Extensive brain stroke: symptoms and treatment
- 24 Jul 17:30
- What is an Extensive Stroke, Its Types of
- Causes and Risk Factors
- Symptoms of Extensive Stroke
- Consequences of Extensive Stroke
- Diagnostic Methods of
- Treatment Principles of
- Extensive Stroke Caring for
A disease like a stroke of the brain isvery relevanta medical and social problem today, as each year its encounter increases and among causes of mortality of the population it ranks second after myocardial infarction. What are the consequences of a stroke and its prognosis depend on the location of the pathological center, the causes of stroke, its type, the amount of damage to the brain tissue, and the timeliness of the provision of medical care.
The more brain neurons die as a result of a vascular catastrophe, the more severe the prognosis and the higher the risk of a fatal outcome. Therefore, extensive brain stroke is one of the most unfavorable variations in the course of the disease, accompanied by high mortality, and in case of survival, severe disability of a person.
What is an Extensive Stroke, Its Types of
Under the term of an extensive stroke, attention is given to the damage to the major arteries that feed the brain, regardless of the nature. This suffers from a large area of the nerve tissue, which often extends to all hemispheres, and sometimes to two. Accordingly, all functions of the affected part of the brain are lost, which is incompatible with the full functioning of the organism, and often with life.
In most cases, extensive brain damage is associated with the pathology of the carotid arteries and their major branches. Such a situation is most often observed in the atherosclerotic narrowing of these blood vessels. Moreover, it often happens hidden and people do not even suspect that every second he risks his life.
In some patients, a major stroke precursor is transient ischemic attack, when a small part of the thrombotic masses that are formed on plaques in the carotid arteries, with blood counts, are transferred to small blood vessels and cause temporary and circular disorders of the blood circulation in the brain.
Important! Any person who has undergone at least one transient ischemic attack is required to examine the vessels of the head and neck. To do this, a fairly simple examination - ultrasound and doppler examination of vessels, but it can save you life. When clinically meaningful narrowing is detected, doctors will suggest one of the options for surgical correction of the violation to prevent future extensive stroke of the brain.
There are 2 major types of extensive stroke:
As a rule, brain ischemia has a better prognosis than a large-sized brain hemorrhage. If the second instantly leads to the death of a patient with extensive brain infarction, you can still save.
Causes and risk factors
Ischemic stroke is caused by occlusion, prolonged spasm or compression of arterial vessels that feed on the brain tissue and occurs in 70-80% of cases. A large ischemic stroke may be atherothrombotic, when brain ischemia is caused by an atherosclerotic plaque and thrombi that are formed on it. TIA is precursors of this particular type of stroke. Also, the cardioembolic mechanism of development of a brain infarction is distinguished, when blockage of arteries is caused by embolies of cardiogenic origin at cardiac defects, arrhythmias, and others.diseases.
Very rare, but severe nerve damage can be due to hemodynamic causes, when blood pressure drops sharply, for example, in shock.
Hemorrhagic stroke is much less commonly ischemic, but its consequences are much more severe. This is due to the rupture of the initially altered wall of the arterial vessel and hemorrhage into the brain tissue. Such a situation can be observed when:
- has congenital defects in the development of cerebrovascular aureus, such as aneurysm, malformations, etc.;
- a sharp increase in blood pressure when the artery wall does not withstand the load;
- with pathological changes in the vascular wall, resulting in loss of strength and elasticity( hyalinosis, atherosclerosis, hypertension, systemic vasculitis).
Important! When it comes to a major stroke, the stem stroke should be mentioned as a type of ischemic or hemorrhagic. Though a rather small area of the brain is affected, but the pathological process is localized in the zone where all vital centers are located( breathing, palpitation, swallowing, etc.).This in 95% of cases leads to instantaneous cardiac arrest, respiration and death.
Who is at risk :
- patients who have a history of transient ischemic attack, with each subsequent case the risk of a major stroke increases;
- people who have a long history of hypertension, especially if the disease is not treated properly;
- individuals with elevated blood cholesterol and diagnosed with cerebral atherosclerosis;
- patients with pathology of the heart, when there is an increased risk of blood clots and embolisms( flashing arrhythmias, congenital and acquired heart defects, prosthetic heart valves);
- people suffering from diabetes mellitus;
- patients with asymptomatic atherosclerotic stenosis of the carotid arteries;
- individuals who have bad habits;
- people who are obese are inactive.
Symptoms of an extensive stroke
Clinical signs of an extensive stroke depend on which hemisphere has been affected by stroke type( ischemic or hemorrhagic).But, as a rule, all such cases proceed very hard with the expressed symptoms, therefore the diagnostics of difficulties does not cause.
