A stroke is an acute violation of cerebral circulation with a sharp depletion or cessation of blood flow in a certain part of the brain, which leads to the death of neurons and the loss of important neurological functions. This is a dangerous vascular disease of the brain, the treatment of which at various stages is carried out by several specialists. Which doctor treats a stroke in a particular patient depends on the severity of the disease, the length of stay in the intensive care unit, and the compliance with rehabilitation.
Stage of the disease and treatment
A cerebral infarction (ischemic stroke) is an acute disease of the circulatory system, resulting in neurological symptoms with paresis and paralysis, impaired speech, and muscle coordination. The extreme danger of pathology to life requires quick action, which should be brilliantly debugged in stationary health care facilities. And the patient and his relatives never have to decide on which doctor treats cerebral stroke. It is enough to contact an ambulance, whose specialists will deliver the patient to the necessary hospital.
Therapy difficulties
How to treat a stroke in a hospital should be examined in more detail. From the moment of admission, treatment tactics and, if possible, revascularization will be decided. By this term is meant the choice of a method for restoring blood circulation in the arteries of the brain, if this is appropriate in a given clinical situation. Since the possibility of revascularization is very limited in time, you should contact immediately when symptoms appear.
As a method of revascularization, thrombolysis is most appropriate, for which it is necessary to apply before 3 hours from the moment of the occurrence (but not detection) of symptoms, after which, based on the results of computed tomography, the question of the appropriateness of TLT in a particular patient will be decided. Regardless of which doctor treats a stroke, during communication with relatives or staff of the ambulance service, he must make sure the timing of the onset of the first symptoms and the absence of contraindications for TLT.
In the case of its implementation, the probability of complete regression of the disease is still quite low, since some parts of the brain died during the first 10 minutes from the development of arterial thrombosis. It is impossible to restore it, only the activation of those parts of the brain that have not died but are in a state of ischemia and hibernation is permissible. After the restoration of blood circulation, their work will reduce the amount of lost neurological functions, as well as improve the prognosis of rehabilitation and the degree of disability.
Treatment goals
Part of the functions as a result of nootropic therapy will be restored, although it will take more time than patients and their relatives wish. This is the first goal of treatment, although the possibility of restoring neurological functions, regardless of which doctor treats the stroke, is probabilistic. Treatment allows you to increase this probability and give a chance for a more effective rehabilitation.
The second goal of treatment is to prevent re-infarction of the brain. These points should be adequately understood, because the impossibility of fully restoring the functions lost as a result of a stroke is not a staff defect, but an objective inevitable reality related to the extent of the damage.
Specialists
At different stages of work with the patient in medical hospitals, where stroke is treated well, many specialists are involved. Their list consists of emergency doctors, neurologist, general practitioner, neurosurgeon, resuscitation anesthetist, cardiologist, rehabilitologist and general practitioner. The main role in the treatment is played by a neurologist and rehabilitologist, while the efforts of other specialists are auxiliary. Which physician treats a stroke depends on the current stage at which the patient is and the level of the hospital. In regional centers, the possibility of thrombolysis is most likely to be absent due to the impossibility of prompt computed tomography. In large cities and the capital, the possibility of using modern technologies can improve the rehabilitation potential.
Personnel areas
Several groups of specialists are involved in the treatment of cerebral infarction at different stages of the development of the disease and its correction. At the time of the formation of the first clinical signs of the disease in the acute period of stroke, an ambulance team is working with the patient. Its task is to stabilize the patient's condition, a preliminary solution to the question of the possibility of performing TLT, antihypertensive, symptomatic and antihypoxic therapy.
After delivery to the hospital, a neurologist examines and resolves the issue of treatment tactics, which is advised by a therapist, cardiologist and, if necessary, a neurosurgeon. The patient must be hospitalized in the intensive care unit, where the resuscitator will support the work of organs and systems. Transfer to somatic departments of hospitals (in this case, neurological) is possible only in a stable state.
Neurological department of the hospital
From this moment, rehabilitation is available, which, depending on the chosen treatment technique and the presence of complications, starts either from the first day or is delayed until stabilization. In the question of which doctor treats after a stroke, a rehabilitologist is the most obvious answer. He is working on an individual scheme, according to which attempts will gradually be made to activate the patient and restore lost functions. Among his methods of treatment are physiotherapy, massage, reflexology, ergotherapy, motor activation.
One of the main tasks of treating cerebral infarction in inpatient healthcare facilities is to prevent complications and save the patient's life. The issue of restoring lost functions is considered after stabilization, when life is not in danger. In this condition, the patient can be discharged home or sent to a hospital-type rehabilitation facility.
Rehabilitation under these conditions helps to restore motor activity and speech. The completeness of the restoration of functions for the most part depends on the amount of brain damage and the choice of treatment methods in the early stages of the development of the disease. Instructions on how to treat cerebral stroke in a particular medical center are available in standard medical care protocols, and are also based on the existing material base of a healthcare institution.
Rehabilitation and Prevention
One of the main goals of outpatient treatment and dispensary observation of the patient is to prevent the development of re-infarction of the brain. Moreover, there are almost always significant concomitant diseases, among which ischemic cardiac disease, angina pectoris, hypertension, atrial fibrillation or diabetes mellitus. This requires the appointment and administration of specialized drugs, and relevant specialists observe the dynamics of well-being, monitor the completeness of treatment.
Which doctor treats after a stroke, more precisely, after discharge from an inpatient health care institution, depends on concomitant diseases. Most often, the patient is observed and treated by a neurologist, therapist, cardiologist and endocrinologist. The most important are the efforts of the therapist, since effective prevention of re-infarction of the brain is realized mainly due to high-quality and complete antihypertensive therapy. Her appointment and control is performed by a therapist.
Observation Features
After a patient with a cerebral infarction enters a neurological hospital and carries out rehabilitation measures after discharge, he switches to an outpatient treatment regimen. Here, doctors (a local therapist and a neurologist) appoint a patient at a certain time to monitor the well-being and completeness of treatment, the actual dynamics of the disease. This is realized in the conditions of a city clinic or a medical outpatient clinic. If the patient's condition worsens or if the dynamics are unsatisfactory, the doctor treating the stroke will be routinely referred to a hospital.
The patient should remember that health care is a professional activity of medical personnel, combined with the efforts of his relatives and assistants. It is unacceptable to leave a patient with existing impaired functions without adequate supervision. You also need to monitor whether he is actually taking medications that are prescribed in a hospital or clinic. Often, due to inadequate observation of relatives and the inability to self-care, medication is ignored, as a result of which a repeated stroke develops.