Cerebral infarction: how scary is this disease? Heart attack is a dangerous enemy at the gates of the brain

In modern medicine, diseases that are associated with brain are not in last place. Every year these pathologies become younger and develop more intensively.

Knowing the initial symptoms of the disease, you can prevent serious consequences in a timely manner. It is recommended that at the first manifestations of pathology, immediately consult a specialist and don't study independent treatment.

Cerebral infarction - what is it?

Cerebral infarction or ischemic stroke– a serious and complex pathology that requires quality treatment. This disease develops due to a violation or decrease in cerebral circulation, which can be caused various factors and states.

At cerebral infarction A condition may occur when blood generally stops flowing to one or another part of the organ.

This condition is considered the most dangerous for the patient and if there is extensive disruption and damage to areas, this provokes violation brain functionality, which is almost impossible to return back to normal.

At ischemic stroke There is an irreversible change in the brain tissue, which occurs quite intensively. If the patient's insufficient blood flow does not change within a few minutes, then some areas of the cerebral cortex are switched off forever.

Consequently, such consequences are considered the most dangerous, irreversible and leading to certain serious consequences.

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Types of heart attack

To assign quality and effective treatment it is necessary to accurately determine what type of cerebral infarction is progressing in the patient. In such a situation, a thorough diagnosis is required, which is carried out exclusively by specialists. We previously wrote about it here.

Lacunar

Lacunar infarction– one of the types of ischemic stroke. This pathology is represented by small-sized brain damage, which occurs due to disruption of local blood flow and gas exchange.

As for the causes, they are different and not fully established. Common reason this disease - blockage of blood vessels, which occurred due to deformation of their walls and emboli.

Lacunar infarction can develop at any time age group, but in to a greater extent patients are susceptible elderly age. In most cases, it is diagnosed in the male half of the population.

Lunar infarction

Significant risk factors for the development of pathology:

1. Hypertension.
2. Diabetes.
3. Chronic renal failure.
4. Post-infarction condition and complications.
5. Heart disease and pathologies in the bloodstream.
6. Rheumatism.
7. Heart arythmy.
8. Blood diseases.

As for the symptoms of lacunar infarction, they can manifest themselves in different ways, but in most situations short term. Everything will depend on where the lesion is located.

Hemorrhagic

Hemorrhagic stroke can have different localizations:

1. Medial.
2. Lateral.
3. Lobar.
4. Mixed.

There are only two types of this pathology - primary and secondary. As for the causes, hemorrhagic stroke in most cases occurs due to hypertension.

There are also other reasons that provoke pathology:

• diabetes;
• spinal cord diseases;
• diseases and disorders of the heart.

Symptoms of hemorrhagic cerebral stroke:

• nausea and vomiting that occurs for no reason;
• numbness upper and lower extremities;
• head pain that is systematic;
• violation skin sensitivity;
• dizziness;
• weakness;
• pulse broken.

Ischemic

Ischemic cerebral stroke – serious pathology, which is not very common. Ischemia of this organ occurs due to the blocking of blood flow by a thrombus or embolus. It can also be triggered by an atherosclerotic process.

Chronic diseases of the cardiac and vascular systems can also provoke this pathology:

1. Vices heart and blood vessels.
2. Increased blood viscosity.
3. Problems with blood circulation.
4. Rheumatic endocarditis in the active phase.
5. Pacemaker.
6. Ischemia hearts.
7. Problems with pressure.
8. Heart failure.
9. Sugar diabetes and others.

Ischemic cerebral infarction has the following severe symptoms, when they occur, it is necessary to urgently seek qualified help:

• dizziness which is accompanied by darkening of the eyes;
• numbness upper or lower extremities;
• weakness in the body or in the limbs;
• Problems with speech that occurs for a short time.

Atherothrombotic

Atherothrombotic infarction brain combined arterioarterial embolism and stroke. It is considered a serious pathology that affects the main arteries of the brain.

Diagnosed according to the following criteria:

1. Availability atherosclerotic lesion main arteries of this organ, in the place where the lesion is located.
2. Ischemic attacks.
3. Symptoms The disease gradually increases and becomes more pronounced after a day.
4. Concerning the size of the lesion, it can be different.

