As it turns out, ischemic cerebral stroke in the elderly, as well as in young patients, is not a disease, but a clinical syndrome. In clear language, we can say that this is a combination of certain signs and symptoms with a common etiology. Let's find out what this condition is, how it is characterized and how the therapy is carried out.
The concept of stroke and its consequences
What is ischemic stroke, as well as how it affects later life, the relatives of those who have encountered this problem know. You can expect anything from paralysis to death.
From the point of view of medicine, such a syndrome is characteristic of the onset of cerebral infarction due to a number of reasons. A secondary cause is a decrease in cerebral blood flow. But what are the root causes, you should understand in each case.
What is happening
Regardless of the age of the patient, ischemic stroke in the elderly or young people has several causes:
- Hypertension or diabetes can lead to a lacunar attack. In this case, circulatory disorders occur in small arteries located in the hemispheres and cerebral cortex.
- Atherosclerosis of the middle or large central artery causes an atherothrombotic attack. In this case, the symptomatology develops gradually and the peak occurs during sleep.
- Clogging of the middle artery of the brain with an embolus, that is, blocking the lumen of the vessel, leads to a cardioembolic attack.
- In rare cases, a stroke occurs due to stratification of the artery wall, a high degree of blood coagulability, existing vascular pathologies (not related to atherosclerotic), and blood diseases.
- Due to a drop in blood pressure, both during physical exertion and at rest, a hemodynamic attack may develop.
It also happens that the cause cannot be determined. However, it is well known that the risk of stroke increases in smokers and patients suffering from obesity and hypertension.
Symptomatology
What is an ischemic stroke and its consequences, you can find out if you make out what are the main signs of the syndrome. Indeed, the recovery period also depends on the severity of the transferred illness. But it is equally important to understand what symptoms indicate a stroke. Among the most noticeable and most common, experts note:
- loss of consciousness;
- the inability to make movements with one or more limbs;
- disorientation;
- problems with speech;
- difficulty swallowing;
- nausea and vomiting;
- pain and dizziness;
- heat;
- sweating
- memory problems.
How is pathology detected?
It is known that the treatment of stroke in the early stages allows not only to save life, but also to alleviate its consequences. What is ischemic stroke and how to diagnose it, both neurologists, paramedics and emergency doctors know.
When visiting a patient at home, the doctor examines him and determines the need for placement in a hospital. In case of suspicion of a stroke, the patient is recommended to go to the emergency room of the neurological department. In the hospital, at first they conduct basic research, including a general and biochemical blood test, an electrocardiogram, after which the doctor makes a decision on further examinations. The most informative methods are MRI and CT. They will help to identify the lesion site, the capacity of the vessels going to it, as well as the area of the heart attack and the damage done to the brain.
Types of Ischemic Stroke
Classification in this case is carried out on several grounds:
- Localization distinguishes ischemia: carotid, main, vertebral arteries, branches of arteries and brain.
- By severity: mild, moderate and severe. With a mild stroke, neurological symptoms are mild, recovery occurs as soon as possible. The middle type does not disturb consciousness, the symptoms are characteristic of focal lesions. In the case of a severe degree, depression of consciousness is noticeable, and the treatment after an ischemic stroke of this type is long, with a mandatory rehabilitation course.
- By development speed: transient attack, small, progressive and total stroke. Transient ischemic attack is the easiest type that develops during the day. However, the attack itself lasts no more than an hour. It cannot be called a stroke in full measure, since a heart attack is not fixed here, and therefore, irreversible damage to a part of the brain is not detected. Usually, patients do not go to doctors, so they do not receive the necessary medicines, which may lead to total brain damage in the future. Minor stroke is characterized by acute impairment of cerebral circulation. You can recover after the manifestation of such a syndrome within a month. It should be noted that even long-term and high-quality rehabilitation after a progressive type of ischemic stroke does not guarantee the restoration of functions in full. A total type of pathology leads to the death of the meninges and most often to death.
- Depending on the site of damage, there are left-sided, right-sided, stem, cerebellar and extensive strokes.
How to identify the affected part of the brain
The right-sided form of ischemic stroke is expressed in paralysis of the left side of the body. Speech disturbances may also occur. If the left side was damaged, then problems with the right half of the body are observed. Paralysis is not all the consequences. With a left-sided stroke, a noticeable speech impairment and the ability to perceive what others are saying are noticeable.
