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Stroke – very heavy and especially dangerous illness at which there is a disturbance of blood circulation in a brain. As a result, tissue of a brain perishes in view of lack of the necessary food in a brain. As a result the person has an injury of a brain, and its vessels are corked or broken off.
Cerebral thrombosis is the main origin of a stroke at the person: the artery which supplies with blood a brain is corked with a clot. Such clots called by blood clots mainly are shown at people who have atherosclerosis. Emergence of a hematencephalon becomes the second reason of a stroke: there is internal bleeding. Sometimes the artery of a brain affected with an illness is broken off, and blood comes out it in nearby tissues of a brain. Therefore, those cells which ate the affected artery do not receive oxygen necessary to them and blood. Generally the hematencephalon happens at those patients who at the same time suffer from atherosclerosis and the raised blood pressure.
Thus, the stroke at the person arises as a result of damage of nervous cells which are in a brain and provide control over functioning of a human body in general. Nervous cells perish because of sharp disturbance of blood circulation in a certain department of a brain. Active brain cells do not receive amount of blood necessary to them. As a result these cells perish, and to certain muscles of a body the necessary teams cease to arrive. Because of it at the patient with a stroke there comes paralysis, an alalia, sight, a number of other disturbances of neurologic character.
Types of strokes
In medicine distinguish two essentially different types of strokes: a hemorrhagic stroke (the vessel is broken off, there is hemorrhage) and an ischemic stroke (the vessel is corked). Both types of strokes are shown mainly at people who are subject to a hypertension, heart diseases (heart diseases, heart failure, a ciliary arrhythmia, tachycardia), cerebral atherosclerosis.
As a rule, development of a stroke happens sharply and suddenly, at the same time the brain is injured already in a few minutes. In this case it is about a complete stroke. In Bol exceptional cases the general condition of the person worsens gradually – for several hours or days in the course of increase in the struck brain tissue. In that case the stroke in development takes place. The illness can stop for a while: the area of the struck fabric ceases to extend for some time.
Symptoms of a stroke ischemic are shown depending on in what part of a brain damage developed. These signs remind symptoms of tranzitorny ischemic attacks, but at the same time brain functions are broken stronger, affect the extensive territory of a body. At an ischemic stroke there can be a coma or oppression of consciousness of easier degree. The person with a stroke suffers from a depression, he cannot often cope with own emotions.
At an ischemic stroke quite often there is brain hypostasis. This the state constitutes danger in view of the fact that in a skull of the person there is no free space. As a result owing to squeezing tissue of a brain is damaged even stronger. As a result the condition of the patient worsens while directly the zone of a stroke does not expand.
People who had an ischemic stroke in due time in the course of rehabilitation recover all functions or their most part. Thus after the postponed illness of people many years can fully live. However in certain cases the patient after a stroke has a disturbance of both physical, and intellectual functions. The person can lose abilities to eat, go, talk normally.
After developing of a stroke in the first days specialists cannot precisely define further development of a condition of the patient: it can both improve, and to worsen. According to the statistics, partial recovery of functions happens at patients to unilateral paralysis and to less serious defeats already by then as they leave a hospital. The person can independently look after himself and continues a rehabilitation course. The patient rather surely goes, his thinking is clear and full-fledged, however to use the paralyzed hand to it still extremely difficult. A hand more than a leg, defeat at paralysis affects.
Approximately the fifth part of the people who got sick with an ischemic stroke die in hospital. This statement concerns more people at advanced age.
Some symptoms of a stroke in this case testify to the adverse forecast: disturbances in cordial activity and respiratory functions, an unconsciousness. In case of preservation of neurologic frustration for half a year it is possible to say that such disturbances will be irreversible, most likely. However, there are also patients at whom improvement progresses very slowly. Bol heavy process of recovery at an ischemic stroke is observed at elderly people, and also at patients with other heavy illnesses.
At a hemorrhagic stroke the person has a hit of blood in brain tissue owing to hemorrhage. The person at intra cerebral hemorrhage sharply has a headache which is followed by the accruing neurologic frustration. It can be strong weakness, confusion of consciousness, impossibility to move, an anesthesia, sight, the speech.
