The condition that precedes a stroke takes decades to develop. But the stroke itself lasts several minutes. The worst thing about this pathology is the consequences that arise from untimely help. Treatment for stroke in older people is prescribed after determining the type of pathology.
Hemorrhagic stroke is one of the most dangerous forms of pathology, which occurs as a result of a violation of the integrity of blood vessels. Most often it develops during sudden surges in pressure (hypertensive crisis), or as a result of a rupture of an aneurysm.
Ischemic stroke is a focal or extensive cerebral infarction that occurs as a result of a complete stop of blood supply to certain areas. The most common cause of ischemia is the clogging of blood vessels with atherosclerotic plaques and blood clots.
Treatment of the second pathology is usually conservative and leads to positive prognosis. A hemorrhagic stroke can be fatal, and severe complications develop in almost 90% of cases.
Causes of stroke in older people
The causes of stroke in an elderly person are various risk factors and etiologies.
Congenital heart or vascular defects
Genetic heart failure and birth defects of the circulatory system negatively affect overall blood flow. This leads to chronic tissue ischemia; the “bomb” laid at birth can explode at any moment.
Thick blood
Blood, with a high content of platelets, is thicker than normal, and poorly supplies all tissues of the body with oxygen and nutrients.
Poor circulation
Stroke in the elderly occurs due to poor circulation. With age, blood vessels become overgrown with various plaques, and blood thickens with age. This often comes from the habit of smoking, overeating, and not moving enough.
Thrombosis of the mitral or aortic valve
A blood clot, disrupting the functioning of the heart valves, can cause a heart attack and enter the vessels through which it reaches the brain.
Separation of thrombotic masses after defibrillation
Resuscitation procedures, such as defibrillation, can cause a large clot to break off. Having reached the brain, the clot can rupture blood vessels or clog them.
Artificial pacemakers and pacemakers
An artificial device, a pacemaker, can cause a stroke only if it is faulty and has expired. There is an outdated type of devices designed for a short service life. If you have a pacemaker and your health worsens, you should consult a doctor.
Cardiac ischemia
A weak heart does not sufficiently supply the brain with blood, which leads to partial or complete death of parts of the brain, ischemic stroke.
Heart failure
It causes deterioration of cerebral circulation, pathological narrowing of the lumen of blood vessels, and the death of some neurons.
Myocardial infarction
Sharply worsens blood flow, insufficient oxygen supply kills brain cells. Partially or completely.
Atrial fibrillation
It disrupts the rhythmic movement of blood and promotes the formation of clots in certain parts of the heart. The resulting blood clot, moving through the vessels to the head, causes rupture of the vessels.
Lipid metabolism disorder
It causes the formation of atherosclerotic plaques on the walls of blood vessels; their separation and movement leads to blockage. Fatty growths also constrict blood vessels, impairing blood supply to the brain.
Diabetes
It can cause hemorrhage in the brain due to the fragility of blood vessels. Elevated glucose levels make the walls of blood vessels brittle and thin.
Physical inactivity
Leads to poor circulation, slower lymph flow, weakening of the heart, muscles of the whole body, obesity and the risk of vascular rupture.
Migraine
A throbbing headache and spasms that last up to 72 hours can lead to a stroke.
Stroke in old age: symptoms that should not be ignored
– Ischemic stroke is a type of stroke in which, as a result of thrombosis, blood does not flow to one part of the brain.
Symptoms
A stroke at 80 years old, the prognosis of which will be positive, is a quick response to the symptoms of the disease and timely treatment. If a grandparent has a hemorrhagic attack, the symptoms will be as follows:
Important! Signs of this type of stroke develop rapidly, so the patient usually loses consciousness at the beginning of the attack.
Depending on the area of the brain where the hemorrhage occurred, the patient may lose hearing or vision, and if it is a major stroke, seizures may begin and a coma may occur.