Stem stroke most often leads to death, since the centers that regulate the cardiac and respiratory systems are located there. The main signs of such a lesion are nausea, vomiting, loss of orientation in space, inability to coordinate their movements.
The cerebellar appearance also manifests problems with coordination and dizziness. In this case, a coma is possible, only part of the patients can get out of it.
Extensive brain damage manifests itself in the rapid development of all possible symptoms, ranging from headache to loss of consciousness.
Consequences requiring serious rehabilitation
Often, the condition after a stroke is complicated by the occurrence of aphasia. This is a speech disorder that is caused by damage to certain brain cells. It manifests itself in the form of both partial and complete loss of ability to use speech. Understanding conversations can also be a sign of aphasia. Doctors diagnose this condition in four directions:
- The defeat in the dominant hemisphere of Brock’s center, located in the frontal lower gyrus, causes motor aphasia when the patient cannot speak, but understands speech. In this case, paralysis of the speech muscles is not diagnosed.
- Violation in the upper temporal lobe of the main hemisphere of the Wernicke center leads to the sensory type, when the patient himself cannot make sentences, and does not understand the speech of others.
- Lesions on the border of the parietal, occipital and temporal lobes of the dominant hemisphere, which can cause forgetfulness with a normal understanding of speech and the ability to communicate, are called amnestic aphasia.
- Destruction in the parietal lobe and the complexity of perceiving whole sentences are called pathology of the semantic form.
Dysarthria after a stroke is expressed by defects in the pronunciation of sounds and words. In this case, experts talk about the disruption of precisely those muscles that contribute to speech. The patient perfectly understands what they are talking with, is able to write and read to himself. This condition appears with a lesion in the frontal lobes of the posterior portions and the death of part of the subcortical structures.
Therapy of aphasia and dysarthria
These are the most time-consuming but usually modifiable disorders that are diagnosed as a result of a stroke. As neurologists say, its reversible consequences. What is ischemic stroke and how to achieve the ultimate cure in these cases, we will describe further.
Dysarthria requires patience and perseverance from others. Day after day it is necessary to teach the patient to pronounce sounds, and then add them into words. It must be borne in mind that a person perfectly understands what they want from him, he hears everything and even remembers as he said before. However, his lower jaw and oral muscles lost their skills. Special exercises will help, including the following exercises:
- protruding from the mouth of an alternately relaxed and tense tongue;
- circular movements of the tongue and its emphasis on the teeth;
- training the articulation of the whole face, i.e. lips, facial muscles and lower jaw.
It is advisable to visit a speech therapist who will help restore the function of swallowing. Mandatory and medical treatment as prescribed by a specialist who observed the patient in a hospital. And after undergoing this kind of therapy, it is necessary to consult a doctor at the place of residence, who will give recommendations for further patient behavior and taking appropriate medications.
The state of aphasia is much more difficult to correct, because there is no full contact with the patient. He either does not understand speech at all, or this function is seriously impaired. Again, it is important to take some time daily to help a stroke victim.
You should talk to him, listen to what he is trying to say. In no case should you interrupt the patient, correct his phrases and instead finish the proposals started by him.
For sensory aphasia, it is recommended to start with pictures where household items will be depicted. Therapy of motor aphasia involves the construction of speech lines. Here you can configure the person to pronounce the days of the week, months, seasons, dates of the first ten. Amnestic and semantic types of defeat require frequent communication with simple questions, the answers to which will not make a person confused at the first stage and allow them to believe in themselves.
Violation of facial symmetry
Sometimes the very first sign and difficult to treat subsequently is a skewed face. After a stroke, this defect is correctable. However, it should be understood that such a condition can be caused by damage to facial wrinkles, as well as the central nerve.
If the doctor diagnoses a stroke, and not possible in the case of the same defect of neuritis of the facial nerve, then the distorted side indicates a damaged hemisphere. The omission of the corner of the mouth on the left indicates the defeat of the right hemisphere and vice versa.
It is possible to restore a face in a number of cases, but the result is not always predictable. It is difficult to remove the asymmetry. Additional drugs are used, that is, drugs other than those that carry out therapy for the general condition of the body. In addition to following the doctor's recommendations regarding the use of medicines, it is imperative to perform special exercises. This is the only way to return facial expressions and normal expression.
