does not react to the light beam; on the side of the lesion it is dilated. The eyes move right and left.
Other symptoms . The patient's breathing quickens and the depth of inspiration decreases. A significant decrease in blood pressure and increased heart rate are possible. Often a stroke is accompanied by uncontrolled urination and defecation.

When the first signs of a stroke appear, you should not hesitate to call an ambulance.

Who can have a stroke? Predisposing factors

It is generally accepted that stroke occurs only in older people. However, in recent decades the disease has been rapidly becoming younger. An attack can occur as early as 40 years of age or even earlier.

Main risk factors:

disturbances in sleep and nutrition when entering a “dangerous” age – over 50 years;
hypertension;
chronic heart disease;
high stress loads at work;
smoking and alcohol abuse;
temporary, rapidly passing ischemic attacks;
high blood cholesterol levels;
obesity;
diabetes mellitus (it increases the likelihood of not only the first, but also a second stroke);
hereditary factor;
lack of timely hospitalization during an attack and lack of qualified medical care in municipal hospitals;
trauma (the rarest cause of stroke)

However, symptoms and causes differ between women and men.

The main distinguishing features of female attacks:

the predominance of the disease is of the hemorrhagic type;
very long and difficult recovery of functions;
high mortality;
high loads on blood vessels during pregnancy;
Among the main causes are migraines, headaches, and great stress;
it’s easier to see the first symptoms of an approaching “blow”;
One of the provoking factors is taking oral contraceptives.

The most pronounced symptoms in women include: weakness, slowness of movement, shortness of breath, wheezing, increased heart rate, blurred vision, double vision, fainting, impaired hearing, pain on one side of the face and body, and unbearable headache.

In men

The main risk factors are impaired blood circulation, blockage of blood vessels, rupture of arteries with subsequent hemorrhage, blood thickening due to various diseases, obesity, diabetes mellitus, lack of physical activity, poor diet and eating disorders, bad habits, severe physical activity, vegetative-vascular dystonia, hypertension .

The main signs of a stroke in men may appear periodically, but go away over time. In this situation, the most dangerous thing is to decide that the trouble is over. After all, most likely, these are just transient ischemic attacks, signaling the approach of a stroke.

With the ischemic type, a man may feel dizziness, severe headache (it cannot be relieved by painkillers), weakness, decreased sensitivity in the limbs and numbness, short-term fainting, and vomiting.

A hemorrhagic attack is expressed by loss of consciousness, a sharp increase in pressure, the face becomes very red, noises are heard when breathing, facial asymmetry is noticeable, and vomiting occurs.

Diagnostic methods

It is important to quickly distinguish a stroke from other diseases that can lead to the development of similar symptoms. It is almost impossible to do this on your own, as well as to determine the type of vascular accident.

The main difference between an ischemic stroke is a gradual increase in symptoms that do not lead to loss of consciousness. With hemorrhagic hemorrhage, the patient passes out quickly. However, stroke does not always have a classic course. The disease may begin and progress atypically.

Diagnosis begins with examination of the patient. The doctor collects anamnesis and determines the presence of chronic diseases. Most often, you can get information not from the victim himself, but from his relatives. The doctor performs an ECG, determines the heart rate, takes a blood test, and measures blood pressure.

It is possible to make the correct diagnosis and obtain maximum information about the patient’s condition thanks to instrumental diagnostic methods. The best option is a CT scan of the brain. Performing an MRI is difficult because the procedure takes a long time. It takes about an hour. It is impossible to spend this amount of time diagnosing an acute stroke.

Computed tomography allows you to clarify the type of pathology, where it is concentrated, to understand how badly the brain is damaged, whether the ventricles are affected, etc. The main problem is that it is not always possible to perform a CT scan in the shortest possible time. In this case, doctors have to focus on the symptoms of the disease.

To determine the source of the stroke, the method of diffusion-weighted tomography (DWI) is used. The information will be received within a few minutes.

Other examination methods include:

Lumbar puncture.
Cerebral angiography.
Magnetic resonance angiography. It is performed without the introduction of a contrast agent.
Doppler ultrasound.

