The vessels of the brain feed it and deliver oxygen. If the pressure rises, then this adversely affects the vascular walls. As a result of this, they become thinner and an aneurysm may form.
If the vessel ruptures in the problem area, then a hemorrhage occurs, and if the lumen is closed by a thrombus, then this indicates the development of a stroke. One of the most severe injuries is ischemic stem stroke.
Disease feature
Stem ischemic stroke of the brain is considered the most severe form of the disease, as this is due to the presence of important nerve centers located nearby and a high mortality rate. However, with proper treatment, you can stabilize and return to normal.
The probability of a full recovery largely depends on the size of the lesion, its location, age and the presence of concomitant diseases. In this case, dysphagia and dysarthria can be observed. Dysphagia is a very dangerous consequence, since it is characterized by a violation of the swallowing process, and a person cannot normally consume food.
Dysarthria is a speech disorder resulting from damage to the nervous system. A similar problem, together with a violation of swallowing, provokes the occurrence of bulbar syndrome.
Among the features of this type of stroke, it is necessary to highlight the occurrence of severe dizziness and impaired coordination of movement. At the same time, a person can hardly move independently.
Stem ischemic stroke is also known as cerebral infarction. It leads to extensive damage to the brain tissue, as a result of ischemia, there is a violation of normal blood circulation and blood formation. Nutrients cease to enter certain parts of the brain, leading to extensive tissue necrosis.
Often the causes of the ischemic process are associated with advanced stage atherosclerosis. In addition, among provoking factors, hypertension, diabetes or rheumatism should be distinguished. Ischemic stroke may not manifest itself at all for a long time, it develops slowly. If the patient has constant headaches, impaired coordination of movements, and there are constant dizziness, accompanied by nausea, then this is the first sign of the development of ischemia.
Main reasons
There are people in whom ischemic stroke is much more common than others. That is why it is very important for them to monitor their health. Among the main causes of stem ischemic stroke, it is necessary to highlight such as:
- high blood pressure;
- heart diseases;
- high blood cholesterol;
- diabetes;
- bleeding disorder;
- alcoholism and smoking;
- obesity.
With increased pressure, the vessels can not withstand stress for a long time, as a result of which their walls lose their elasticity, resulting in a significantly increased risk of rupture. That is why people who are at risk need to know the basic rules for measuring pressure.
In young people, the causes of the ischemic process may be associated with:
- aneurysm, arterial hypertension, hemangioma;
- hemophilia, venous thrombosis, lupus erythematosus;
- atherosclerosis at an early age.
In older people, atherosclerosis is a common cause of this problem. In this case, blood circulation worsens, the elasticity of blood vessels is lost. Common causes of this problem are infectious diseases, vasculitis, vasopathy.
Development mechanism
Stem ischemic stroke can affect the vast areas responsible for the functioning of the body. This type of disease is becoming the leading cause of death. It is worth noting that with ischemic stroke, a significant area is affected. Blood then ceases to nourish large areas of the brain, which contributes to a more rapid softening of cellular structures.
If there is a lack of oxygen for a long time, this can lead to necrosis in the affected area. Often the pathology that triggered an ischemic stroke is atherosclerosis. The disease is especially severe if the patient has a severe somatic pathology or endocrine disorder, in particular diabetes.
In addition, the course of the disease is significantly complicated in patients suffering from rheumatic fever or hypertension. With damage to the medulla oblongata and the bridge, very serious complications are observed, which after treatment require prolonged correction and recovery.
Signs of illness
Symptoms of stem ischemic stroke are divided into autonomic, focal and cerebral. These include such as:
- impaired consciousness;
- headache, drowsiness, nausea, and vomiting;
- increase in pressure.
It is worth noting that transient circulatory disorders in the brain pass literally within a few minutes. Among other signs, you need to highlight such as:
- the appearance of weakness in the arms or legs on one side;
- it is impossible to formulate a thought, slurred speech ;
- shoots at the temples;
- visual impairment;
- tinnitus and congestion;
- memory impairment;
- increased or slowed heart rate;
- violation of thermoregulation ;
- respiratory depression;
- impossible to concentrate.
The occurrence of a stroke is often quite sharp, and this is mainly due to overvoltage. Usually this happens during the day, and at the same time the pressure rises significantly.
Initially, when a person is defeated, he shoots in the temples, and then speech disorders gradually occur. At the same time, the patient's speech becomes quiet, slurred, confused. After this, dizziness and disorientation in space are observed. A person loses the ability to swallow. Such a violation persists even if a person manages to survive.
