Stroke.  Drawing from the site

What is it?

Stroke — an acute circulatory disorders of the brain, leading to damage and death of nerve cells. A stroke occurs when a blood vessel in the brain is either blocked (by plaque, thrombus — an ischemic stroke) or ruptures (hemorrhagic stroke). Once part of the nerve cells die, the body loses one of the functions for which the dead cells responded: paralysis, loss of speech and other serious violations. The larger the area of necrosis in the brain, the more serious the consequences of a stroke.

According to the Framingham study, and Rochester, the overall death rate from ischemic stroke in the first 30 days was 19%, and the annual survival rate — 77%. In our country, the figures below. About 20% of patients with primary stroke die within a year.

The risk of stroke increases with age, but nowadays the disease is much younger. 40-year-old man with stroke are not uncommon. After 55 years, the risk of stroke increases with age twice for every ten years.

The prognosis of stroke depends on the extensiveness of lesions of the brain, but also on the quality of rendering first aid, speed of delivery of the patient to the hospital, and in the future — on the validity and scope of rehabilitation. From relatives and friends posleinsultnogo patient requires a lot of patience and hard work, in order to provide him with proper care during rehabilitation.

Since stroke is much easier to prevent than cure, it is necessary to monitor their health, and the appearance of risk factors to take appropriate action under the supervision of a physician.

What's going on?

Insult occurs when squeezed, blockage or rupture of blood vessels supplying thehead brain.

The majority of strokes are ischemic. On the mechanism of the development of such insult very similar to a heart attack (in fact, it is a cerebral infarction) atherosclerotic plaque, located in one of the arteries of the brain is disrupted, and the site of injury forms a blood clot — a blood clot that closes the lumen of the vessel. Brain cells lack oxygen, and if the adjacent arteries can not take the blood supply to this area for yourself, then for a few minutes, they die. Much less the artery becomes blocked fat droplets or air bubbles (fat and air embolism), thrombus in the left ventricle of the heart, or is squeezed from the outside as a result of trauma or tumor.

The reason hemorrhagic stroke is hemorrhage. This is less common but far more dangerous to life. In this case the gap defective artery wall. The cause may be an aneurysm, or loss of integrity of the vascular wallbecause of the same atherosclerosis, and precipitating factor — increased blood pressure. As a result, the blood spilled on the brain tissue. Cells die from lack of oxygen, and the spilled blood soaks and compresses the surrounding tissue, preventing proper operation.

May serve as a harbinger of stroke transient violation stroke, or transient ischemic attack (TIA). It can happen for weeks or months before this stroke. This is a "small stroke", temporarily suspending the blood circulation in the brain. Because of lack of blood brain can not function normally. The symptoms of a TIA are similar to the symptoms of a stroke, but is fully pass through 10-15 minutes. At this stage, the body still manages to quickly restore normal blood flow and to avoid irreparable.

Certain areas of the brain responsible for movement of the arms, legs, speech, vision, etc. Therefore the effects of a stroke depends on which part of the brain was an accident. This may be paralysis (complete immobility) or paresis (partial movement disorder), arm or leg on the opposite side of lesions, severe speech and writing, memory disorders, impaired sensitivity, etc.

What way?

Stroke often occurs early in the morning or late at night. His first signs are:

  • sudden numbness or weakness of the muscles of the face, arm or leg, especially on one side of the body;
  • suddenly appeared articulation difficulties or speech perception of the text;
  • sharp deterioration of vision in one or both eyes;
  • sudden loss of coordination of movements, gait unsteadiness, dizziness,
  • sharp and sudden unexplained headache.

Typically, these manifestations occur against the increase of blood pressure. If you or the person next to you there were similar symptoms, immediately call an ambulance. Remember that in this situation, procrastination really "like death." Accurately describe the dispatcher what had happened, came to a specialized neurological team.

While doctors do not come, lay sick, provide at rest and fresh air. On admission to hospital doctors evaluate cardiac and respiratory activity, provide the necessary emergency care. If necessary, go directly to the person neyroreanimatsionnoe department.


First of all, clinicians need to establish a kind of stroke. This is carried outMagnetic resonance Brain imaging (MRI), which allows to distinguish between haemorrhagic insult from ischemic and rule out other diseases, as well as the exact location and size of the affected area of the brain.

Once a diagnosis of "ischemic stroke" performed ultrasound of the neck vessels and brain, including duplex scanning and cerebral angiography and echocardiography. Additionally may require Holter monitoring (ECG recording during the day).

When the diagnosis of "hemorrhagic stroke" to determine the cause of cerebral hemorrhage is necessary to conduct angiography and Doppler blood vessels of the brain. If necessary, may need to consult a neurosurgeon.


At the stroke in the brain is formed from the dead center of the nerve cells, the position and size are determined by the degree of impairment of a function. And around and around it — the cells are said to be temporarily inactivated, "retarded." They are something and must be returned to activity. There are also those which have not previously been involved in ensuring the movement, speech, however, are ready to rebuild and to some extent take the "duty" of the victims. "Teach" them to work in the new environment, thereby removing the obstacles to the normal operation of certain areas of the brain, it is possible only through a variety of exercises. It is, first of all, is the purpose of rehabilitation of stroke patients.

Restoration of disturbed functions is slow, so patients who have had a stroke, require special attention and careful maintenance.


To reduce the chance of stroke, especially if you suffer from hypertension, regularly (twice a day!), Make sure your blood pressure. This is not that difficult: you just have to have a blood pressure monitor at home and learn to use it. It was found that only one measurement of the pressure and retaining it in the norm can reduce myocardial infarction19-21%, And reduce the number of strokes by 43-45%! In addition to high blood pressure, there is a group of risk factors for stroke, attention to which may well prolong your life, and life is full.

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