If, for example, an ischemic stroke occurs on the right side, the symptoms will be as follows:
- severe headache with vomiting and nausea;
- it is difficult for the patient to make any movement due to almost absolute weakness;
- visual function decreases, often the picture bifurcates;
- vertigo with impaired spatial orientation;
- memory lapses, disturbances of touch and speech.
Important! Time in the case of ischemic stroke is extremely important, because the symptoms develop gradually and become acute in 5-6 hours.
- severe headache with vomiting and nausea;
- it is difficult for the patient to make any movement due to almost absolute weakness;
- visual function decreases, often the picture bifurcates;
- vertigo with impaired spatial orientation;
- memory lapses, disturbances of touch and speech.
Neglect syndrome
Most patients develop neglect syndrome after a cerebral infarction. It is characterized by neglect of perception of half of the space on the opposite side of the affected brain. The patient does not see objects located in another part of the space, or does not respond to sounds coming from one side. He may not feel his own paralyzed limb.
Problems may also arise in the area of social perception - the patient may not distinguish the intonation of speech, or respond inadequately to ordinary stimuli. In this case, he faces isolation from other people.
First aid
Vascular rupture occurs at lightning speed. Therefore, an elderly person who has had a stroke should be given first aid as soon as possible:
- you should quickly call an ambulance;
- Before doctors arrive, place the victim in a horizontal position;
- if a person begins to vomit, his head, and if possible, his body, should be turned to the side;
- free the oral cavity from dentures;
- ensure a flow of fresh air, unfasten the tightening elements of clothing, the top buttons.
Causes and nature of the disease
The main causes of the disease are:
- hypertension and atherosclerosis;
- genetics and heredity;
- pregnancy, taking contraceptives;
- traumatic brain injury;
- great emotional shock or great physical exertion;
- obesity and diabetes;
It is worth noting that these are not all the reasons for the development of stroke, since epilepsy, migraines, and mental disorders often become prerequisites. In this case, the patient is faced with the gradual death of nerve cells in the brain due to blockage of blood vessels and poor supply of oxygen and glucose. When capillaries or vessels rupture, hemorrhage may begin in the brain or a certain lobe, from which the cerebral cortex suffers more deeply.
Treatment Options
Treatment of stroke in older people can be carried out differently, depending on the degree of damage to the blood vessels and brain.
Hospital treatment
A small-focal stroke is treated in the neurological department of the hospital as a mild pathology. If the stroke is extensive, surgery may be necessary. Doctors choose the treatment method based on examination results. Accurate diagnosis and intensive treatment increases the chances of survival, not falling into a coma, and not becoming disabled for the elderly.
Procedures
When the patient's condition allows him to move freely, he is prescribed:
- compresses;
- pain-relieving ointments;
- therapeutic exercises;
- physiotherapy.
Such rehabilitation measures are prescribed when the consequences of ischemic stroke in the brain of elderly patients lead to impaired motor skills.
First, the physical therapy doctor himself moves the patient’s limbs. Then the patient does gymnastics without getting out of bed. Patients begin to get up, sit, and walk under the supervision of a doctor when their health allows.
When older people have sleep disturbances due to stroke, they are prescribed sleeping pills.
After a stroke in old age, the speech apparatus is sometimes impaired. In this case, after examination by a speech therapist, the person is taught to speak, read, and write again. Patients with mild pathology recover completely over time. Speech impairment in elderly patients with severe stroke is sometimes only partially restored.
Doctor's supervision
Rehabilitation of older people after a stroke is carried out under the strict guidance and supervision of doctors with the necessary specialization:
- speech therapists;
- massage therapists;
- physical therapy doctors;
- physiotherapists;
- neuropsychologist;
- psychotherapist.
Patients are prescribed training on simulators to restore motor functions. To restore speech faster, you need to communicate more with others, a speech therapist, and listen to the radio and TV.