Stages

In modern medicine, there are four stages of brain infarction:

1. First stage of the disease. The period of exacerbation of pathology is up to three weeks. The formation of necrosis occurs within five days. Deformation of the cytoplasm and karyoplasm is also observed, and perifocal edema develops.
2. Second stage of the disease. The recovery period, which can last up to six months. The patient has pannecrosis of cells. Collateral blood flow develops.
3. The third stage of the disease. Late period recovery, which ranges from six months to a year. The development of glial scars or cystic defects in brain tissue may occur.
4. The fourth stage of the disease. A year later, the patient has residual phenomenon stroke.

Causes

The causes largely depend on the type of pathology and are therefore varied. Very often, cerebral infarction provokes blockage vessels with cholesterol plaques. The formation of this plaque occurs in the carotid artery, which disrupts the flow of blood to the organ.

Also thrombus can also form in the heart, and then, traveling through the vessels, enters the brain. This phenomenon occurs due to inflammatory processes in organism, infectious diseases and also due to drug use.

Risk factors for developing cerebral infarction:

1. Elderly patient's age. Diagnosed at the age of 80 years.
2. Diseases hearts.
3. Arterial hypertension.
4. Sugar diabetes.
5. Tobacco smoking.
6. Reception oral contraceptives.

The patient may also develop several risk factors at once.

Symptoms

This pathology can be diagnosed by the following symptoms:

1. Paralysis limbs.
2. Involuntary movements.
3. Paresis facial expressions.
4. Violation speech function.
5. Pupils begin to gradually increase in size.
6. Painful sensations are completely absent.

If the above symptoms occur, you should consult a specialist and undergo a thorough examination, which will help make the correct diagnosis and prescribe effective treatment.

Diagnostics

First of all, after the patient is admitted with pronounced symptoms, he is referred to computed tomography, which makes it possible to distinguish an outpouring of blood from a heart attack.

In the early stages of pathology, magnetic resonance imaging may be prescribed in parallel, which is not used for emergency diagnosis. MRI makes it possible to carefully study images of cerebral vessels. It is considered a non-invasive, but completely safe research method.

If it is not possible to perform a CT or MRI, then liquor research– a lumbar puncture is performed.

To study the carotid arteries, ultrasound diagnostics are performed - duplex scanning and dopplerography. Duplex scanning is considered more informative method diagnostics, as it visualizes the carotid arteries and combines Doppler examination of blood circulation in them.

Before surgery, be carried out cerebral angiography, which is carried out only as prescribed by a specialist.

Treatment

It is recommended to treat this pathology immediately after its first manifestations, without wasting a single minute. Timely help helps reduce the risk of consequences and prevent the subsequent development of cerebral infarction.

If the patient is diagnosed with the development of the condition, then prescribed drugs, which reduce blood clotting. When such medications are administered in the first hours after an attack, it helps to avoid paralysis and other serious health consequences.

It is also necessary to consider contraindications These drugs are not recommended for use when bleeding into the brain. In the first days after the attack, the patient takes medications that reduce swelling of the organ.

If the pathology is caused by blockage of the carotid artery, then it is necessary to carry out surgical intervention. The operation helps eliminate the defect, thereby reducing the threat of a recurrent attack. Surgery may also be required to increase perfusion pressure, reduce intracranial pressure, and maintain cerebral blood flow.

Prevention of heart attack is as follows:

1. Treatment arterial hypertension and heart failure.
2. Refusal from smoking and drinking alcohol, oral contraceptives.
3. Treatment diabetes mellitus
4. Control cholesterol in the blood.

Consequences

If the patient is not diagnosed with vital damage important centers, the patient is conscious, his needs are controlled, then successful treatment is carried out in a hospital, then rehabilitation measures are carried out.

Patients with lacunar ischemic stroke can expect a full recovery; other patients need to work hard to return to normal life.