Major symptoms of extensive stroke :
- violations of consciousness, as a rule, comes a coma of varying depths, but perhaps a simple stunning;
- severe headache and dizziness, with subarachnoid hemorrhage there is a characteristic feeling of a stroke in the head;
- vegetative manifestations - cold sweat, pallor of the skin, face redness, dry mouth, palpitations, shortness of breath, fear of death, nausea, vomiting;
- is a complete paralysis of one side of the body and facial muscles( with the damage to the right hemisphere, the left half of the body affects, while the stroke of the left is right);
- sensitive violations on the opposite side of the body from brain damage( all types of sensitivity are lost, paresthesia arises);
- speech abnormalities( aphasia) with left hemisphere stroke;
- failures in memory;
- problems with vision, hearing, smell, orientation;
- violation of coordination and equilibrium;
- mental disorders.
Often because of the immediate loss of consciousness and coma, it is difficult to immediately suspect a stroke, because in this case it is impossible to deal with speech, motor activity, sensitivity, vision. A simple test will help: you need to evaluate the state of human pupils and their response to light. If one of the pupils is wider than the other and does not react to light narrowing, then most likely, the stroke of the victim.
The Consequences of Extensive Stroke
As has already been said, a large stroke is accompanied by a high risk of death. But if a person still managed to survive, and all medical care was provided in full, then the consequences of a major stroke are as follows:
- hemiparesis of the right or left side of the body, half of the face;
- sensitivity loss on the opposite side of the stroke;
- loss of ability to speak or understand the target language( motor and sensory aphasia);
- impairment of vision, smell, hearing of different character;
- violations of swallowing process( bulbar syndrome) and paralysis of muscles of the sky;
- memory loss, inability to assimilate new information;
- violates the cognitive function of the brain, the ability to think logically, formulate conclusions, communication;
- persistent violations of coordination and equilibrium;
- epileptic seizures;
- mental disorders;
- development of vegetative state( brain death).
It's important to remember! Unfortunately, but complete restoration of brain functions does not occur when a large stroke occurs. If you make maximum effort, you can reduce the degree of manifestations of existing deviations, but to get rid of them completely will not succeed.
Suspect an extensive stroke can be based on clinical symptoms, history( risk factors).But confirmation of the diagnosis will help such additional methods as MRI and CT of the brain. In each case, the survey program includes methods that will detect concomitant illnesses, as well as timely detection of complications and eliminate them.
Principles of Treatment for
Treatment for a major stroke should begin as soon as possible and be differentiated. The patient should be urgently hospitalized in a specialized hospital. As a rule, treatment with a large stroke passes into a resuscitation, as a person often needs a connection to the system of life support.
Conduct the fight against cerebral edema, respiratory correction and cardiac rhythm, homeostasis disorders, blood pressure normalization, cramping, fever, vomiting and other pathological symptoms.
also undergo differential treatment. When ischemic stroke, thrombolytic therapy is prescribed( drugs that dissolve existing thrombi), as well as drugs that dilute blood and prevent the re-formation of blood clots.
It is important to bring a person to a specialized clinic on time, because thrombolysis can only be performed in the first 6 hours after the onset of a stroke. This procedure reduces the degree of damage to the brain tissue and improves the prognosis.
In the case of a hemorrhagic stroke, on the contrary, drugs are introduced that contribute to the formation of blood clots and stroke in the brain. If stopping it with medication fails, then a neurosurgical operation can be performed to stop the active bleeding. At times, only this can save a person's life.
. Care for a person who has undergone extensive
stroke. After the acute period of the disease has passed, and the patient and doctors have managed to overcome death, full-care care for the post-stroke patient needs to be provided. As a rule, people who have suffered extensive stroke require constant care, as they are in most cases left to bed for a lifetime. Such care can be provided both by relatives at home and by medical staff in specialist restoration facilities.
The main areas of care for a person who has suffered extensive stroke:
- fight with bedsores;
- prevention of muscular contracture formation;
- therapeutic regenerative gymnastics;
- breathing gymnastics;
- prophylaxis of congestive pneumonia;
- prevention of thromboembolic complications due to prolonged immobilization;
- prevention of re-stroke;
- Blood Pressure Control;
- ensuring thorough human hygiene and its bed;
- regular feeding in accordance with the recommended diet;
- ensures that the patient receives all the medicines prescribed by the doctor;
- rehabilitation of speech skills of a person;
- social and psychological adaptation.
Stroke. Causes and consequences.
Extensive stroke of the brain is a very serious disease that is accompanied by high mortality and severe disability. Therefore, it is very important not to allow such a walking event and to actively engage in primary prevention, especially important for people at risk.