Home treatment
The recovery period after ischemic stroke in elderly people continues after discharge from the hospital, where intensive treatment was provided. Rehabilitation lasts several months, sometimes a year, or even more. It all depends on the efforts of the patient himself and the degree of brain damage. You can do gymnastics and massage at home, periodically visiting a psychotherapist and neurologist.
Complications
The nature of complications after a stroke in a man depends on his age . Young patients have a better chance of recovery than older people.
In young age
In the absence of timely assistance for a stroke, a young person begins to develop pathological abnormalities. These include:
- convulsions;
- motor activity disorders;
- temporary or partial memory loss;
- hearing loss;
- paralysis of parts of the body, including arms and legs.
During rehabilitation, motor activity can be restored. However, loss of coordination will continue for six months after the attack. In most cases, recovery in young people is faster and more successful than in older people. The number of deaths varies from 1.5 to 7%.
At a young age, it is easier to restore speech functions. After rehabilitation, the young man can return to his normal life, observing only a number of recommendations and contraindications.
Home care
Many older people live long after a stroke, so they need home care. Close people should know what changes have occurred in a person and treat this with understanding.
The consequences of a stroke in old age manifest themselves in different ways:
- slow movements;
- paralysis of one side of the body or complete;
- memory loss, partial or complete;
- loss of speech skills, partial and complete;
- aggression;
- poor arm or leg function.
Care instructions
Relatives should pay attention to what the patient needs help with. For some, it’s enough to help comb their hair or brush their teeth. And the other person found himself bedridden.
Prognosis for elderly patients
The prognosis for elderly patients is not comforting; the risk of death is high; most often, if a repeated major stroke occurs, they fall into a coma, staying in it for no more than seven days and subsequently die without leaving it. The chances of survival are minimal. But it is important to understand that everything depends on the overall picture of the course of the disease. What is the focus of the brain lesion and its location, is there atherosclerosis, hypertension or vascular diseases of the neck. While in a coma, the patient does not breathe on his own, he has a fever and due to low pressure the movement of blood throughout the body is disrupted, and the following are also possible:
- Paralysis of any part of the body or the whole body.
- Paresis.
- Prostration.
- Confusion of speech and consciousness.
- Lack of swallowing movements.
- Hearing loss.
- Psychical deviations.
- Problems with urination.
Question: what to do
There are several options for organizing patient care.
Caring for yourself
Set aside time to help your family, take turns on duty, quit your job. The family has to adapt to new circumstances.
Hire an assistant
Those who cannot quit hire a paid assistant who performs all care procedures.
Invite a social worker
The social assistance service can assign a worker who will do the necessary work by agreement free of charge.
Choose a boarding house for the elderly
Today, many boarding houses are open that specifically care for elderly people who have survived a stroke or a ruptured aneurysm. Everything is organized here to restore health and prevent recurrence of problems.
Pneumonia after stroke
Pneumonia, like other inflammatory processes or infections, develops in all patients who have had a stroke. This happens due to the fact that the immune system drops sharply, the overall tone of the body deteriorates and it is simply not able to fight all the problems. Pneumonia also begins due to the accumulation of fluids in the lungs, poor air permeability, then this leads to difficulty in transporting oxygen to the cells through the blood, inflammation begins in just a couple of days. And it is important to treat it immediately, otherwise there is a high probability of a second attack and death.
Probability of disability
The decision to assign a disability group is made by an expert commission consisting of a group of doctors. The basis for this is a medical report that describes the diagnosis and degree of capacity of the victim. Depending on how limited the actions of a person who has suffered a stroke are, he is assigned one of the following groups:
- The third group is mild limitations of motor and cognitive functions, self-care and ability to work.
- The second group includes severe disturbances in orientation, movement, communication, self-care and self-control of behavior.
- The first group is severe impairment or absence of basic life support and self-care functions.
Every year, a stroke victim must undergo a commission to confirm the previously assigned disability group. If any changes are noted in the patient’s condition, his group may be revised. The exception is women and men over 55 and 60 years of age, respectively. For them, the disability group will not be re-examined in the absence of significant changes in a positive direction.
