Ischemic stroke of the heart. Heart disease and stroke

According to statistics medical practice half of the cases with a stroke attack develop within the first hour and a half, about 70% within 6 hours. From this it follows that the most effective therapeutic manipulations to save brain neurons, as possible in early dates. It is also important to note the following point that in the diagnosis of ischemic stroke - the recovery of the patient plays one of the main and basic functions. After all, this will not only help the patient to rehabilitate, but also to avoid repeated attacks, which, unfortunately, happen already in the first year.

Stroke is a disease of the heart or brain

Ischemic stroke is one of the most common cerebrovascular diseases, leading to disastrous consequences: disability or lethal outcome. According to statistics, the considered violation of the blood circulation of the brain is about 80-85% of all cases of strokes. Ischemic stroke is classified into the following three types:

1. thromboembolic stroke, this variety occurs more often than others. Thromboembolism, by its definition, means thrombosis of cerebral vessels, which is a consequence of a violation of the structure of the walls of the vessel.
2. Hemodynamic stroke, this type is the result of prolonged spasm of cerebral vessels, occurring due to a deficiency of nutrients necessary for the full functioning of the brain.
3. Lacunar stroke, which manifests itself more often in the form of motor and sensory disorders.
4. In patients with ischemic stroke, the primary disturbance occurs in the connection of the heart with the brain, as a rule, such vascular diseases, how:

• Atherosclerosis;
• Cardiac ischemia;
• Arterial hypertension;
• Rheumatic heart disease;
• Violations heart rate and other pathologies associated with the cardiovascular system.

Therefore, each person subject to the above listed diseases should be more attentive to their health. Consider some typical manifestations diseases, in the event of which, it is necessary to urgently seek qualified medical help in order to avoid complications. So the signs are:

• Malaise, weakness and (or) numbness of one half of the body;
• Discomfort in the same limbs;
• Unreasonable at first glance headaches;
• Dizziness associated with nausea;
• Speech disorders.

If the condition worsens, immediate Ambulance, diagnosis and early hospitalization. Later remedial measures carried out in a specialized ward of the neurological department.

Ischemic stroke - rehabilitation of the disease

At favorable course illness, following acute attack neurological manifestation, a period of stabilization begins. The principle of a decline in the severity of neurological clinical picture on the process of adaptation of neurons, the essence of which is that some parts of the brain are functionally responsible for the affected parts. This process is characterized by an increase in the energy and metabolic reserves of cells.

Recovery of the body after an ischemic stroke includes at least three aspects of rehabilitation:

• Motor;
• Speech;
• Cognitive.

Activities require immediate action with mandatory systematic repetition. Duration typically varies from 6 months to a year, provided that rehabilitation period runs at maximum efficiency.

So in in general terms consider sample diagram rehabilitation. Namely, what actions need to be taken, and which ones will have an extremely negative effect on the victim. Recommended physical activity on the fresh air, which includes the following markers:

• Morning exercises - be sure to adhere to daily performance, have a beneficial effect breathing exercises, rubdown;
• Dosed hiking- walking only on flat terrain with mandatory accompaniment, the pace is about 45-55 steps per minute, rest as needed;
• Independent physical exercises- it is advisable to get the complex in the office of exercise therapy.

It is possible to supplement the scheme with massage sessions and physiotherapy procedures.

The important point is psychological rehabilitation which will help the patient cope with the deterioration in the quality of life and teach him to adapt to the new situation. The main thing is that the post-stroke patient should have a sincere belief in the success of the treatment.

Disorders after a stroke affect various departments of the brain, including the place to be a fairly common phenomenon, as memory disorders. For rehabilitation, memory after a stroke is one of the most difficult and time-consuming moments of the process, which can be accompanied by both complete amnesia and short-term impairments. But only experienced specialist and the environment of loved ones will help the patient to fully restore memory.

Patient care

After stabilization of the patient's condition, it becomes possible to discharge him. Relatives and friends should ask specialists and methodologists in advance rehabilitation center how to help you recover at home.

The main point is the spiritual and emotional closeness with the victim, maintaining his faith in the success of treatment and recovery. Drug treatment carried out with the advice of a doctor, and all the necessary non-drug effects by relatives:

• Necessary exercises to restore vision, hearing, memory;
• Hygiene of the patient;
• Conducting psychological trainings;
• Maximum close interaction with a person requiring rehabilitation.

