Signs of stroke in women over 60 years of age, treatment and prognosis

About microstroke

“Micro-stroke, symptoms, first signs in women” is the topic of our article today.

Minor stroke, transient ischemic attack (TIA) , transient cerebrovascular accident - different names for the same vascular process - micro-stroke.

A microstroke is a local lesion of the blood vessels of the brain , has a number of similar symptoms to a large stroke, but its manifestations are not so pronounced, and the attack is characterized by “transience”, lasting from several minutes to a day.

Men and women can be equally exposed to transient ischemic attack , but due to the natural differences between male and female bodies, the course of the process will differ in the clinic.

Test "IMPACT"

How to recognize a stroke: characteristic symptoms
Due to the abundance of symptoms, recognizing a stroke at a young age can be difficult. Signs of apoplexy are especially often ignored by others in men who are mistaken for drunks. You can distinguish the clinical manifestations of an acute stroke using the “IMPACT” test:

• Smile – Ask the person to smile. A characteristic symptom of a stroke is one of the tips of the mouth lowered down and the other raised;
• Movements – Ask the victim to raise both arms up at the same time. A bad sign is that one limb is lower than the other or lowered.
• Articulation – ask the patient how he is feeling. An incomprehensible answer, the victim confuses, drawls words, sentences sound unnatural - a typical manifestation of a cerebral infarction or intracranial hemorrhage.
• Reaction – did at least one symptom coincide? Call an ambulance immediately.

Differences between a microstroke and a stroke

A microstroke is a transient circulatory disorder in the cerebral vessels . It occurs against the background of constantly elevated blood pressure, its sharp rise, or atherosclerosis, when cholesterol plaques are deposited on the inner walls of blood vessels.

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The mechanisms of development of TIA and stroke are the same, they are similar in manifestations and symptoms:

1. Bursting pain appears in the back of the head.
2. You can clearly feel the blood pulsating in your temples.
3. The sense of orientation disappears even in a familiar, familiar space.
4. Limbs become numb and swollen. Swelling begins in the toes and feet, then swells in the fingers and forearms.
5. Hyperhidrosis begins - increased sweat production throughout the body.
6. The heart rhythm is lost.
7. Both with a micro-stroke and with a large stroke, dizziness, fainting, and loss of consciousness are noted.
8. In both the first and second cases, a change in vision is noted: “spots” or colored spots or circles appear before the eyes. At the very beginning of attacks, objects may look unnatural
9. bright and clear, after a few minutes the colors fade, the surroundings are seen as if through a veil or fog.
10. Loud sounds and bright colors begin to irritate.
11. Paresis develops.
12. Dysphagia develops - a violation of the swallowing reflex.
13. Facial facial muscles are affected. And as a result, facial distortion occurs. A crooked, lopsided smile appears on the face, and the corners of the mouth droop.

Both during a stroke and during a transient ischemic attack, the whites of the eyes may turn red. In both cases, confusion and speech disturbances may occur, when it becomes slurred and difficult to understand.

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With all this, the processes differ in clinical picture:

1. The symptoms of a microstroke are less pronounced.
2. All manifestations of TIA disappear in a short period of time, the maximum duration of an attack is 24 hours, but usually it lasts no more than a few minutes.
3. With a microstroke, a rapid heartbeat is observed, the skin of the face turns red; With a major stroke, the heart rate slows and the face turns pale. Facial pallor during a stroke is an alarming sign indicating a serious condition of the patient.
4. With a microstroke, paresis develops - partial loss of motor activity; with a stroke, complete paralysis of the upper or lower extremities is possible.
5. With a major stroke, large vessels supplying a given area of ​​the brain are blocked or ruptured and, as a result, necrosis of the affected area and death of its nerve cells occurs. With a microstroke, small vessels are affected - capillaries and arterioles, the recovery of which occurs faster.
6. In case of a microstroke, examination for the Babinski reflex will always give a negative result.
7. With TIA, there is no enuresis; with a stroke, urinary incontinence is one of the constant symptoms.
8. With a microstroke, gaze paresis does not develop, when friendly eye movement becomes impossible.
9. With a microstroke, the pupils are the same size. With a stroke, anisocoria develops when one pupil is enlarged and the second is reduced in size.