Very often as symptoms of a stroke hemorrhagic spasms, nausea, vomiting are shown. The patient faints, and all this occurs in several minutes.
As a rule, diagnosis of a hemorrhagic stroke is made without purpose of additional researches. But if the suspicion on an ischemic stroke takes place, then carrying out a computer tomography or magnetic and resonant tomography is necessary.
At a hemorrhagic stroke, in difference from ischemic, the vessel is broken off at a high blood pressure, at patients with atherosclerosis the wall of an artery becomes thinner unevenly. Blood which comes out in brain tissue under a high pressure begins to move apart brain fabrics then in a cavity there is a blood tumor which is called still an intracerebral hematoma.
In the course of a hemorrhagic stroke hemorrhage can happen also during a rupture of education in the form of a sack which appears on a vascular wall (aneurysm). Similar hemorrhage occurs most often in a meninx. It is accepted to call it subarachnoidal. The similar kind of hemorrhage is most characteristic of the young people who did not reach forty-year age. Characteristic symptoms of a stroke are in that case shown. The person feels sudden blow in the head, comparable with sharp blow a dagger. Very severe headache forcing the person to shout and faint is shown. Developing of spasms is possible. A little later the consciousness returns, at the patient drowsiness, block, a headache very intensive is observed, display of nausea and vomiting is possible. However a basic difference of symptoms is absence of paralysis unlike a stroke with the advent of a brain hematoma.
If at the person the hemorrhagic stroke develops and the intracerebral hematoma is formed, then it is shown rather violently. Initially there is hypertensive crisis, the headache amplifies, most often it is observed in one half of the head. A bit later at the person complexion on red or gray changes, the patient rattles, faints, sometimes it is overcome by attacks of repeated vomiting. Later certain time at a stroke of this type the convulsive attack can be shown, at the same time spasms will prevail on one half of a body. On the party of a stroke the pupil extends. If to the patient the consciousness returns, it observes paralysis. At the same time if extremities are paralyzed on the right side, then such paralysis is followed by disturbance of the speech (the phenomenon called by aphasia). At paralysis of extremities at the left at the person bright mental deviations will be observed.
Symptoms of an ischemic stroke are less brightly expressed, do not differ in the clearness and therefore this kind of an illness is more artful. Symptoms of an illness in this case accrue gradually.
If the ischemic stroke is shown, then at the patient nape muscle tension takes place. The person cannot bend the head forward to touch by a chin to a breast in view of very strongly intense neck muscles. The same phenomenon develops in muscles of legs. Cannot raise a direct leg of people, having taken it for a heel. Also at a stroke to this form the meningeal syndrome which demonstrates irritation of a meninx blood is shown.
At people with a hemorrhagic stroke the disease always comes to an end with a lethal outcome: people with such illness can live no more in two days. They die, without regaining consciousness. Subarachnoidal hemorrhage comes from aneurism most often after heavy exercise stresses or serious nervous stresses which are followed by sharp increase of arterial pressure.
Not less artful illness are passing disturbances of cerebral circulation. It is dependent on that, where exactly there was a damage of a brain, the patient feels low in a leg or a hand on the one hand. At the same time the patient has speech frustration: he cannot distinctly speak. Display of a blindness is also possible. After a while these symptoms disappear, but for days they are periodically shown again. Thus, calling the ambulance, the patient can feel bad, and on arrival of the doctor his state happens already absolutely normal. Later at such patient unilateral paralysis, aphasia is shown.
This state is yet not a complete stroke, and it that will occur shortly. Therefore urgent hospitalization is necessary for the person with such symptoms.
First aid at a stroke
The help at a stroke needs to be provided the first minutes, exactly at once after a stroke medical care will be the most effective. The patient should be laid in a comfortable position, to exempt from clothes which prevent to breathe deeply, to provide inflow of clean air. In a mouth there should not be prostheses, emetic masses. Important that the neck lay exactly not to worsen a blood flow on vertebral arteries.
