What is a stroke of the brain?

1 The essence of the pathology of

In its essence, stroke of the brain is a sharp violation of blood circulation in the indicated organ, manifested, as a rule, unexpectedly, for no apparent reason and characterized by the appearance of obvious signs of local( focal) or generalized( general cerebral) neurological damage. Acute symptoms can persist for more than 20 hours, which, if no urgent measures are taken, leads to death or irreversible consequences.

In addition to a direct stroke with rapid development of neurological damage, such varieties of pathology as the transient circulatory abnormality, which regresses the day, and a minor stroke, in which the duration of the decaying process can last up to 20-22 days, are distinguished. The following major types of cerebral stroke are distinguished according to the mechanism of the development of the brain: cerebral infarction, cerebral hemorrhage and hemorrhage of the subarachnoid type.

2 Brain infarction

A cerebral infarction, or stroke of an ischemic type, develops as a result of the restriction or complete cessation of blood flow to specific sites or to all brain tissues. Because of this, brain cells, not receiving the necessary amount of oxygen and nutrients, die, which causes partial or complete cessation of the functioning of the organ. This type of stroke is caused by violation of the patency of the vessels( constriction, thrombosis) or changes in blood properties and is most typical for men over 65 years of age.

Several types of ischemic stroke can be noted:

1. Atherothrombotic type. Most often it is caused by atherosclerotic plaques, which narrow the lumen of the middle and large arteries, which leads to thrombosis. The onset of this type of stroke usually occurs during sleep, and development can last from 10-15 hours to 2-3 days.
2. Cardioembolic type. Such a stroke is caused by emboli( torn clots), which lead to clogging of the brain vessels. The main causes: heart valve defects, endocarditis, other cardiac disorders( in particular paroxysm of ciliary arrhythmia).There is a sudden stroke and develops dramatically.
3. Hemodynamic variety. Stroke occurs due to a sharp violation of dynamic blood characteristics. The main causes: arterial hypotension due to hypovolemia, improper use of medications, etc.; decrease in cardiac output due to severe bradycardia, myocardial ischemia and other cardiac pathologies. Often, this type of stroke is combined with atherosclerosis, arterial stenosis, and other vascular anomalies.
4. Lacunar type - a characteristic focal stroke with the most frequent localization of the lesion in the subcortical zones. Occurs when small perforating arteries are disturbed. A common cause is high blood pressure.
5. Defeat with the development of micro-occlusion. The main causes: abnormal course of hemostasis and fibrinolysis, changes in hemorheological nature. Symptoms are poorly expressed in the neurological plan, but are significant in terms of hemorheological changes.

3 Brain hemorrhage

Brain hemorrhage, or hemorrhagic stroke, is a spill of blood into the brain tissue as a result of rupture of blood vessels or diapedesis, that is, a significant increase in the permeability of the vascular walls. This type of stroke becomes the main mechanism of development of pathology in people of young and middle age.

The most common cause of intracerebral hemorrhage is the hypertensive crisis in chronic arterial hypertension. Other common factors include: atherosclerosis, blood diseases, intoxication, avitaminosis, inflammatory bowel disease. Harbinger precursors are such signs: a feeling of heat, severe headaches, blurred vision.

Hemorrhagic stroke is often provoked by emotional overload, stress, physical overstrain. The risk of stroke increases dramatically with the use of drugs, especially cocaine and amphetamines. A significant increase in the number of pathologies is found when taking cannabinoids, opioids, hallucinogens. Direct dependence is recorded for alcohol abuse.

4 Risk of subarachnoidal lesions

Hemorrhage in the subarachnoid cerebral region, or subarachnoidal stroke, is caused by rupture of the arterial aneurysm. Most often this phenomenon is fixed in case of craniocerebral trauma, but it can be explained by brain pathologies( tumors, malformation) or by taking drugs and alcohol.

This type of stroke is characterized by the accumulation of blood mass on the surface of the medulla oblongata, temporal lobes, brain legs, and bridge. The most significant spreading of blood is found along large grooves. Sometimes the localization of the lesion is noted on the cerebral upper-lateral surface.

5 Symptoms of

Symptoms of brain damage depend on the location of the focus and the extent of the affected area. The main manifestations of general cerebral character in any type of stroke: a very severe headache leading to nausea and vomiting;drowsiness or, conversely, excessive excitement;dizziness with periods of unconsciousness for a short time;partial or total loss of the ability to temporal and spatial orientation;intense heartbeat;excessive sweating;dryness in the oral cavity;feeling the heat all over the body at normal temperature.

Neurological symptoms of stroke depend on what the affected area of ​​the brain is responsible for. After a stroke, there are such complications of a focal character:

1. When the area that regulates motor reflexes: limb dysfunction( up to their complete paralysis), loss of sensitivity in the limbs.
2. With a focus on a site that regulates blood flow through the carotid artery: muscle dysfunction, loss of verbal connectivity, decreased vision to one eye, excessive pulsation of the carotid artery.
3. When affected areas that control the coordination of the body: shaky gait, loss of sense of balance, intense dizziness and vomiting, visual hallucinations and pathologies.

It should be noted that often the symptoms and most lesions persist for a long time after the stroke, and sometimes are irreversible, that is, lead to disability and partial or complete loss of efficiency.

6 First aid for

The problem of how to treat cerebral stroke should be divided into several stages: first aid, intensive therapy in inpatient settings and rehabilitation after a stroke at home.

The effectiveness of treatment and the survival of the affected person depend on the adequacy and timeliness of the measures taken at all stages.

Quite often, a person's life is determined by the speed of first aid and the urgency of delivery to a medical institution capable of providing the necessary therapy. The chances of survival are significantly increased if the patient gets to the necessary hospital within 1 hour after a stroke, and therefore the first action is a call of emergency medical care.

Further, the victim is ensured complete rest, reclining position and freedom of breathing. Categorically prohibited eating and drinking. In case of unconsciousness, cardiopulmonary resuscitation should be performed. Often, the saving circumstance is the possibility of using a portable defibrillator.

To treat a cerebral stroke, it is necessary in a specialized intensive care unit with intensive care. The following medical measures are provided:

1. Within 4-6 hours the lesion is determined and thrombolysis is performed, that is, resorption of the thrombus with the use of special equipment.
2. Complete control of all vital functions is provided.
3. A high dose of Pentoxifylline, Reopoliglyukin is introduced to reduce blood viscosity.
4. Higher doses of Cortexin, Cerebrolysin, nootropes are prescribed to protect brain cells from destruction.
5. After the basic therapy, funds are used to help reduce the chance of a second stroke, and symptomatic therapy is performed.

Rehabilitation after completion of an intensive care course is important in eliminating the consequences of a stroke. They are carried out within the framework of neurorehabilitation in home or stationary conditions. The following specialists will be needed: a professional in exercise therapy( the physical education program should be individual and begin literally from 2-3 days after a stroke), a speech therapist, a neuropsychologist for restoring memory and thinking abilities, a physiotherapist, and a psychotherapist.