Coma after stroke
There is a high probability of developing coma after a stroke when there is significant damage to brain cells and untimely medical assistance. The main signs of coma are:
- unconscious state;
- lack of response to external stimuli such as sound, light, pain, touch;
- spontaneous act of defecation or urination.
Depending on the size of the lesions and the degree of damage to brain cells, there are four stages of coma after a stroke:
- Minor damage to brain cells. The victim has impaired or absent consciousness, while reflex functions are preserved. Doctors' forecasts in this case turn out to be positive; there is a high probability of the victim's recovery in a short time.
- Moderate damage to brain cells. The victim falls into deep sleep, breathing becomes noisy and intermittent, convulsions appear, and the reaction to touch and pain disappears.
- Significant damage to brain tissue. The condition described above is aggravated by a strong decrease in body temperature and blood pressure.
- Extensive death of brain tissue. The prognosis for life is negative, since the brain tissue is severely damaged and cannot be restored. At the 4th stage of coma, the victim dies.
The time factor plays a key role in the recovery of a patient after a coma. For a favorable prognosis after a stroke, it is important to recover the victim from this state within an hour.
Ischemic stroke: consequences
- Limitation of motor functions – it is difficult for the patient to perform simple movements of the limbs.
- Decreased memory and orientation – there is forgetfulness of basic things (house or telephone number, name, residential address), loss of time and space.
- Decreased sensitivity of the facial nerves and limbs.
- Speech impairment is characteristic of a left-sided stroke and is expressed in the difficulty of pronouncing simple words and phrases, their incoherence and illegibility.
- Swallowing reflex disorder.
- Mental disorders - depression and feelings of hopelessness are replaced by aggression, anger, panic attack.
- Epilepsy.
- Involuntary urination and defecation.
Positive prognoses for recovery after an ischemic stroke are quite high, provided that drug treatment is started in a timely manner and detailed implementation of the rehabilitation program recommended by doctors.
Right side stroke: consequences
Despite the fact that a stroke localized in the right hemisphere has less severe symptoms, its consequences can be more serious compared to a left-sided disease. Due to mild initial signs and late diagnosis of stroke, brain cells are subject to deeper and more extensive damage. In this regard, the victim after an attack experiences the following consequences of a stroke:
- left-sided paralysis of the limbs, body or face;
- perception and touch on the left side are absent, which creates the feeling that a larger part of the body is affected;
- memory decreases in terms of the present and recent past, while even emotionally vivid events are forgotten;
- difficulty perceiving the surrounding space on the left side;
- the sense of proportion regarding the efforts made is lost;
- orientation decreases - it is difficult for the victim to determine the distance, for example, between him and the door in the room;
- vision decreases, up to blindness in the left eye;
- the swallowing reflex becomes difficult or completely disappears;
- psycho-emotional imbalance manifests itself - the patient’s mood changes quite sharply: from a depressive state and a passive mood for recovery to negative manifestations of character in the form of swagger, rudeness, lack of a sense of proportion and tact.
Victims of a right-sided stroke perceive the emerging consequences as a normal phenomenon, without noticing the limitations of vital functions.
How long do they live: forecasts for life after a stroke
The prognosis for survival after a stroke depends on the type of disease, the degree of damage to brain tissue, the competence of doctors, the effectiveness of the treatment method they selected, the promptness of primary care at the onset of an attack, and the patient’s compliance with medical recommendations.
According to statistics, the mortality rate for ischemic stroke is several times lower than for hemorrhagic stroke. Thus, 75% of patients who have suffered a cerebral infarction have a life prognosis. In hemorrhagic stroke, this figure is reduced to 35%. Within a year, up to 65% of people die from a cerebral hemorrhage, of which 15-20% do not survive the first month after the attack. The reason for the high mortality rate after a stroke is complications affecting the brain and other vital systems of the body.