This is the danger of a micro-stroke - in most cases it is endured “on your feet” , once, twice, three times, until an acute vascular catastrophe occurs, a major stroke.
In case of a stroke, doctors have negligible time left to save the patient - only four and a half hours.

How to treat

A person is treated for a stroke in a hospital, where constant monitoring is provided. During therapy, the following activities are carried out:

1. The cause that caused the stroke is eliminated. This could be a sharp increase in blood pressure due to hypertension, vascular atherosclerosis, ischemia, or kidney problems. The patient's condition is stabilized with the help of medications.
2. Blood flow is restored. For this purpose, agents are used that thin the blood and eliminate vascular spasms. But if a hemorrhagic stroke occurs, in which there is severe bleeding and the walls of the vessels rupture, then it is necessary to reduce the blood pressure on the vessels.
3. Medications are prescribed to improve the tone of the vascular walls.
4. Blood pressure is normalized with the help of drugs injected into the blood.
5. Diuretics are taken to lower blood pressure and prevent brain swelling.

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For stroke in older people, medications are prescribed to maintain heart function and reduce cholesterol in the blood. The treatment also includes a diet that must be strictly followed. The person’s lifestyle is also adjusted.

Distinctive features of female and male microstroke

Despite the similarity of symptoms and clinical picture, there are a number of specific differences between a “female” microstroke and a “male” one :

Features of the manifestation of the disease

Due to the low prevalence of the pathology and ingrained stereotypes, most people under 45 years of age deny the possibility of developing a stroke. American scientists conducted an interesting survey of 1000 men and women who were described the symptoms of a stroke. When asked what their next steps would be, only 30% of respondents said that they would seek medical help. Other people would prefer to monitor their condition and only if their health deteriorates significantly would they call a doctor.

Such an incorrect assessment is very dangerous. After all, doctors have only 3 hours from the moment the first signs appear to make a diagnosis and begin treatment. Therefore, it is very important for young people to know the symptoms of a stroke and be able to recognize it.

Specific signs of apoplexy include:

• weakness/paralysis of an arm, arm, leg, or all four limbs;
• loss of mobility of half of the face;
• violation of spatial orientation, coordination;
• decrease/loss of pain, tactile, temperature sensitivity;
• slurred, slow, mumbling speech with atypical construction of phrases and sentences;
• lack of adequate response to questions;
• unilateral hearing impairment;
• pupil trembling.

Specific symptoms may be supplemented by:

• fainting;
• convulsions;
• headache;
• dizziness;
• nausea;
• vomiting;
• ear noise;
• swallowing disorders;
• inhibition or, on the contrary, excitement.

Ischemic and hemorrhagic forms occur in different ways. Cerebral infarction (ischemic stroke) is characterized by a smoother onset and a gradual increase in symptoms. Fainting, nausea, vomiting, and convulsions are rare. But paresis, paralysis or speech impairment are almost always present.

It happens that after 10-15 minutes the patient’s condition improves. This phenomenon is called a transient ischemic attack (TIA) or mini-stroke. Despite its deceptive ease, it also requires emergency hospitalization and full treatment. Because the risk of a full-blown stroke, especially considering the specificity of its causes in young people, is very high.

With cerebral bleeding, the attack begins suddenly, often with fainting. Other symptoms: paresis, paralysis, speech impairment, coordination, and severe headache appear quickly. It is often accompanied by convulsions, nausea, and vomiting.

The course of stroke in men more often corresponds to the classic clinical picture. For women, atypical forms are more typical, occurring without paresis or paralysis, but with fainting, dizziness, shortness of breath, and visual impairment.

Early subtle signs of microstroke in women

Early neurological symptoms depend on which part of the brain is affected by the ischemic attack.

So, if the blood vessels of the parietal lobe are affected, there is a decrease or complete loss of tactile sensitivity . It is impossible to determine the characteristics of an object with closed eyes, it is impossible to determine whether it is cold or warm, what kind of surface it has, smooth or rough; What shape is it - square, round, triangular.

When the occipital lobe is damaged, ophthalmological problems : vision decreases, it is impossible to visually identify even well-known objects.