Teach the post-stroke patient to think that a person after a stroke is a common person, just requiring a little more attention than the rest. The disease given to each of us is not only a test of the strength of the body's resources, but also a signal that we need to stop and rethink life principles. Try and be able to direct all your efforts to improve health at a conscious level.

When an ischemic stroke is diagnosed, not only the victims undergo recovery, but also their closest relatives who care for him. One good advice does not exist, but it should be remembered that the process is not for pessimistic people. Remember: faith in healthy life is the only way to achieve it.

Tatyana Pimenova

2016-04-22 15:07:20

Thank you, unfortunately we encountered (Mom. What to do, my head is spinning.

Stroke (cerebral infarction) is a disease of cardio-vascular system in which the blood supply to the brain is interrupted. In the case of the ischemic type, there is a decrease or complete cessation of blood flow along cerebral arteries. With the hemorrhagic type, hemorrhage develops into the substance of the brain, subarachnoid space or ventricles.

it pathological condition known since the time of Hippocrates, who called it apoplexy. And in the middle of the 17th century, a Swiss pathologist established the main causes of the disease associated with stopping blood flow through the cerebral arteries or intracerebral hemorrhage. But it wasn't until the early 20th century that stroke was officially divided into two subtypes.

Causes of a stroke

The cause of hemorrhagic stroke is a rupture of an intracerebral vessel. As a rule, the wall of the altered artery is damaged. This is possible with aneurysm, arteriovenous malformation and some other anatomical disorders. In addition to the disturbed structure of the vessel, as a rule, there is a provocative factor leading to an increase in pressure.

Ischemic stroke is a disorder cerebral circulation due to blockage of a cerebral artery by a thrombus.

At ischemic stroke oxygen delivery to certain areas of the brain is disrupted. The reasons for this are:

• cerebral vessels, detected in 90% of cases;
• artery, which is formed when the inner membrane (intima) is damaged;
• from the cavities of the heart or veins of the lower extremities;
• Severe spasm of the arteries in response to the release of catecholamines (stress hormones).

Stroke is more common in men. This is due to the fact that they are at risk for. Unlike women who hormonal background before menopause protects blood vessels from plaque formation, in the stronger sex even slight increase level leads to its deposition in the walls of the arteries. In addition, men are much more likely to smoke and abuse alcohol, and bad habits also significantly increase the risk of stroke.

Other risk factors for cerebrovascular accident are low mobility, overweight body, malnutrition.

Stroke Symptoms

Signs of a stroke are approximately the same for ischemic and hemorrhagic form, however, in the latter case, the disease proceeds more rapidly.

Common symptoms of a stroke include:

• Headache;
• Nausea and vomiting associated with intracranial pressure;
• An epileptiform seizure, which can be confused with an epileptic seizure;
• Hand tremor;
• Coma due to increased cerebral edema and displacement of median structures;
• Violation of breathing and heartbeat caused by damage to the brain stem.

Rigidity neck muscles typical for subarachnoid hemorrhage. Stroke in women often presents with atypical symptoms that include pain in the heart, face, and extremities, as well as rapid heart rate and shortness of breath.

Focal neurological symptoms depend on the specific localization of the lesion. It may appear as:

• Paresis or paralysis of the upper or lower extremities;
• Asymmetry of the face associated with a violation of the innervation of the mimic muscles;
• When the focus is located in frontal lobes characteristic mental changes up to acute delirium;
• Paresthesia and other sensory disturbances;
• Various speech changes;
• Oculomotor disturbances and changes in pupil size.

For more late stages diseases are joined by signs of pathology of other organs, as complications of a stroke develop. The most serious of them are purulent-septic, manifested by infection of the respiratory, urinary and other systems. In addition, due to limited mobility, limb contractures and soft tissue bedsores can form. Due to violations of the digestive processes often develops peptic ulcer including bleeding.

Diagnostics

A stroke can be suspected based on the examination of the patient and the collection of anamnesis, but to clarify the nature and area of ​​damage, it is necessary to perform an objective study.

To detect hemorrhage, it is enough to carry out computed tomography, which will give clear characteristics of volumetric education. Also, using CT, you can determine the degree of edema and dislocation of the brain, the presence of blood in the ventricles.

