Ischemic stroke of the brain: types, symptoms, diagnosis, prognosis, treatment and rehabilitation

It is customary to refer to ischemic stroke as a group of diseases characterized by deterioration or cessation of cerebral circulation. The disease can be expressed in the form of a small symptomatology, which disappears during the day or under the influence of medications, in severe cases, stroke leads to the death of the patient.

Previously, the disease was typical of people of mature age, in recent years there has been a tendency to increase the number of patients in their prime.

Types of ischemic stroke

Depending on the localization of ischemia, symptoms, etiology, ischemic cerebral stroke is classified into several types.

Ischemic strokes, determined by the rate of increase in symptoms:

1. Transient ischemic attack - passing through the day, cerebral circulation. The appearance of different types of symptoms depends on the localization of the focus of the pathology.
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2. "Small stroke" - characterized by the occurrence of long-acting ischemic attacks. Neurological symptoms undergo reverse development under the influence of drug therapy, which lasts from 2 to 22 days.
3. Progressive ischemic stroke - characterized by an increase in symptoms within a few hours or days. Restoration of impaired functions can occur in an incomplete volume.
4. Total ischemic stroke develops with a full heart attack, that is, death of the meninges. The symptomatology is severe, the prognosis is serious.

Ischemic cerebral stroke by severity:

1. Brain stroke of mild - Neurological symptoms are minor, complete recovery occurs in a short period of time.
2. Stroke of medium degree - focal neurological symptoms prevail, consciousness does not suffer.
3. The severe degree of ischemic stroke of is characterized by oppression of consciousness, the appearance of extensive neurologic symptoms. Treatment is long, a course of rehabilitation and restoration of the functioning of brain areas is needed.

Classification of ischemic strokes depending on the cause:

1. The atherothrombotic appearance of the stroke appears under the influence of arteriosclerosis of the central arteries. Symptomatic increases gradually, the peak of registered strokes of this type is at the time of sleep. The ischemia of the brain regions develops as a result of the separation of the thrombus, which leads to clogging of the vessels.
2. Cardiembolic type develops with embolism of the lumen of the vessels. It develops suddenly with concomitant diseases of the cardiovascular system - infarction, malformations, arrhythmias. Neurological signs at the time of an attack are manifested as maximally developed.
3. The hemodynamic type of stroke develops when there is a violation of hemodynamics - at the time of falling blood pressure, reducing the minute volume of the heart. Among the predetermining causes, atherosclerosis, stenosis and other vascular anomalies are distinguished. It develops both against a background of complete rest and physical activity.
4. Lacunar stroke is typical for patients with diabetes mellitus and with hypertension. The pathological process is limited to one of the small arteries located in the hemispheres and brainstem. With such ischemia, a cavity is formed, filled with cerebrospinal fluid.
5. Rheological type of stroke. Occurs in the absence of diagnosed vascular disease.

Ischemic stroke is subdivided and in the place of localization:

1. Carotid artery ischemia;
2. Ischemia of the main, vertebral arteries and their branches;
3. Brain ischemia.

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Signs and general symptoms of ischemic cerebral stroke

Symptomatic of ischemic stroke is determined by the part of the brain where the inflammation is located. At the time of an attack, movements, speech, and sensitivity are disturbed.

Motor violations of the .The patient has weakness and lack of coordination in movements, most often recorded from one half of the body.

Weakness can appear simultaneously in both hands and feet. There may be a violation of swallowing, speech becomes inhibited or indistinct, some patients develop visual disorders.

Vegetative disorders are expressed in the appearance of dizziness, twilight consciousness .

Violation of behavior in .When ischemic attacks occur, it becomes difficult for the patient to perform the usual actions - to dress, brush his teeth. Violations in orientation, memorization are noted.

How to determine the stroke yourself

The effectiveness of treating ischemic stroke of the brain directly depends on the time of medical care. It is believed that drug therapy, used in the first three hours after ischemia, can completely restore the health of the patient with mild forms, and in severe cases, significantly reduces the rehabilitation period.

Therefore, everyone needs to know how to determine the disease in themselves and their loved ones. There are several criteria, the presence of which allows the patient to suspect a violation of the blood supply to the brain, for their detection, you can make a small test.