The manifestations of a microstroke are surprising when the temporal lobe is affected. There are lapses in memory and a feeling of “déjà vu” - “recognition of the past,” a mental state when a person “remembers” a place, situation or event.

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The following are considered as common and earliest manifestations of microstroke in women:

1. Semi-fainting conditions, accompanied by constant dizziness and severe headaches.
2. Nausea, retching, or vomiting directly.
3. Redness of the face and whites of the eyes.
4. Characteristic tingling in the limbs.

Consequences and what are the chances of survival

The chances of surviving a stroke and recovering will be in the following cases:

• the hematoma in the brain tissue, formed as a result of hemorrhage, is small in size, and this was confirmed by examination;
• during the first 5 days after the stroke the person did not lose consciousness;
• no problems with the functioning of the cardiovascular system;
• There are no surges in blood pressure, it remains normal.

A stroke after 80 years of age gives a disappointing prognosis. Recovery is slow and depends on which hemisphere of the brain is affected.

If a person’s right side is paralyzed, this means that the hemorrhage occurred in the left hemisphere. With a stroke on the right side, the prognosis is favorable due to the fact that the diagnosis is made faster and treatment begins immediately. The pathology can be determined by the main symptom: in this case, speech function is impaired.

With a lesion in the right hemisphere, the left side of the body is completely or partially paralyzed. In this case, the functioning of some internal organs may be disrupted. A stroke on the left side is manifested by the following symptoms:

• paralysis of the left eye or loss of vision occurs;
• hearing is impaired partially or completely;
• the left arm and leg are completely or partially immobilized, the person cannot estimate the distance from the arm to any object;
• there is a change in facial expression, because many facial muscles are paralyzed;
• manifestation of aggression, depression, inappropriate behavior;
• the patient does not distinguish colors and shades.

Damage to the central part of the brain leads to complete paralysis of the limbs. When hemorrhaging in the parietal part, a disturbance in the perception of heat and cold occurs, the patient may not feel pain.

How long you live after a stroke depends on its type. Patients tolerate ischemic attacks more easily, after which the chance of survival is 75%.

Hemorrhagic stroke is more dangerous in old age. 65% of victims cannot survive after it, even with timely assistance. Already in the first month after hemorrhage, the mortality rate is 20-25%. The reason for this is the complications that occur after an attack. In most cases, cerebral edema, pneumonia develops, and problems with the heart and kidneys worsen.

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After the first attack, a person has a greater chance of surviving and recovering as much as possible than after the second attack.

Noticeable signs of the disease

As the process develops, the symptoms and first signs of a microstroke in women become brighter. This is exactly the moment when a microstroke can be differentiated from other diseases:

1. Facial expressions are disrupted. When trying to smile, one corner of the mouth remains motionless, the smile turns out to be “crooked.”
2. The sense of orientation in space disappears.
3. Memory lapses begin.
4. Numbness in fingers or toes.
5. Vision is partially lost. An object or image is not completely visually perceived; only its right or left side is visible. With a microstroke, one of the symptoms is photopsia. a phenomenon where “floaters”, colored spots, zigzags or circles appear before the eyes.
6. Muscle tone sharply decreases, the body is subjected to a drop attack, when a person suddenly loses consciousness for no apparent reason.
7. In some cases, Wallenberg-Zakharchenko syndrome is observed - loss of coordination on one side of the body, unsteadiness of gait, dragging of the legs, inability to maintain balance.

Symptoms and warning signs that should prompt you to see a doctor

Symptoms of microstroke in women quickly disappear; often the disease can be diagnosed only in a medical institution.

There are several “ifs”, the combination of which makes it necessary to see a doctor:

• If severe and persistent headaches begin.
• If you see black or colored circles, spots, lightning before your eyes.
• If your heart rate and pulse rate are abnormal.
• If the limbs lose sensation.
• If control over facial expressions is lost.
• If one eye is in normal condition, and the other is half-closed.
• If speech is impaired and it is impossible to pronounce a logically completed phrase.
• If coordination is impaired and movements become uncoordinated.