As for the consequences of a cerebral infarction, they remain until the end of life:

1. Problems with the musculoskeletal system.
2. Problems with limbs.
3. A loss sensitivity of certain parts of the body.
4. Violation speech and intellectual functions.

Cause of death: stroke

If cerebral infarction proceeded with complications, this could provoke negative consequences – a stroke and, as a consequence, death. In such a situation, it is rarely possible to provide timely assistance to the patient.

Cerebral infarction – serious illness, which can cause irreversible consequences if urgent medical assistance is not provided. The first symptoms of the disease should not be ignored. To assign effective treatment, it is recommended to correctly diagnose and establish the type of pathology.

Cerebral infarction is dangerous pathology, in which there is a disruption in the supply of blood to a certain area of ​​the organ.

As a result of this process, the brain does not receive enough oxygen and nutrients, which leads to the death of its tissues.

The sooner treatment and rehabilitation are started, the less damage the organ will receive.

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First aid

If symptoms of a cerebral infarction appear, you should urgently call an ambulance. This is an emergency condition that requires immediate medical attention.

Before the specialists arrive, you can do the following:

1. If the person remains conscious, he should be placed so that the head and shoulders are slightly higher than the body. This will reduce blood pressure on the brain. It is very important to avoid shifting or moving the patient, as his condition may worsen.
2. It is strictly forbidden to give him food or drinks. With a cerebral infarction, swallowing function is often affected, which can lead to food or liquid entering the respiratory system.
3. You cannot give a person medications until doctors arrive. They can bring a lot more harm than good.
4. It is important to remove any secretions or objects from the mouth - blood, mucus, food.
5. Ensure influx fresh air. In addition, you should get rid of tight clothing that interferes with normal breathing.
6. If a person remains unconscious, but breathing function remains intact, he should be placed on his side with his head resting on his arm and leaning slightly forward. In this case, the leg must be bent at the knee to prevent the patient from turning over.
7. If there is no breathing, the person should be placed on his back and given cardiac massage and artificial respiration. In this case, the ratio of the number of breaths and heartbeats should be 2:30. Such manipulations are carried out until respiratory function is restored or an ambulance arrives. They can only be done if you have the necessary skills.

Cerebral infarction is emergency which requires urgent help. Optimal time It is considered 2-4 hours from the onset of the attack.

If you take the necessary measures at this time, you can avoid many negative consequences for good health.

Therapy

Treatment and rehabilitation of cerebral infarction directly depend on the type of disease. The attack can be ischemic and hemorrhagic.

Ischemic form

It is important to consider that it can have various forms - hemodynamic, hemorheological infarction. They all have different etiopathogenetic mechanisms of development.

In any case, to cope with a heart attack, it is very important to restore blood flow to the brain. Therefore, doctors immediately after an attack prescribe medications to destroy a blood clot or blood clot, as well as prevent their occurrence.

It is important to start treatment no later than 3-4 hours after the attack develops. Thanks to this, the prognosis for life and health is significantly improved.

To thin the blood and prevent blood clots, medications such as aspirin, cyclopidine, and warfarin are prescribed. Thanks to their use, it is possible to minimize the threat of a recurrent attack. It is important to consider that such medications can cause bleeding. Therefore, the doctor must select the optimal dosage.

In case of ischemic cerebral infarction, intravenous administration of tissue plasminogen activator is indicated. This tool promotes the destruction of blood clots. Due to this, blood supply to the brain is restored. However, this drug can also cause bleeding, so it should be prescribed with great caution.

Sometimes effective treatment is impossible without special medical procedures which are performed to remove a blood clot or treat a damaged artery. One such method is intraarterial thrombolysis. During this procedure, a drug is injected directly into the area of ​​thrombosis.

This technique involves inserting a thin catheter into a large femoral vessel, through which it is passed to the area where the blood clot is located, which helps deliver the drug there.

Thanks to this manipulation, it is possible to significantly reduce the dosage of the drug, which minimizes the likelihood of bleeding. At the same time, the procedure is highly complex and labor-intensive.