Once the diagnosis is made, the doctor will immediately begin treatment.

Who is at risk

There are people who need to be especially wary of developing a stroke, as they are at risk.

Among them:

Persons with hypertension.
Patients with diabetes.
Men and women over 65 years of age.
People with abdominal obesity.
Persons with a hereditary predisposition to vascular pathologies.
Patients who have previously had a stroke or heart attack.
Patients with diagnosed atherosclerosis.
Women over 35 years of age taking oral contraceptives.
Smokers.
People suffering from heart rhythm disturbances.
People with high cholesterol levels.

Most often, patients with the listed diagnoses are registered at the dispensary. Special mention should be made of people living in a state of chronic stress. Emotional stress negatively affects all systems of the body and can cause a stroke.

Cost of initial appointment, research, treatment

It is advisable to talk about the price of the initial appointment during a preventive examination, when there is no stroke as such, but the person has pathologies that increase the risk of its development. The cost of diagnostic procedures for stroke can be found in the corresponding table, but it must be taken into account that many studies are used repeatedly to monitor the treatment process.

It is quite difficult to determine even the approximate cost of stroke treatment in Moscow. Much depends on the type of stroke, the extent of brain damage, the patient's condition, the timeliness of medical care and other important factors. In any case, the cost of medical services will be justified - after all, we are talking about preserving life.

Treatment of patients in specialized stroke departments, cardiology centers - stroke units (IB) - reduces mortality and disability by 20%, reduces financial costs at all stages of treatment.

How to provide first aid for a stroke

There is a clear algorithm for providing first aid to a person suffering from a stroke :

Call a medical team . To do this, you need to dial 103 from a landline phone. If you happen to have a smartphone at hand, then the call is made to the single number 112. The doctor must immediately be informed that the person is unwell and there is a suspicion of a stroke.
The victim must be laid on a flat surface so that his head is higher than his body. They take off his glasses and remove his lenses. If possible, you need to help him get removable dentures.
If there is no consciousness, then you need to open the patient’s mouth slightly and turn his head to the side . This is done to prevent aspiration of vomit. It is imperative to listen to the patient’s breathing.
For better access to fresh air, it is recommended to open a window or vent..
Before the arrival of the medical team, it is necessary to prepare documents, if any..

Doctors need to be informed about the person’s illnesses, as well as what medications he is taking. It is prohibited to give the victim any medications. Medication correction should be carried out by emergency physicians. You should not try to give water or food to a person. This may make the situation worse.

If the patient falls and has an epileptic attack, there is no need to unclench his teeth or try to hold him. It is necessary to protect the victim from injury. To do this, place a soft object, such as a pillow, under his head. If a stroke with an epileptic attack happened on the street, then you can use a jacket or other suitable thing. Foam flowing from the mouth is wiped away with a cloth. The head should be elevated at all times.

There is no need to try to bring a person to his senses with ammonia. Until the end of the attack, it should not be moved from place to place.

If breathing stops, resuscitation measures must be started immediately. To do this, perform a heart massage and breathe mouth to mouth or mouth to nose.

Prevention

To prevent a micro-stroke, you need to follow these fairly simple recommendations from specialists:

Give up bad habits: alcohol, smoking, and especially drugs;
Avoid stress and overexcitement, do not quarrel whenever possible and do not succumb to depression;
Play sports with moderate physical activity;
Get enough sleep;
Avoid obesity, eat properly and in moderation;
Periodically undergo examination and preventive treatment.

It is enough to follow these simple rules, and the likelihood of a micro-stroke can be minimized.

Treatment and rehabilitation

The patient receives treatment in a hospital. All patients with suspected stroke are hospitalized on an emergency basis. The optimal period for providing medical care is the first 3 hours after a brain accident has occurred. The person is placed in the intensive care unit of a neurological hospital. After the acute period has been overcome, he is transferred to the early rehabilitation unit.

Until the diagnosis is established, basic therapy is carried out. The patient’s blood pressure is adjusted, the heart rate is normalized, and the required blood pH level is maintained. To reduce cerebral edema, diuretics and corticosteroids are prescribed. Craniotomy is possible to reduce the degree of compression. If necessary, the patient is connected to an artificial respiration apparatus.