Providing first aid for a microstroke

If it is impossible to quickly call a doctor, follow this algorithm:

1. The patient is placed in bed, providing unhindered access to fresh air.
2. They give you a tablet of Aspirin, Agrenox or, if they are intolerant, Clopidogrel.
3. To improve blood flow and protect brain neurons, give Piracetam or Vinpocetine.
4. Blood pressure is measured, and if its first number exceeds 200, it is slowly lowered. Furosemide or Captopril are used.
5. In diabetes mellitus, glucose levels are reduced.

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Treatment (therapy) of microstroke

When treating a microstroke, the following is prescribed:

1. Thrombolytics : drugs that kill blood clots, restore blood flow, dissolve blood clots. Indicated for micro-strokes and ischemic strokes. But their use in hemorrhagic stroke leads to the death of the patient.
2. Anticoagulants : reduce blood clotting and prevent blood clots.
3. Disaggregants : prevent blood cells from joining into a single clot.
4. Diuretics : relieve swelling in brain tissue.
5. Neuroprotectors : restorative therapy drugs that support brain cells and reduce the risk of relapse.

Treatment includes physical therapy classes, water treatments, massages, breathing exercises, and diet. An important factor in eliminating relapses and maintaining vascular activity is giving up alcohol and smoking and controlling weight.

Prevention

The main principle of primary prevention is to eliminate the possible cause of stroke in young people, as well as risk factors for developing the disease. To do this, all patients with identified pathologies of the cardiovascular system, diabetes mellitus, hypertension need to undergo a full diagnosis in a timely manner and begin treatment. It is also recommended for young people who have relatives with early cardiovascular diseases to visit a doctor and undergo a comprehensive examination.

In addition, it makes sense to start leading a healthy lifestyle:

• give up cigarettes and drugs;
• reduce alcohol consumption;
• control your weight;
• Healthy food;
• exercise.

To prevent relapse, it is important to follow the same principles, as well as follow the doctor's instructions.

Consequences of a mini-stroke

TIA does not go away without a trace. The symptoms will disappear, but the attack will happen again and again. In 300 people out of a thousand, TIA will lead to the development of a stroke - its most severe and most dangerous consequence.

There are two types of stroke development:

1. Ischemic (the most common consequence of a microstroke), when blood flow to a certain area of ​​the brain stops. It is the result of either a blood clot that has closed the vessel or prolonged vascular spasm.
2. Hemorrhagic (rarely develops after TIA, considered only as a special case) - a severe brain catastrophe, the result of a breakthrough of large vessels and hemorrhage in the brain.

During a stroke, cells in large areas of the brain die, the patient develops paresis and plegia with complete or partial loss of sensitivity, the person ceases to adequately assess the situation, memory loss occurs, and in some cases, swallowing dysfunction occurs.

In addition to the risk of stroke, recurrent TIAs threaten:

• decline in intelligence;
• memory impairment;
• changes in mental state, lack of control over emotions and their frequent changes, when from tears to aggression, from irritability to apathy and depression - one step.

Today TIA is “getting younger.” Micro-strokes are diagnosed in women who have barely crossed the 30-year mark. Neither self-medication nor letting the disease “go on its own” is permissible, because the consequences can lead to irreversible changes.

How to avoid

The following tips will help women avoid strokes in old age:

1. Constantly monitor blood pressure levels. Increased blood pressure is the first sign of a pre-stroke condition.
2. Prevent diabetes. People suffering from this disease are at high risk of stroke due to vascular problems.
3. Do not include in your daily diet foods high in cholesterol, which is deposited on the walls of blood vessels and clogs them, creating the preconditions for hemorrhage.
4. Monitor your body weight. Extra pounds cause the development of diseases that can cause a stroke (diabetes, hypertension).
5. Lead a healthy lifestyle, completely stop drinking alcohol, smoking, and follow a daily and nutritional regimen.
6. Avoid the use of hormonal drugs, because they increase the risk of blood clots.
7. Do not self-medicate. Uncontrolled use of medications can cause irreversible reactions in the body, a sharp increase in blood pressure and stroke. Any drug can be taken only on the recommendation of a doctor.

For an elderly person, a stroke is a great threat to life. Timely treatment will help avoid irreversible consequences.