10-15 percent of all strokes occur in people under 45 years of age

Author of the article: Marina Dmitrievna

2017.10.23

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Vessels

Medical indications

What is a stroke? This is a severe disruption of blood flow in the brain. The main consequences of the disease include:

stunning or complete loss of consciousness;
involuntary bowel movement;
respiratory arrest;
urinary incontinence after stroke;
violation of the frequency, rhythm and depth of breathing;
tachycardia, hypotension;
heart failure;
painful cough after a stroke.

It has been proven that the frequency of episodes of the disease increases with age. Persons with a sedentary, sedentary lifestyle are prone to strokes. They rapidly develop global or focal disorders of the brain.

The pathology is accompanied by vivid symptoms:

pronounced facial asymmetry;
slurred speech or its complete absence;
misunderstanding of spoken speech;
severe visual impairment;
an epileptic attack may develop;
paresis or paralysis of the limbs (often unilateral);
increased tone of striated muscles.

Doctors distinguish 2 subtypes of the disease: hemorrhagic and ischemic strokes. Ischemia is caused by blockage of a cerebral artery by a thrombus. Persons with atherosclerosis and hypertension are more susceptible to developing the disease. The attack leaves a significant impact on the patient: the physical and emotional state changes radically, and behavioral characteristics appear.

Another reason for the development of the disease is a violation of blood flow to certain areas due to a ruptured blood vessel. This occurs due to sudden fluctuations in pressure. For the body, even a moderate stroke is severe stress, a crushing blow to the nervous system. A person loses control over his body. This provokes strong anger, irritation, tearfulness, and aggression. Therefore, the care of loved ones often causes strong indignation. Their help is met with hostility. Increased excitability impairs the body's recovery process.

Pathogenesis of the disease

For the brain to function properly, a constant supply of oxygen is required. For comparison: the mass of the organ is 2% of the total weight of the body. For the functioning of the organ, more than 20% of oxygen and 17% of glucose from the total intake are required. The brain is not designed to reserve oxygen. Therefore, even minor ischemia lasting more than 5 minutes provokes irreversible damage to neurons. Restoring such structures is impossible.

In the acute period of the disease, large areas of damage appear. In this case, extensive swelling occurs, which aggravates the course of the disease, prolonging the recovery process. After a few weeks, the process subsides. The damage area is reduced. After a stroke, there is significant loss and impairment of many body functions.

This is due to damage to brain cells - neurons. They lose conductivity, the ability to function properly. The person stops coordinating his movements, thoughts, and begins to speak poorly. Serious disruptions make it difficult for the body to recover after an attack. The death of neurons is triggered by a lack of blood and oxygen. Scientists have proven that the basis of ischemic or hemorrhagic stroke is damage to blood vessels and disruption of blood flow in them.

Apoplexy significantly impairs a person's cognitive functions. Initially, memory is affected, resulting in complete or partial loss. The patient cannot remember his name and loved ones. Memory is similar to fragments of a vessel; the patient is unable to assemble them into a single picture.

Stroke causes significant functional impairment and structural changes in the brain. Therefore, the disease is accompanied by a decrease or complete absence of vision. A sharp, sudden deterioration in vision is a harbinger of apoplexy. This symptom occurs if blood flow is interrupted for at least a minute. Therefore, vision problems and pain in the head are the earliest manifestations of an attack.

Disease clinic

Moderate pathology with concomitant embolism or thrombosis causes complete loss of vision. Recurrent mild ischemia causes short-term problems. Therefore, restoration of vision depends on the severity and extent of the lesion.

The most common consequences of a stroke include paralysis and paresis. They can occur in any part of the body. It all depends on the location of the damage zone. If the left lobe is affected, paralysis of the entire right side of the body or part of it is noted. Someone becomes deaf, goes blind, stops moving and speaking. Some patients retain communicative functions, but do not move. The rest have all the negative consequences of the disease at the same time.

According to statistics, more than half of people with a stroke do not survive it. Patients who undergo it remain disabled. A deadly condition is hemorrhage in the right hemisphere. Damage to the left lobe is considered more favorable and has an easy, quick recovery.

Reasons for the development of the disease

Stroke is not a sudden illness. The causes of stroke develop over a long period of time. In young men and women, it can begin as a result of blockage of a vessel with a blood clot or inflammatory processes in the walls of the arteries. In old age, the main cause is atherosclerosis, a chronic disease of the human vascular system.

As the disease progresses, the formation can completely block the blood flow in the vessel, resulting in decreased blood circulation and stroke.