Be sure to direct efforts to eliminate the symptoms of stroke and alleviate the patient’s condition. He is prescribed medications to lower body temperature, anticonvulsants, and antiemetics. Medicines that have a neuroprotective effect are used.

Pathogenetic therapy is based on the type of stroke. In case of ischemic brain damage, it is necessary to restore nutrition to the affected area as quickly as possible. To do this, the patient is prescribed drugs that resolve blood clots. It is possible to remove them mechanically. When thrombolysis fails, the patient is prescribed Acetylsalicylic acid and vasoactive drugs.

In case of a stroke, it is extremely important to provide timely treatment to the damaged areas of the brain. A course of use of the drug accelerates the process of recovery of brain cells after a stroke, even in cases of impaired blood circulation or hypoxia. This allows for rapid restoration of memory, thinking, speech, swallowing reflex and restoration of other functions of daily activities. Gliatilin has a positive effect on the transmission of nerve impulses, protects brain cells from repeated damage, which prevents the risk of recurrent stroke.

The drug is well tolerated by patients; it is contraindicated for use by pregnant, lactating women and people with hypersensitivity to choline alfoscerate.

Courses will need to be taken regularly. You definitely need to do physical therapy, undergo physical therapy, and visit a massage therapist. After a stroke, many patients have to restore motor skills over a long period of time and learn to care for themselves independently.

Relatives and friends should provide support to the patient and not leave him alone with the problem. Psychologists are involved in the work. Sessions with a speech therapist are often required.

Content

What is a stroke?
Complications after a stroke

Paralysis
Coma
Brain swelling
Aphasia
Loss of coordination
Apraxia of walking
Relapse of the disease - why does it happen?

Who can have a stroke? Predisposing factors

The main distinguishing features of female attacks
In men

Precursors of stroke

The main thing is to see a doctor in time

Drugs for stroke

Possible consequences, complications

The main danger of a stroke is death. If a person survives, the disease will still make itself felt with certain complications.

Early consequences include:

Brain swelling.
Coma.
Pneumonia.
Paralysis. It can be partial or complete. Most often, one half of the body is affected.
Repeated stroke.
Bedsores.
Mental disorders. They can manifest themselves in moodiness, irritability, aggression, and anxiety. Sometimes dementia develops.
Sleep disorders.
Myocardial infarction, gastric ulcer. These disorders develop against the background of increased levels of stress hormones.

After an ischemic stroke, death occurs in 15-25% of cases. Hemorrhagic damage to the blood vessels of the brain leads to the death of 50-60% of patients. The cause of death is precisely severe complications, for example, pneumonia or acute heart failure. The first 3 months after a stroke are considered the most dangerous.

Arms recover worse in patients than legs. A person's future health is determined by the severity of brain damage, the speed of medical care, his age and the presence of chronic diseases.

Long-term consequences include:

Formation of blood clots in various parts of the body.
Depression.
Speech problems.
Memory loss.
Deterioration of intellectual abilities.

After a stroke, you have to deal with the consequences for many months. Sometimes a person never manages to fully recover. For rehabilitation to be as successful as possible, you must strictly follow all the doctor’s instructions.

Stroke is a serious pathology because it affects the brain. Therefore, even the slightest suspicion of a developing vascular accident is a reason to urgently seek medical help.

Types of microstrokes

Microstrokes are divided into two types, based on the cause of their occurrence:

Ischemic occurs when the blood supply to certain parts of the brain is stopped due to obstruction of blood vessels or arteries. It does not matter what blocked the blood flow - a blood clot, a blood clot or an overgrown atherosclerotic plaque.
A hemorrhagic stroke is a microstroke that occurs as a result of a hemorrhage that occurs when a small vessel ruptures. In addition, thinning of the vascular wall is also a risk of intracerebral hemorrhage.

Both conditions are dangerous and require the help of qualified professionals.

Diagnostic methods

To determine the source of the stroke, the method of diffusion-weighted tomography (DWI) is used. The information will be received within a few minutes.

