Stroke.

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Stroke: developmental causes and risk factors

The cause of a stroke is a disruption of blood circulation in a specific area of ​​the brain caused by blockage and rupture of blood vessels in the cerebral hemispheres. The cause of this blockage may be an embolism or thrombosis. Cerebral artery rupture can occur due to hypertension, congenital vascular defects (weak vascular walls), aneurysms, serious injuries.

Factors that increase the likelihood of developing a stroke include:

• Age. The older a person is, the more likely they are to develop a stroke. The condition of the blood vessels worsens with age, and chronic diseases affect the cerebral circulation, and this becomes more severe with age.
• Taking certain medications. Some medications (long-term use) increase the chances of developing heart disease. Oral contraceptives containing estrogens increase the risk of developing stroke.
• Arterial hypertension. Women taking contraceptives or pregnant women should be especially careful.
• Cardiovascular diseases.
• Bad habits, especially smoking. Excessive alcohol consumption and smoking are important provocative factors for stroke. Smoking and alcohol together significantly increase the likelihood of developing cardiovascular disease, which in turn contributes to the occurrence of stroke.
• Diabetes mellitus.
• Stenosis of the carotid arteries.

Types of disease: classification of stroke

There are several types of strokes:

• Ischemic stroke (cerebral infarction). This is the most common type, accounting for about 80% of cases. This type of stroke is an acute circulatory failure in a specific area of ​​the brain.
• Hemorrhagic stroke (intracerebral hematoma). It is an injury to a specific part of the brain with blood. It accounts for about 10% of all cases.
• Subarachnoid hemorrhage. This condition develops as a result of rupture of cerebral blood vessels. Subarachnoid hemorrhage accounts for approximately 5% of all cases.
• Common stroke. It is a term that combines massive strokes. Common stroke is specific to the type of severe stroke and is manifested by general brain symptoms.
• Lacunar stroke. This is a type of ischemic stroke. This type of stroke is characterized by narrowing of small arteries. The name is given because the injection is located in the infarct lacunae that are included in this fluid. According to statistics, lacunar stroke accounts for 20% of ischemic strokes. Approximately equal amounts are observed among men and women. Most often, this pathology is diagnosed in individuals aged 48-75 years. The most common cause of lacunar stroke is atherosclerosis on the background of arterial hypertension.
• Spinal cord stroke. This type of stroke is an acute deficiency of blood circulation in the spinal cord. The cause of spinal stroke is often an ischemic or hemorrhagic stroke of the brain.

5% of strokes develop for other unknown reasons.

Signs and symptoms of stroke

Symptoms of a stroke:

• Sudden weakness, insomnia, paralysis of facial muscles (usually on one side of the body);
• Loss of speech;
• Impaired ability to see one or both eyes;
• Dizziness and acute headache;
• Loss of balance and sudden gait disturbance.

An ambulance should be called immediately when these symptoms occur!

The most common symptoms of stroke are divided into two conditional groups:

• General brain symptoms. These are symptoms associated with cerebral hemisphere injury. These symptoms include dizziness, numbness, and so on.
• Oven signs. These include sudden paresis, paralysis, as well as visual disturbances, changes in the location of the pupil, insecure speech, incoordination of movements, irritated neck muscles, and others.

It is very important to be able to correctly accept the symptoms of a stroke, as treatment will only have a positive outcome if it is started 3-6 hours after the vascular injury. The first signs of hemorrhagic stroke are associated with bleeding in the brain, while ischemic stroke is associated with the appearance of a necrotic area in the brain. These signs can be detected using instrumental diagnostics, particularly CT, MRI, and EEG.

When a stroke is observed, the patient…

If symptoms of a stroke are detected, an ambulance should be called.

Diagnosis of stroke

Stroke is diagnosed on the basis of the most important diagnostic studies, in particular computed tomography (CT) and magnetic resonance imaging (MRI). In many cases, computed tomography can detect strokes and other types of “new” cerebral hemorrhage.

MRI can identify areas of ischemia, as well as assess the prevalence of ischemic brain damage. MRI allows to differentiate hemorrhagic stroke from ischemic stroke, as well as to determine the exact location of the affected area and its size. It is also possible to exclude other diseases with similar symptoms using MRI.

A number of additional studies have also been performed in ischemic stroke, including ultrasound examination of the cervical and cerebral vessels (UTT), echocardiography, and cerebral angiography.

Methods of treatment of stroke

General therapeutic treatment of stroke is aimed at normalizing the cardiovascular system, restoring respiratory function, reducing brain tumors, as well as preventing recurrence and treating complications.

In ischemic stroke, blood circulation and the injured area are restored by antiaggregant, anticoagulant, neuroprotective (cavinton, etc.) and nootropic (picamilon) drugs. If necessary, surgical treatment is performed. Normal brain function is supported by antioxidants, vitamins, and medications to improve metabolism in tissues.

In hemorrhagic stroke, angioprotectants, vasoactive drugs were prescribed. The most effective method in the treatment of hemorrhagic stroke is surgical intervention.

Consequences of stroke

Stroke can lead to prolonged coma, paralysis, or paresis of muscles in certain parts of the body. Stroke leads to loss of mind and memory. A severe stroke can lead to the death of the patient.

Stroke prevention

Stroke prevention is done by measuring blood pressure regularly. People with hypertension should be especially careful and follow all the recommendations of their doctor, such as taking the prescribed medication, exercising regularly, and introducing dietary restrictions. Stopping smoking and controlling blood sugar levels reduces the chances of developing the disease.