Infarction is a disorder of the blood circulation of the brain. Problems arise because of a lack of blood supply. In this case, the nerve cells ...
Strotal stroke - how to increase the patient's chances and what is the prognosis
Elastic and strong blood vessels provide normal blood flow, and maintain a stable metabolism. With loads on the vessels, they are thinned, which leads to fragility - the risk of various diseases increases.
What causes the load? The pressure on the vessels occurs against a background of increased pressure associated with diseases or the age of a person.
Also unhealthy lifestyle, namely alcohol abuse, smoking and malnutrition become the main cause of vascular changes. The vessel can be thinned in one place and with a sudden jump in pressure it can tear due to plugging with a plaque or a high load.
Such a rupture can occur in any part of the brain, so the consequences and severity of the stroke will depend on the localization of the hemorrhage. The rupture of the vessel in the brainstem followed by a hemorrhage is called a stroke.
Contents of the brainstem
- Surgical intervention
- Medication treatment
Features of the brainstem
The brain stem connects the head and spinal cord. Through it, all the brain commands are processed by the human body, the person's motor ability depends on its normal functioning. When the integrity of the vessels in the brain stem is compromised, changes in performance may occur in the following departments:
- medulla oblongata;
- middle brain;
- varioli bridge.
These parts of the brain are responsible for breathing, blood flow, swallowing functions, facial expressions( smile, wiggling of eyelids, etc.) and thermoregulation.
In stem-stroke, many departments are at risk. Hematoma, formed due to hemorrhage, can stop the access of oxygen to the brain cells because of what they atrophy and die.
The mechanism of occurrence of the disease
Stem stroke on the mechanism of action is divided into ischemic and hemorrhagic. An ischemic stroke occurs when the vessels are obstructed due to a blockage by a thrombus or plaque. Hemorrhagic occurs when the vessel is ruptured due to thinning.
Hemorrhagic stroke is different from ischemic high rate of increase in symptoms. Ischemic infarction is the most dangerous, because the symptoms can manifest so late that the patient can not be saved.
What causes a violation of
The main causes of cerebral infarction include the occurrence of clots and plaques in the lumen of the vessels, as well as the thinning of the walls of the vessels. But in themselves such reasons do not appear, they are the consequence of the following diseases:
- constant high blood pressure( hypertension) and its jumps;
- vascular aneurysm;
- poor blood clotting;
- diseases of the cardiovascular system;
- thinning of blood vessels in the background of diabetes mellitus;
- elevated cholesterol and atherosclerosis;
- hormonal disorders that occur with improper intake of contraceptive pills.
In the presence of at least one disease a person falls into the risk group of developing a stroke stem.
Clinic of violation of
The occurrence of a stroke is always sudden, and some symptoms may be similar to other diseases, which complicates the correct diagnosis.
In 70% of untimely detection of a stroke, a lethal outcome occurs immediately or after a few days. Therefore, it is important to know the symptoms indicating a cerebral hemorrhage, since there is only 3 hours to help the patient.
The general symptoms include:
- speech impairment: words become fuzzy, speech is indistinct;
- varying intensity of headaches;
- pallor of the face can be replaced by a flush of blood and vice versa;
- impaired mobility of the eyes;
- face and whole body becomes covered with cold sweat;
- body temperature jumps, with very low to high;
- reduction in heart rate;
- numbness of hands and feet, inability to move, lift, walk;
- heavy intermittent breathing, shortness of breath;
- there are no swallowing reflexes, it is impossible even to drink water;
- the person can skew, there is an asymmetry, the patient can gnaw on one eye;
- paralyzes one side of the trunk.
Sometimes, if the brain stem is broken, complete paralysis of the body may occur, the person can not move and speak, but his mind and mind are clear, he understands everything - this happens very rarely. Clear breathing and pulse can speak about clarity of consciousness, attempts to blink an eye or move your lips.
Hemorrhagic stroke develops very quickly, which allows you to deliver a timely diagnosis. Ischemic can develop from a few hours to a day, with a slight numbness in a part of the face or body, tingling, pain in the eye, dizziness, and visual impairment of one or both eyes.
Importance of timely diagnosis of
After the onset of symptoms and first aid, it is important to perform a diagnosis to determine areas of brain damage. It depends on this, how serious the consequences will be and what is most important is how long the restoration will be.
After consultation of the neurologist, a number of examinations are assigned:
- MRI .With ischemic and hemorrhagic stroke at the initial stage of development helps confirm the diagnosis and stop its further development. In some cases, a contrast tomography can be performed.
- Cardiography .With its help, it is determined whether there are changes in the rhythm of the heart, which can indicate a violation of the intensity of the blood flow.
- Angiography of the .Detects violations in the cardiovascular system with atherosclerosis, thrombosis, etc.
- Cardiogram .
- General and detailed blood test .
- Ultrasound of cerebral vessels .
Basically, all stages of diagnosis occur in intensive care settings.
First aid in medical institution
When a stroke of the brain is confirmed, a drug that dissolves the blood clot immediately, which causes blockage of the vessel, is immediately introduced.
This will restore blood flow to the vessels of the brain, which not only improves the patient's condition, but also prevents the progression of the disease.
The lung and heart are then monitored. If the patient is unconscious, there is often a violation of breathing, to eliminate the problem in the trachea of the patient, a breathing room is added, which supports oxygen supply.
Stem stroke can not be cured, the only thing doctors can do to save a patient's life is by eliminating the cause of the stroke. Treatment depends on the severity of the stroke, as well as its type( ischemic or hemorrhagic).
In hemorrhagic cerebral infarction, the main treatment is an operation to remove the formed hematoma.
A less traumatic operation is performed using a small opening, through which a thrombolytic is injected, which resolves the hematoma.
This type of operation is contraindicated in aneurysms and other vascular pathologies, it is well tolerated by hypertension.
After the operation or after the drug restoration of the blood flow, medication is prescribed with drugs that dilute blood, control the level of pressure and heart rate, antiemetic drugs and drugs that reduce cholesterol are also used.
Stem stroke treatment is performed using the following medicines:
- Drugs that control blood pressure ( Verapamil, AD Norma, Isoptin, Kordafen).
- Anticoagulants , which promote the improvement of blood clotting( Trombin, Vikasol, Fibrinogen).
- Drugs for improving metabolism and reducing cholesterol ( Vazilip, Ovenkor, Simvastol, Sincard).
- With increased body temperature, antipyretic ( Diclofenac, Nurofen, Analgin) is prescribed.
- Hormonal preparations for restoration of functions damaged in damage to the brain stem( Epithalamin).
Drug treatment helps partial recovery, and is also necessary to stop the progression of the disease. In addition, to accelerate the recovery, massage, hirudotherapy, reflexotherapy and acupuncture are prescribed.
Consequences and prognosis
The prognosis after stroke is disappointing. Even with timely first aid, a person often remains paralyzed, partially or completely.
Major consequences of stroke of the brain stem:
- speech disorders;
- violation of swallowing and respiratory functions;
- impairment of motor abilities;
- impaired coordination;
- instability of thermoregulation;
- loss of vision.
How not to admit?
After a stroke of the brain stem to prevent complications, as well as a relapse or the onset of the disease for the first time, the following rules should be observed:
- to lead a healthy lifestyle: not to drink, to smoke, to watch weight;
- monitor the pressure and prevent its jumps;
- to avoid stressful situations;
- systematically visit a cardiologist after 45 years;
- curing existing chronic heart and vascular diseases.
Compliance with the rules does not guarantee that the disease will not break into your life, but significantly reduces the risk of its occurrence.