Cerebral infarction and hemorrhagic stroke
The content of the article:
- Signs of cerebral infarction and hemorrhagic stroke
- Consequences and complications
- Approach to the treatment of strokes
- Causes of Stroke
- Prevention
Cerebral infarction and hemorrhagic stroke differ both in the causes of development and symptoms, and in the necessary therapeutic measures. Therefore, in order to prevent the development of serious consequences, it is important to understand how these diseases manifest themselves and what primary measures should be taken.
A cerebral infarction is an acute condition caused by impaired circulation, which is caused by blockage of the cerebral blood vessels. The more familiar name for pathology is ischemic stroke. Usually, a cerebral infarction lasts more than a day and in some cases leads to disability and even death. Cerebral infarction is the most common type of stroke. Today this disease is one of the most common causes of death in the population. Mortality in this pathology is about 25%, and 40% of surviving patients remain disabled. The prognosis of the disease largely depends on how quickly the patient received medical assistance.
A cerebral infarction is called ischemic stroke.
In addition to cerebral infarction, or ischemic stroke, hemorrhagic stroke, or cerebral hemorrhage occurs. Mortality in hemorrhagic stroke is higher and amounts to 60-70%, which is explained by damage to the brain tissue not only as a result of ischemia, but also due to soaking and squeezing with blood.
Signs of cerebral infarction and hemorrhagic stroke
The symptoms of both forms of stroke depend on the location of the lesion.
General signs of the disease: headache, nausea and vomiting (usually caused by severe headache), dizziness, impaired consciousness (up to coma), blurred vision, dry mouth, cold sweat.
What is the difference between a stroke and a cerebral infarction? The difference is that with a hemorrhagic stroke, the headache is much more intense, patients describe it as unbearable, the most severe that they had to experience. Headache with ischemic stroke, i.e., heart attack, is less pronounced, and the symptoms increase gradually.
When the lesion is localized in the right hemisphere of the brain, hemiparesis or hemiplegia of the extremities of the left side of the body develops, sensitivity in the left half of the face and trunk decreases, left-handed people may experience speech impairments (in right-handers, this symptom is noted when the left hemisphere of the brain is affected), facial asymmetry (smoothed nasolabial fold, the left corner of the mouth can go down).
With a left-sided stroke, speech disorders usually develop, the right side of the trunk is affected (decreased sensitivity, paralysis). If the lesion is localized in the vertebrobasilar basin, the patient has impaired coordination of movements, disorders of the visual analyzer, difficulty in swallowing, hoarseness, dizziness, which is aggravated by throwing the head back, as well as paralysis, paresis on the side of the trunk opposite to the lesion focus in the brain.
Symptoms vary depending on which of the cerebral arteries is damaged. So, with damage to the anterior cerebral artery, paralysis of the legs (incomplete), motor aphasia (difficulty in pronouncing words), and disturbances in eye movements are noted. In case of damage to the middle cerebral artery, incomplete paralysis, impaired sensitivity of the upper limbs, lower part of the face, motor and sensory aphasia are observed. When the posterior cerebral artery is damaged, there are disorders on the part of the visual analyzer, as well as speech disorders.
Consequences and complications
Complications of both cerebral infarction and hemorrhagic stroke include congestive pneumonia (the risk of its development increases when the patient is in a horizontal position for a long time, usually more than 3-4 weeks), acute heart failure, cerebral edema (the most common cause of death after suffering an ischemic stroke), bedsores.
The long-term consequences of a stroke of any etiology are different types and degrees of neurological deficits - from mild and reversible to those leading to disability.
Approach to the treatment of strokes
An important condition for effective treatment is the patient's admission to the hospital within three hours after the onset of an attack - during this period, treatment is most effective, and the risk of developing severe irreversible disorders is small. With a hemorrhagic stroke, this requirement is easier to fulfill, since it manifests suddenly (the old name for hemorrhagic stroke is a stroke), the symptoms unfold immediately. With a cerebral infarction, the pathological condition grows gradually, it may take several hours before it becomes clear that the patient needs hospitalization, the most favorable period for therapy may be missed. That is why, despite the greater severity of hemorrhagic strokes, the neurological consequences are less pronounced in them than in ischemic ones.
The patient should be transported to the hospital in the supine position, with the head raised by about 30 °.
There are some differences in the approach to the treatment of different forms of stroke. Treatment of ischemic stroke primarily involves the appointment of thrombolytic therapy, but it is indicated only if the diagnosis is confirmed, since hemorrhagic stroke can be fatal.
With a cerebral infarction, sometimes there is a need for surgical decompression in order to reduce intracranial pressure.
For all types of stroke, it is important that the patient is taken to the hospital as soon as possible.
It is advisable to begin rehabilitation of patients after any form of stroke as early as possible, immediately after the condition has stabilized. Rehabilitation includes passive and active physical therapy, massage, physiotherapy, classes with a speech therapist, restoration of coordination of movements, as well as work with a psychologist or psychotherapist, if necessary.
Causes of Stroke
Among the main reasons for the development of cerebral infarction, atherosclerotic lesions of the blood vessels are distinguished. The main causes of hemorrhagic stroke include arterial hypertension, the most dangerous is a blood pressure level of about 150/100 mm Hg. Art.
Patients who have had myocardial infarction have a higher risk of developing cerebral infarction. So, in about 8% of cases during the first month after a myocardial infarction, the patient develops ischemic stroke, in 25% of patients it occurs within 6 months.
Heart failure and coronary heart disease increase the risk of all forms of stroke. In addition, risk factors include atrial fibrillation, diabetes mellitus and other pathologies of the endocrine system, anemia, leukemia, and malignant neoplasms. The occurrence of strokes is facilitated by a genetic predisposition, insufficient physical activity, obesity, bad habits, old age, and chronic stress.
Prevention
Prevention of all forms of stroke, as well as many other vascular diseases, is to maintain a healthy lifestyle.
Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
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