Usually, the doctor prescribes drugs to restore blood circulation, relieve inflammation, normalize intracranial pressure, get rid of muscle paralysis and reduce swelling. They also carry out a massage course, physiotherapy and recommend performing gymnastics for the face. The special complex includes the following exercises:
- Raise and lower the eyebrows, then relax the muscles and repeat the movement.
- Move eyebrows.
- Frown and wrinkle your nose at the same time.
- Smile with your mouth open, close it, relax your muscles, and repeat the exercise.
- Smile with pinstriped lips.
- Put your lips in a tube.
- Close your mouth, puff out your cheeks and try to smile.
- Sing vowel sounds for as long as possible.
- Move your jaw in a circle.
- Try to reach out to your nose and chin with your tongue.
- Having moved the jaw to the left, hold it in this position, and then repeat the exercise in the other direction.
However, you should not start such movements on your own. It is better to consult a doctor. Some patients may begin gymnastics a week after the crisis, while others should wait a month. In addition, the doctor should also recommend the number of repetitions, given the patient’s health status.
What to expect
In the first few days, neurological experts prefer not to give predictions. Ischemic stroke in the elderly, as well as in young people, can cause a whole range of conditions that are often impossible to cure. Most often, difficulties arise with paralysis. Violation of the sensitivity of half of the body, if it goes away, is by no means immediately. Long rehabilitation is required. It is known that with paralysis of the right side, the prognosis is more favorable, since fewer vital organs are located here. However, well-being can also be difficult, and a person is on the verge. A return to a full life if resuscitation actions ended in overcoming the crisis, it is possible after taking a rehabilitation course, including:
- Determination of the root cause and the appointment of therapeutic measures that can stabilize the condition. This refers to lifelong medication, for example, supporting hypertension, atherosclerosis, renal failure, coronary heart disease.
- Taking drugs to thin the blood and prevent spasms of blood vessels. For this purpose, various medications are used that contribute to the normalization of blood flow.
- Prescribing drugs to bring the walls of blood vessels and their tone into correspondence.
- Monitoring and stabilization of blood pressure.
- The use of diuretics, which not only reduce pressure, but also prevent cerebral edema.
In addition to these measures, medications are often prescribed to improve heart function and lower blood cholesterol. Also, therapy should include strict adherence to diet and lifestyle adjustment.
After the crisis is over, the patient's relatives wonder how much they live after an ischemic stroke. The answer is far from clear. Statistics say the following:
- The number of deaths is 75%.
- 40% of patients in the older age category live more than a year.
- 65% of all patients are able to live more than five years.
- 25% overcome all problems, successfully rehabilitate and die in old age.
It should be noted that the severity of the post-stroke state and the quality of life of the patient are directly related to the lifestyle that he led before the tragedy. Undoubtedly, chronic diseases, rehabilitation measures, and proper medication have an effect. Increasing the chances of a full recovery will help motor activity and the desire to physically work on yourself.
What medications help to recover
There are a number of classic drugs after ischemic stroke. Most often prescribed drugs of the following groups:
- Thrombolytics: "Dipyridamole", "Ticlopidine", "Clopidogrel", "Pentoxifyline".
- Nootropics: Cerebrolysin, Piracetam, Picamilon, Aminalon.
- Anticoagulants and antiplatelet agents: Aspirin, Enoxaparin sodium, Phenylin, Warfarin, Calcium nadroparin.
- To improve the rheological properties of blood: plasma, albumin, reopoliglyukin.
- Calcium antagonists: "Nicergoline", "Vinpocetine", "Aminophylline", "Instenon", "Cinnarizine", "Vazobral".
- To improve metabolism: lipoic acid, Actovegin, Diavitol, Solcoseryl, Cytochrome.
Sometimes a special chamber is used in which the patient is placed to enrich his body with oxygen.
Relatives of the patient need to know that the process of recovery and subsequent rehabilitation is complex, it takes time and effort. Significant improvements take several months, and sometimes a whole year. The only recommendation for a close environment is to follow the instructions of the attending physician and the absence of any initiative. If you want to help the victim, any therapy is best coordinated with the doctor. This advice applies to both medical and folk methods of treating stroke, of which there are a great many on the Internet.