Cholesterol deposits

The development of atherosclerosis is accelerated by high levels of low-density lipoproteins in the blood. This component consists of cholesterol combined with special carrier proteins. Cholesterol is a fat-like substance needed by the body. But excess contributes to the strengthening of atherosclerotic deposits.

At high levels, dietary restrictions in the consumption of fats are necessary.

Right-sided disturbance of blood flow in the brain

With a stroke, complications do not always appear. It all depends on the magnitude of the disorder and the type of lesion itself. With extensive right-sided lesions, problems with movement arise: persistent paresis, paralysis, disturbances of sensitivity and muscle tone. Hemorrhage into the right hemisphere causes left-sided hemiparesis. In this case, a persistent violation of muscle tone of the spastic type occurs. As a result, contractures are formed, sensitivity and eye movement are impaired (the head and eyes are turned to the left). During an attack of asphyxia, a tracheostomy is used.

Hemorrhagic intracerebral stroke, or subarachnoid hemorrhage, is characterized by a general cerebral clinical picture. Meningeal signs with episodes of loss of consciousness and cerebral coma are pronounced. Often there is severe pain in the head, attacks of dizziness, unsteadiness of gait, and falls.

Consequences of right-sided hemorrhagic stroke:

left-sided hemiparesis;
muscle spasms;
sensory disturbance;
significant dizziness in the head;
vestibular disorders;
blindness;
marked decrease in visual acuity;
ignoring the left half-space;
left-sided diplopia;
central pain syndrome;
neuropsychiatric disorders;
persistent sleep disturbances;
problems with swallowing, sometimes the tongue sinks.

Recovery after a hemorrhagic stroke is somewhat difficult. Such patients are paralyzed, have bedsores, and septic ailments (pneumonia, damage to the genitourinary tract). Complex arthropathy, spastic contractures, and sometimes hydrocephalus are observed. Such conditions prolong the patient’s healing and provoke depression and chronic stress. This may cause relapses of the disease.

Treatment of stroke in old age

The most effective therapy for elderly patients is thrombolytic therapy. However, Western clinics often refrain from this method, as they believe that thrombolysis can cause subarachnoid hemorrhage. It is also very difficult to observe the effect of treatment during this intervention. The best treatment results were achieved by endovascular methods and intra-arterial thrombolysis. These treatments significantly reduce the negative effects. The use of antiplatelet drugs gives good results. Thus, taking aspirin in the first hours of a stroke significantly reduces the likelihood of subsequent development of paroxysms. Antihypertensive therapy is carried out both as a primary measure and during secondary prevention. The sooner measures are taken to restore post-stroke and physiological functions, the easier it is for an elderly patient to endure negative consequences and complications.

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What does ischemia lead to?

Ischemic stroke develops more slowly, with a slight increase and subsequent regression of symptoms. With this type of stroke without paralysis, rapid healing and return to a full life are possible.

More severe cases of the disease leave behind formidable complications:

paresis, paralysis of the left half of the body (the tongue may sink);
urinary disorders after stroke;
disturbance of perception and sensation;
loss of memory for current events;
ignoring the left half of the space;
cognitive disorders;
violations of the emotional-volitional plan.

After an ischemic stroke of the right hemisphere, pathological syndromes occur with the appearance of depressive states and behavioral disorders. Patients become untied, disinhibited, and do not feel tact and moderation. They are characterized by a certain foolishness, a penchant for flat jokes. The presence of such disorders of the emotional-volitional sphere significantly lengthens and complicates healing. Patients do not perceive reality objectively, therefore they require consultation with a psychiatrist.

Perinatal conditions

Cerebrovascular pathology, including hemorrhage, affects children of perinatal age. In older children and adolescents, the disease is diagnosed less frequently. Cerebral strokes develop with vascular malformations and cerebral aneurysms. Vasculitis, various angiopathy, severe damage to the heart and blood vessels (defects, arrhythmias, blockades, endocarditis) can provoke hemorrhage.

It has been proven that perinatal hemorrhage occurs due to traumatic injury to the skull. It develops against the background of the following phenomena:

discrepancy between the size of the fetus and the birth canal;
rapid labor activity;
severe cervical rigidity;
use of a vacuum extractor.

Prematurity is considered an important predisposing factor in the development of the disease. An unformed skull is too flexible and soft, and therefore increases the risk of stroke. What are the consequences of perinatal right hemisphere strokes?