Paralysis can be complete or partial. Basically, the defeat is one-sided, which saves a chance for a successful recovery. Ocular manifestations of a stroke are characterized by the fact that the eyeballs roll up under the eyelids or to the side where the lesion occurred.
Heart rhythm disturbance manifests itself in the form of its acceleration or deceleration. This condition is very dangerous for life, so it is important to stop it in time. Failure of the thermoregulation system is observed quite rarely, just before the death of the brainstem. Often, temperature readings cannot be aligned with medications.
First aid
First aid for stem stroke should be provided immediately after the first signs of damage. This requires the following actions:
- the patient fits in a strictly horizontal position;
- the head rises a little;
- the necessary conditions for air intake are created;
- when unconscious, the head turns to one side.
Be sure to apply a cold to the side opposite the paralysis of the limbs. The patient needs to be covered with a blanket. Before an ambulance arrives, you need to monitor your heart rate, pressure and respiratory parameters. If signs of clinical death are observed, then urgent resuscitation is required.
Diagnostics
The correct diagnosis and determination of the exact lesion area helps to choose the treatment for stem ischemic stroke, as well as to avoid dangerous consequences. In addition to conducting a survey of the victim or his relatives, an examination of the head, heart and vascular system is additionally carried out. To do this, appoint:
- computed tomography;
- magnetic resonance imaging;
- Doppler examination.
When performing tomography, doctors receive a three-dimensional image of the brain to determine the presence of damage and bleeding. In addition, blood biochemistry, ultrasound of the heart, ECG and angiography may also be required.
Treatment feature
Stem stroke treatment should be carried out from the very first hours after signs of the disease are detected. Since it is initially impossible to determine the form of the lesion, all appointments relate to the stabilization of vital brain functions and the elimination of tissue swelling. To normalize breathing, oxygen therapy is performed using a mask. In case of violation or lack of breathing, the patient is transferred to a special apparatus.
To normalize blood pressure and heart rate, antiarrhythmic drugs are introduced, as well as nitrates and cardiac glycosides. To improve metabolism, drugs with potassium and magnesium, an alkaline solution are required. The density and coagulability of the blood can be normalized using Reopoliglyukin.
Protection of brain cells is carried out using neuroprotective drugs, in particular such as Piracetam, Cerebrolysin. To eliminate puffiness of the brain, diuretics are used, sulfate magnesia is introduced. Perhaps the patient will also require symptomatic agents, in particular such as:
- analgesic;
- soothing;
- muscle relaxants;
- anticonvulsants.
Their introduction is determined by certain symptoms in the patient. Thrombolytic therapy is possible only with full confidence in the presence of thrombosis of the arteries of the brain. It is effective only in the first 6 hours from the onset of clinical manifestations.
Drug therapy
Stem stroke is a dangerous condition that threatens the patient's life, so it requires immediate treatment. The prognosis of the course of the disease largely depends on how quickly the therapy was carried out. All patients, without exception, must be hospitalized in a specialized department.
The optimal period for starting therapy is the first 3-6 hours from the onset of the course of the disease. The patient should spend the first week after the defeat in the intensive care unit. When the acute period passes, it is possible to transfer to a common chamber.
If there is a violation of swallowing and a cough reflex during a trunk ischemic stroke, pulse oximetry is required, which allows you to saturate the body with oxygen. Such drugs as Dibazol, Labetalol, Klofelin, Captopril are used to correct pressure. In the acute period, drugs are administered intravenously, and the level of pressure is strictly controlled. After this, the transition to oral administration is possible.
Some patients suffer from hypotension, in which hypoxia and damage to neurons are somewhat enhanced. To correct this condition, infusion therapy with special solutions is carried out, and then vasopressor drugs are used.
Be sure to strictly control the biochemical parameters of blood. With a decrease in sugar level, glucose is required, and with its increase insulin is required. Infusion therapy is indicated for a sharp deterioration in blood circulation. It is also used to prevent the occurrence of cerebral edema.
Almost all patients with a stroke have a fever, since the center of thermoregulation is located in the affected part of the brain. To reduce it, you need to use "Ibuprofen", "Paracetamol", "Naproxen." A good result can be obtained by intravenous administration of magnesium sulfate.
An important step in the treatment of brain stroke is the elimination of edema. To do this, apply such means as:
- osmotic diuretics;
- the introduction of a solution of albumin;
- muscle relaxants.
