Practice diagnosis and treatment of stroke

2021-04-16 04:34 PM

Thromboembolism, or embolism, is an obstruction caused by a block (usually a blood clot) in a brain artery.

Damage to a part of the brain caused by not getting enough blood or from bleeding through the wall of a vessel. This will affect sensations, movements or functions related to the damaged brain area.

Stroke is one of the leading causes of death in developed countries. In the United States alone, stroke is the third leading cause of death, and the leading cause of death

causes lifelong disability sequelae. It is estimated that every year about 700,000 Americans suffer a stroke. Despite receiving care with the most modern medical conditions, of these, up to 25% died. Taking together the physical damage caused by the stroke and the health care costs of dealing with the condition, the United States must spend more than 40 billion dollars each year!

Overall, about 50% of patients with a stroke are expected to recover almost completely from the first stroke. Others recover more slowly. Most patients with paralysis are still able to walk again. About 5% of cases leave sequelae disabled for life and patients need long-term care.

Reason

As mentioned, a stroke occurs when there is anemia in an area of ​​the brain. The most common causes of this condition are:

Blood clot: A blockage caused by a blood clot in the wall of an artery, so the blood cannot be taken to feed a particular area of ​​the brain. About 40

50% of cerebrovascular accident is due to this cause.

Thromboembolism, or embolism, is an obstruction caused by a block (usually a blood clot) in a brain artery. This cause causes about 30-35% of cerebrovascular accident.

Cerebral haemorrhage: caused by rupture of a blood vessel and bleeding inside or on the brain's surface. This causes about 20-25% of stroke cases, but usually affects a larger area of ​​the brain, with sudden and more severe symptoms, with a much higher mortality rate. for other reasons.

Risk factors that can be considered indirect causes of stroke are:

High blood pressure weakens artery walls, allowing blood vessels to break easily.

Atherosclerosis, narrowing of the arteries, facilitates obstruction more easily.

Heart conditions such as atrial fibrillation (a type of arrhythmia), damage to the heart valves, and myocardial infarction. These are the causes of blood clots in the heart, which are then transported with the blood stream to the brain. Here, when the artery is narrow enough for a blood clot to be trapped, an obstruction occurs.

Polycythaemia vera, hyperlipidaemia, and tobacco addiction are also causes of increased risk of stroke, as they worsen high blood pressure and atherosclerosis.

Diagnose

Symptoms can come on suddenly and progress very quickly, from a few minutes to a few hours, but can also last up to a few days, depending on the nature of the brain damage.

Symptoms can occur to varying degrees, depending on the location, cause, and extent of the damage. The following symptoms are the most common:

Headache.

Dizzy.

Confusion, memory loss.

Visual disturbances.

Difficult or unable to speak.

Difficulty swallowing.

The following symptoms appear in severe cases:

Loss of consciousness quickly.

Coma .

Patients can die quickly or experience irreversible physical or mental disabilities.

Stroke in the dominant hemisphere of the brain (usually the left hemisphere in right-handed people) can cause speech and language disorders.

Damage to the motor brain regions in the right hemisphere weakens or paralyzes the left half of the body, and vice versa. Unilateral mild paralysis or hemiplegia is the result of a serious stroke.

If symptoms occur quickly and last for no more than 24 hours, then recover completely, this stage is called a transient episode of anemia.

Confirmed diagnosis requires brain tomography to exclude cases such as brain tumor, brain abscess, encephalitis or hemorrhage.

Puncture of the spinal cord for diagnosis excludes meningitis.

Tests are needed to determine the cause and extent of brain damage:

ECG.

Blood tests.

Chest X-ray.

Angiogram and magnetic resonance imaging.

Treatment

Patients who are unconscious or in a lethargic state need to have airway clearance, intravenous feeding or nasogastric tube insertion. Change patient position often to avoid pneumonia or skin ulcers.

The cases of cerebrovascular accident due to embolism, giving anticoagulants or dissolving blood clots.

Treatment with aspirin in many cases has been shown to be very effective in reducing the risk of recurrence.

Post-recovery effects such as mobility and sensation may need to be treated with physical therapy. Patients with speech disorders need to practice speaking.

Patients at high risk of recurrence should be well treated for diseases such as high blood pressure, diabetes, increased cholesterol in the blood, and especially advised patients to quit smoking.