The clinic of intraventricular strokes has several variants of the course. Complications and consequences of cerebral stroke depend on the massiveness of the hemorrhage, the degree of hydrocephalus, the severity of focal disorders and the severity of concomitant pathology. Often after perinatal strokes, cerebral palsy of varying severity, visual impairment (strabismus, amblyopia) and cognitive function occur.

Complications after a stroke of ischemic origin are caused by the “hypoxia-ischemia” syndrome. Movement disorders, some brain dysfunction, and mental retardation develop. Increasingly, after ischemia, a single epileptic seizure is observed in children.

Consequences of senile illness

Old age complicates the course and consequences of stroke, aggravated by severe cerebrovascular pathology and progression of encephalopathy. Therefore, after a stroke, the brain is not able to function fully: memory is impaired and intelligence declines.

The ischemic form of the disease leads to cognitive impairment. Epilepsy often develops after a stroke. Primary signs of an attack are observed within a week after the stroke. The difference in neurological manifestation is the absence of a visible catalyst factor. Epilepsy occurs unexpectedly.

During the rehabilitation period, epilepsy occurs due to cortical atrophy or a cyst, which has an irritating effect on the damaged tissues and the patient’s health. Late epilepsy after an attack can occur several months later (against the background of the appearance of a tissue scar).

This significantly complicates the rehabilitation of elderly patients. Major stroke and its consequences in old age are associated with neurological deficits and movement disorders. In this case, organs may fail.

Occasionally, a form of “thalamic” syndrome develops and visual impairment develops. The condition is dangerous, as there is a risk of urinary failure, cerebral edema with the development of dislocation-trunk syndrome or hydrocephalus. Dropsy occurs.

A stroke has characteristic signs by which the zone and extent of damage can be determined: lacunar, brainstem or spinal process. Problems with motor skills and spatial coordination indicate damage to the cerebellum. But often the spinal variant of the disease has a similar clinical picture.

Usually the side opposite the cerebral zone of the disorder is affected: the limbs and facial muscles fail, and dysarthria appears. In a spinal stroke, parts of the spinal cord are damaged. In this case, the patient is completely paralyzed. Peripheral neuropathy often occurs: there is no temperature sensitivity, taste is distorted.

Paresthesia often appears - an attack of tingling or numbness of the limbs. Problems with urodynamics are a clear manifestation of the consequences of lacunar infarction. The patient does not regulate renal and intestinal rhythm: does not control urination and defecation.

Aphasia is the loss of the ability to speak and adequately perceive speech. The intensity of the symptom directly depends on the severity of the condition. Deaths are the saddest consequences of cerebral hemorrhage. They occur in severe forms or in the absence of timely medical care.

Precursors and symptoms of stroke

A few days before the onset of a stroke, both men and women are likely to experience the following strange sensations:

sudden drowsiness during the daytime during normal rest periods;
spontaneous attacks of tachycardia or slowing of heart rate;
severe dizziness in the absence of active movements and changes in body position;
nosebleeds for no reason.

A stroke may be preceded by a transient ischemic attack: a sharp or increasing headache with disturbances in vision, hearing, coordination of movements and sensitivity of body parts. It usually lasts for several hours, then the state of health gradually returns to normal. The attack is caused by a passing disruption of the blood supply to the brain tissue. This process is similar to a stroke, but unlike it, a transient attack ends safely. Blood circulation is restored, and necrosis of the affected cells does not occur.

Common symptoms of a developing stroke:

attack of unbearable headache;
visual disturbances: changes in color perception, spots and darkened areas before the eyes, double vision, flickering of “midges”, narrowing of the field of vision;
changes in coordination of movements and facial expressions: inability to walk normally, gesticulate, paralysis of the facial muscles on one side, numbness of the limbs;
Severe nausea, abdominal cramps or single vomiting are also likely.

Sometimes patients mistake such attacks for migraines, severe fatigue, or the consequences of stress. Preferring to simply take a painkiller, rest and lie down, they often lose time to save themselves.

Doctors' recommendations

Stroke is a disease that requires complex treatment. But this is only the first stage of therapy. At the second stage, it is important to carry out correct and adequate rehabilitation. This is a rather complex program involving various specialists. The participation of the patient himself in the process is mandatory.

It is important to convince the patient of the effectiveness of therapy and a speedy recovery from the disease. Physiotherapy methods improve the flow of medications into the brain, and manual therapy restores muscle sensitivity and performance.

Official therapy advises, against the background of drug treatment, to resort to the services of a competent psychologist. Many patients, hoping to heal quickly and easily, turn to unconventional treatment methods. Stroke is a serious disease that cannot be treated on its own. Otherwise, you can complicate its course (kidney failure) or provoke death.