In especially severe cases, if it is not possible to stabilize the pressure, muscle relaxants and sedatives are used at the same time, as well as mechanical ventilation. If this does not bring any result, then surgery is performed. The operation helps reduce pressure from the area of the brain. Symptomatic therapy includes:
- anticonvulsants;
- drugs for nausea;
- sedative medications.
Specific therapy involves the implementation of thrombolysis, as well as the introduction of special drugs that help restore blood circulation through a thrombosed vessel. Antiplatelet therapy consists in the introduction of "Aspirin", and in some cases, the use of anticoagulants is indicated. All these methods of therapy are selected strictly separately for each patient.
Specific therapy implies the use of neuroprotectors. Surgical removal of the hematoma is quite difficult due to its in-depth location.
Rehabilitation measures
Necessarily requires rehabilitation after a stroke, as this will achieve very good results and normalize well-being. If there are problems with the swallowing process, but motor activity is not impaired, then classes with a speech therapist are required.
In case of problems with movements, it is important to restore the normal functioning of the limbs in the first 2-3 months, since after that the dynamics is significantly reduced. If during the year after the onset of the disease, motor activity did not normalize, then subsequent rehabilitation will be significantly more difficult.
It is impossible to eliminate respiratory distress during a stem stroke on its own. The prognosis of rehabilitation is disappointing, as patients can not do without artificial aids. With a partial violation of the center of respiration in patients during sleep, there is a slight shortness of breath.
Violation of the heart and thermoregulation practically cannot be corrected, as this may indicate atrophy of brain cells.
The recovery process takes a lot of time. Even with a minor and localized brain damage, it is almost impossible to completely eliminate all available changes. In the process of patient rehabilitation, he is prescribed exercise therapy and visits to additional rehabilitation procedures. The first classes are performed lying down, and they are aimed at the full restoration of the required motor functions of the limbs. Over time, exercise therapy is prescribed to restore facial expressions and speech functions. Massage and manual therapy are very good. There is also evidence of the effectiveness of magnetotherapy, as it has a positive effect on the restoration of nerve endings.
Forecast
The prognosis of a stem stroke largely depends on the characteristics of the onset of a change in the part of the brain stem that is responsible for a certain function of the body. Depending on the location of the damage, the main signs of damage are manifested. Often, after hemorrhage, speech disorders of varying severity are observed. They appear in the form of a very quiet speech, which is made inaudible.
When conducting rehabilitation, it is quite difficult to regain previous skills, despite maintaining clarity of consciousness, patients experience certain problems with speech and cannot independently correct it. In this case, the prognosis for life cannot be considered favorable.
With timely treatment, the results can be very good, and it is possible to achieve full recovery. If the focus of ischemia in the brain stem is large enough, then this can be fatal, often leading to disability. After treatment, the result may be unstable, and further rehabilitation therapy is often required.
Possible consequences
After an acute cessation of blood flow to the brain, various neurological disorders remain. They appear in the form of impaired movements in the limbs, deterioration in sensitivity, changes in the state of the psyche. A person loses the ability to move, the existing skills of self-care. Often there is dysarthria - this is a speech disorder that is difficult to treat, and for a long time classes with a speech therapist are required.
If weakness of the right arm and leg is observed, then this means that the lesion site was located in the left hemisphere of the brain. With such localization, functions such as:
- speech and language perception;
- memorization, reading and writing;
- understanding the meaning of words;
- mathematical abilities;
- logical and analytical thinking;
- motion control.
That is why even after the normal restoration of the required range of movements in the right leg and arm, a deterioration in mental abilities is noted. The most serious consequence is the inability to express one’s thoughts.
In ischemic stroke with a lesion localized in the right hemisphere, paralysis of the left arm and leg is observed. Muscle tone is often greatly increased, in which case a spastic condition occurs. A person does not feel pain, touch, heat and cold.
With a significant lesion, a very severe headache, visual impairment, dizziness is observed. If a person is only in a supine position for a long time, then various complications in the form of pneumonia, pressure sores, and pathologies of the urinary system join.
Prophylaxis
To reduce the likelihood of stem ischemic stroke, there is a whole range of various measures. In the case of prevention, the disease does not threaten a person. Among preventive measures, it is necessary to highlight such as:
- dieting;
- getting rid of bad habits;
- physical exercise;
- stress avoidance;
- blood pressure control.
The risk of a disease exists in a certain category of people who forget to monitor their health. In all other cases, unpleasant consequences are unlikely.