It is necessary to transport the patient with a stroke only in lying situation. Looking after the patient afterwards, it is necessary to overturn constantly him from outside aside that there were no decubituses, to feed, carry out all hygienic procedures, to do massage, etc.
Diagnosis of a stroke
Three stages of establishment of the diagnosis at a stroke are defined. First of all it is necessary to distinguish a stroke from other morbid conditions at the patient at which the brain is surprised. After that establish what type of a stroke takes place. The third stage – definition of where hemorrhage is localized. For definition like a stroke it is necessary to carry out laboratory analyses, biochemical researches, and also research of cerebrospinal fluid. If necessary a number of additional researches is conducted.
Treatment of a stroke
In order that treatment of a stroke was carried out according to the correct scheme, the attending physician first of all defines in what state at this o'clock the vital functions of the patient stay. It is about breath and blood circulation. In the presence of problem points in work of these systems or presence of other states having urgent character at first all measures are taken for prevention of such problems and normalization of work of the specified systems. And only after that the doctor finds out type of a stroke and appoints treatment.
Treatment of a stroke is appointed depending on what its type. If the ischemic stroke is diagnosed, then all efforts first of all will be bent on recovery of blood circulation in a brain. In case of a hemorrhagic stroke it is important to lower a blood pressure and to stop bleeding in a skull or in a brain.
Also in the course of treatment of a stroke vascular therapy is carried out, medicines which stimulate a brain exchange are appointed. Also the oxygen therapy is carried out. After a basic course of treatment long recovery therapy follows.
Rehabilitation after a stroke
Rehabilitation after a stroke is carried out with use of a number of efficient methods. These are massage courses, physiotreatment, special physiotherapy exercises.
The most important points which relatives of the patient who had a stroke always have to remember is need to watch strictly the level of arterial pressure, pulse, and also to provide observance of Regulations of Admission of all medicines ordered by the doctor.
In the course of a nosotrophy it is necessary to control his body temperature, a chair regularity, amount of the emitted urine. If the chair at the person is absent within three days, it is necessary to make to it a cleansing enema. At the noticed aberrations in the course of supervision over urine and body temperature it is necessary to inform the doctor at once.
It is important that the patient felt comfortable: the room has to be silent, pure, constantly aired. Optimum, that the person lay on a mattress from foam rubber which does not cave in.
Respiratory gymnastics – one of the most important elements in the course of rehabilitation after a stroke. To train breath, the person can force to be inflated rubber toys, balloons. Approximately time the patient needs to be overturned at three o'clock that owing to long lying it had no decubituses.
Depending on whether the person without assistance can move, it is necessary to provide him a possibility of carrying out all hygienic procedures.
Patients who undergo rehabilitation after a stroke often become more susceptible to people and to events or, on the contrary, to show extreme passivity. At the same time they often have mental disturbances. To such people whims need to show a certain patience, however a connivance also it is not welcomed. It is important that there were no conflicts, and the person remained quiet. The quiet and balanced psychological climate promotes fast rehabilitation.
Food also has to be healthy with daily caloric content no more than 2200-2500 kcal.
It is important to be adjusted for the long period of rehabilitation after a stroke, and some functions at the person can be recovered only partially.
Prevention of a stroke
To warn a stroke, it is important to adhere to a number of the recommendations checked by time. It is especially carefully necessary to watch over the health to those people in whose families there were already cases of strokes. If there is a similar predisposition to strokes, then pressure needs to be controlled regularly.
One more indicator demanding a constant control, this content of cholesterol in blood. Normal indicators in this case make no more than 6,2 mmol/litre. If this figure is exceeded, it is necessary to get advice of the specialist and to change way of life.
For prevention of a stroke it is important to minimize the everyday use of salt and fats of animal origin, to refuse flatly smoking and an alcohol abuse.
It is not less important to provide an organism with the due level of exercise stresses. It is useful to run, to go, ski much and the bicycle. Positively swimming, moderate bathing procedures and a hardening influences an organism.
Section: Diseases of vessels