To identify the focus of ischemia, it is desirable to conduct, while not always in the early stages you can get full information. Since the focus of necrosis gradually increases, reaching a maximum by the third day of the disease.

An objective method for studying blood vessels is X-ray contrast angiography, in which it is possible to determine the dynamics of blood flow through the arteries.

It is desirable to supplement the picture with a blood test and cerebrospinal fluid, but it is allowed to conduct it only after receiving CT data, since there is a risk of wedging the brain stem into the occipital foramen and the patient from stopping breathing.

Stroke treatment

The treatment of a stroke (also known as a cerebral infarction) is a rather difficult task, since the brain tissue is most sensitive to the effects of a damaging factor. It is known that without oxygen, a neuron can live no more than 6 minutes, and then its death occurs. Therefore, the doctor has very little time to manage to save at least part of the brain. The situation is aggravated by the low awareness of patients, which is the reason for the late seeking medical help.

Medical therapy

As an etiotropic therapy for ischemic stroke, thrombolytic drugs (streptokinase, actilyse) are used, which dissolve the artery that has closed the lumen. In connection with high risk hemorrhagic complications, it can be carried out only in the absence of contraindications and in the first 4 hours of the disease. With a cerebral hemorrhage, they can also be used, but for more later dates. To do this, a thin catheter is inserted into the area of ​​​​the hematoma, through which a thrombolytic agent enters. After dissolution of the thrombus, it is aspirated with a syringe.

To maintain life, all means of emergency medicine are used:

• ACE inhibitors at high blood pressure;
• Dopamine for hypotension;
• Beta blockers and blockers calcium channels with spasm of the arteries and palpitations;
• Diuretics (mannitol) - to reduce intracranial hypertension;
• Tools for improvement rheological properties blood (rheopolyglucin) only in ischemic stroke;
• With electrolyte disorders - saline solutions.

In case of violation of breathing and heartbeat, the patient is connected to the device artificial ventilation lungs and install a temporary transvenous pacemaker.

For treatment infectious complications apply various antibiotics, the appointment of which should be taking into account the data of the culture of the microorganism and the determination of sensitivity.

Surgical intervention

Surgery is the most effective method treatment of hemorrhagic stroke. In this case, the hematoma is removed, and in some cases a decompression craniotomy is performed to reduce increased intracranial pressure. If an artery defect is detected, it is sutured or a special hemostatic clip is applied.

Apart from open way operations, it is possible to perform a minimally invasive intervention, in which all manipulations are performed through a puncture in femoral artery. Using this method, it is possible to embolize the aneurysm cavity with special coils in which a thrombus forms. After that, blood flow in it becomes impossible.

Folk remedies for the treatment of stroke

Alternative treatment of stroke should by no means be the only one, that is, it can only be used against the background of traditional methods.

• For decreasing high blood pressure you can use a tincture of red cones, which should be taken 5 ml three times a day for two weeks.
• Tincture of hawthorn and shells walnut strengthens the vessels of the brain and reduces the risk of recurrent stroke.
• For paralysis, a decoction of birch leaves is used. It is drunk half a cup a day, and also added to baths to reduce muscle tone.
• To reduce intracranial pressure, you can drink tincture on horse chestnut a teaspoon before each meal.

Before applying the methods traditional medicine you need to consult a doctor.

Rehabilitation

Treatment is aimed at restoring lost functions various bodies especially the limbs. Effective for this:

• Special massage;
• Physiotherapy;
• Physiotherapy (electromyostimulation, electrophoresis with various drugs, UHF).

To restore speech, the patient is engaged with a speech therapist. A person after a stroke is strictly forbidden to drink alcohol, smoke, eat fatty foods.

- restoration of lost functions of various organs, especially limbs.

The prognosis of the disease is determined by the volume and nature of the lesion, as well as the timeliness of the treatment. In most cases hemorrhagic stroke is more severe than ischemic, and more often leads to death.

Regardless of the nature of cerebrovascular accident, the condition is quite dangerous and can lead to the patient. The effectiveness of treatment is significantly reduced if it is not started on time, since nerve cells are very sensitive to a lack of oxygen and die quite quickly under hypoxic conditions. That is why everyone should know what a stroke is and how it manifests itself in order to seek medical help in the first hours of the disease.