Other examination methods include:

Lumbar puncture.
Cerebral angiography.
Magnetic resonance angiography. It is performed without the introduction of a contrast agent.
Doppler ultrasound.

Once the diagnosis is made, the doctor will immediately begin treatment.

Who is at risk

There are people who need to be especially wary of developing a stroke, as they are at risk.

Among them:

Persons with hypertension.
Patients with diabetes.
Men and women over 65 years of age.
People with abdominal obesity.
Persons with a hereditary predisposition to vascular pathologies.
Patients who have previously had a stroke or heart attack.
Patients with diagnosed atherosclerosis.
Women over 35 years of age taking oral contraceptives.
Smokers.
People suffering from heart rhythm disturbances.
People with high cholesterol levels.

Advantages of treatment at the clinic of JSC "Medicine"

On the basis of a multidisciplinary medical center (academician Roitberg’s clinic) there is a cardiac rehabilitation center specially created for the treatment of strokes. How does IB differ from a regular neurological or therapeutic department:

specializes in the treatment of patients with stroke, its staff is trained to care for this group of patients;
the necessary diagnostic facilities - from computer and magnetic resonance imaging scanners to a laboratory with round-the-clock operation, an intensive care unit;
work according to local protocols developed on the basis of domestic and international principles of stroke treatment;
early mobilization and intensive rehabilitation.

multidisciplinary team:

vascular neurologists;
nurses are trained to care for stroke patients;
rehabilitators who help restore physical capabilities and self-care skills;
speech therapists – restore the ability to oral and written communication, correct swallowing disorders;
neuropsychologists - working to restore cognitive functions.

In addition, in the cardiac rehabilitation center there is a constant opportunity to consult with doctors of various specialties: cardiologist, neurosurgeon, psychiatrist, urologist, endocrinologist, etc. In developed countries, hospitalization in stroke units has become the “gold standard”. In the UK and Germany, 9 out of 10 patients with stroke are treated in an IB, in Poland - 8 out of 10.

How to provide first aid for a stroke

There is a clear algorithm for providing first aid to a person suffering from a stroke :

Call a medical team . To do this, you need to dial 103 from a landline phone. If you happen to have a smartphone at hand, then the call is made to the single number 112. The doctor must immediately be informed that the person is unwell and there is a suspicion of a stroke.
The victim must be laid on a flat surface so that his head is higher than his body. They take off his glasses and remove his lenses. If possible, you need to help him get removable dentures.
If there is no consciousness, then you need to open the patient’s mouth slightly and turn his head to the side . This is done to prevent aspiration of vomit. It is imperative to listen to the patient’s breathing.
For better access to fresh air, it is recommended to open a window or vent..
Before the arrival of the medical team, it is necessary to prepare documents, if any..

There is no need to try to bring a person to his senses with ammonia. Until the end of the attack, it should not be moved from place to place.

If breathing stops, resuscitation measures must be started immediately. To do this, perform a heart massage and breathe mouth to mouth or mouth to nose.

Treatment and rehabilitation

If a patient develops a hemorrhagic stroke, it is important to stop the bleeding. To do this, the patient is prescribed drugs that thicken the blood, for example, Vikasol. It is possible to perform an operation to remove the resulting hematoma. It is aspirated using special equipment, or through open access by performing craniotomy.

Relatives and friends should provide support to the patient and not leave him alone with the problem. Psychologists are involved in the work. Sessions with a speech therapist are often required.

Which doctors treat stroke?

Most patients with ischemic or hemorrhagic stroke are subject to urgent hospitalization in a specialized neurovascular (stroke) department or center, or, in the absence of one, in a neurological department. In case of violation of vital functions, they are hospitalized in the intensive care unit, in case of epi-, sub-, intracerebral hematomas - in neurosurgery.

The leading doctors in the treatment will be neurologists, neurosurgeons and neurovascular specialists. In addition to them, doctors of instrumental and laboratory diagnostics, cardiologists, ophthalmologists, psychologists, speech therapists, endocrinologists, rehabilitation specialists and physiotherapists, and other specialists take part in the treatment process.