1. You need to smile. The asymmetry of the face, the skewing of the mouth to one side serves as one of the signs of an ischemic stroke.
2. The patient should be asked to answer a few questions. Inconsistent speech, absence of some sounds, difficulty in pronunciation of words - an occasion to call an ambulance.
3. You have to raise both hands to the top. With ischemia of the brain, one of the limbs will be weak and the patient will not be able to lift it or hold it by weight.
4. Ask to show the tongue - if the brain is damaged, it will move away from the middle line.

To pay attention it is necessary and on eyes - they can "mow", at walking of the sick person it is appreciable, that coordination of movements suffers - the sick person can limp, drag a leg.

At registration of two of the listed signs it is necessary to immediately call an ambulance team, even if the patient will assure himself that he feels well.

In the early hours, the introduction of medications helps prevent the development of irreversible ischemia in the brain, which in the future will allow a person to feel completely healthy.

Diagnosis of ischemic stroke

After hospitalization, a number of instrumental examinations are carried out to the patient, which allows to accurately determine the lesion, its size and disruption of functions. The main directions in the diagnosis of ischemic stroke are:

1. Anamnesis. The doctor at the patient and relatives finds out when the first signs appeared, in what order, what preceded him. It is necessary to collect data on chronic diseases, medications taken, whether there was such a symptomatology in the past.
2. Physical examination consists of recording violations in the cardiovascular, respiratory, urogenital systems. The doctor conducts a series of tests, the main purpose of which is to determine the neurological disorders that have arisen from the focus of the brain lesion, and their degree.
3. Laboratory tests of blood and urine.
4. Instrumental examination is performed using MRI and CT.Such diagnostics is necessary for differential difference of a stroke from other diseases, for detection of the lesion, for determining the type of stroke - hemorrhagic or ischemic. MRI is performed repeatedly in the course of treatment to determine the effect of drugs on the affected area.

Treatment and prevention of complications

The main goal of treatment of cerebral ischemic stroke is restoration of impaired functions, prevention of complications. Basic standard therapy includes the following steps:

• Measures normalizing respiratory function. If necessary, tracheotomy, sanitation of the respiratory tract, connection to the ventilator is done.
• Regulation of the cardiovascular system. Inadmissible sharp decrease in blood pressure, it is recommended to maintain the pressure at a level of more than 10% of the normal parameters of a particular patient. Depending on the symptoms, antiarrhythmic drugs, cardiac glycosides, antioxidants are prescribed.
• Support of water - salt and acid - base balance of the body.
• Neuroprotection - measures aimed at protecting the structure of the brain from changes. Ideally, the use of such drugs should still begin at the stage of emergency care.
• Reduction of cerebral edema;
• Symptomatic therapy according to signs;
• Care of the patient includes measures aimed at the prevention of bedsores or their treatment.

Complications after an ischemic stroke can be minimal if a highly effective treatment using modern drugs starts during the "therapeutic window" that lasts for three hours after an ischemic attack.

Rehabilitation after ischemic stroke of the brain

Rehabilitation of the patient after treatment with essential drugs is an important part of restoring the impaired functions of the body.

The methods of rehabilitation differ depending on the severity of the disease, the time after treatment and violations in other organs.

At the end of the first week, a massage is prescribed, only a specialist who is engaged in such patients and trained. For the patient is shown a moderate physical load, increasing with time.

The complex of physical exercises is selected by a doctor, based on the severity of the disease.

In the recovery period, the medications that restore the function of the brain are administered by the courses.

Consequences of Ischemic Stroke of the Brain

The main consequences of stroke are violation of speech, sight, movements, memory and memory. The patient may experience disturbances in the sensitivity of the body - a lack of perception of high or low temperatures, difficulty swallowing. All these consequences can be either single, or in a complex.

Complexity for others and the patient itself represents mental disorders - there are causeless changes in mood, irritation or vice versa, euphoria, hallucinations. Defeat of the brain can cause convulsive, epileptic seizures.

In severe cases, recurrence of a stroke is possible, a secondary attack significantly affects the prognosis and consequences of the disease.

These violations over time with a favorable forecast are fully or partially restored. The entire recovery period can take a year or more. Following the recommendations of the doctor, the use of a set of massages, gymnastics, classes with speech therapists and psychotherapists significantly reduce the severity of the consequences of the disease.

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General prognosis

The prognosis for ischemic cerebral stroke depends on the area of ​​the lesion, the speed of the drug therapy and the patient's age.

The most important period is considered the first five days, at this time there is an increase in cerebral edema, which causes a further clinical picture and the appearance of complications.