One more effective method is mechanical removal blood clot This procedure is similar to intra-arterial thrombolysis, but does not affect the blood clot. medicinal substances, and is pulled out using a special device. Using a catheter, which is equipped with a capture device, the thrombosis zone is reached, the blood clot is captured and removed through carotid artery.

To prevent a recurrence of the attack, a procedure may be required to cleanse the arteries that are severely damaged by atherosclerotic plaques. This is done surgically - in particular, using carotid endarterectomy.

In this procedure, a longitudinal incision is made in the neck to provide access to the carotid artery. It is through this that plaques are removed. After this, the doctor restores the vessel.

To increase the lumen of the vessel and normalize blood flow, angioplasty and stenting are performed. During the procedure, a catheter equipped with a special balloon is inserted into the human body through a large femoral vessel. It is then advanced to the area affected by atherosclerosis.

The balloon is inflated, which makes it possible to increase the lumen of the vessel. A stent is then inserted into this area, which prevents subsequent narrowing of its walls. Thanks to this, nutrition is restored and the likelihood of developing a cerebral infarction is reduced.

In order to prevent the development of complications, it is very important to provide the victim with qualified medical care in a timely manner.

Hemorrhagic

This form of heart attack requires control of bleeding and reduction of pressure on the brain. Drug therapy helps only in simple cases and allows you to cope with the cause of bleeding.

If an attack is triggered by an increase in pressure, measures are taken to reduce it. If a heart attack is a consequence of taking blood thinners, you need to stop using them and start using drugs with a reverse effect.

After the bleeding has stopped, therapy consists of following bed rest, special diet and the use of auxiliary methods.

For extensive bleeding use surgery, which is aimed at removing blood and reducing intracranial pressure. The operation is performed to remove the consequences of vascular rupture, aneurysms, and malformations.

Various techniques can be used to treat and prevent hemorrhagic infarction:

Rehabilitation after treatment of cerebral infarction

Rehabilitation measures after a cerebral infarction are aimed at restoring the functions of the affected organ and improving a person’s quality of life.

The effectiveness of these procedures is influenced by the following factors:

• amount of brain damage;
• qualifications of doctors;
• participation of relatives and friends in the patient’s recovery process;
• time of commencement of rehabilitation activities.

Recovery after a cerebral infarction includes the following components:

A cerebral infarction is a very serious condition that entails many negative consequences and significantly reduces a person’s quality of life. The quality of rehabilitation activities is of no small importance.

Cerebral infarction is a complex pathological disorder, clinical syndrome, expressed in the form of acute disruption of certain brain functions. The duration of this syndrome can be 20-24 hours. If a person is not provided with quality treatment within this time frame medical care, then with a high degree of probability he will die. During a heart attack, serious problems with blood circulation in the brain structures are observed, because arteries become clogged. At the site of blockage they begin to actively die nerve cells, because of which important parts of the brain simply stop working.

Brain stroke is also commonly called ischemic cerebral stroke (the only difference is in the name). Pathology of this type for modern world is extremely relevant because this disease is killing many people in all countries. With the development of pathology, a fairly rapid death outcome is observed in 25% of cases. During the first 6-12 months after a cerebral infarction, another 20% of patients die. Approximately 30% of people who were able to survive remain disabled. Full recovery after this complex disease observed in 10-15% of patients. The disease code according to ICD-10 is I63.

Symptoms

Cerebral infarction has characteristic symptoms. Therefore, doctors can fairly quickly differentiate the disease from other similar disorders and diagnose it. The most common symptoms are the following:

• Numbness of the limbs (or one half of the body). Similar symptom usually observed in the first hours after a heart attack. The patient experiences severe weakness and fatigue even after minor physical and mental stress. Chronic weakness and fatigue can occur even several months after a heart attack.
• Loss of sensation in the limbs. The symptom is also temporary, often observed in the first days and weeks after a heart attack. Loss of sensation can be observed both in the fingers (usually on the hands) and along the entire length of the limb.
• Severe headaches of a compressive nature. Pain syndrome similar to migraine, usually develops during sleep (at night) and in the morning before breakfast immediately after waking up. It happens that the pain does not go away throughout the day (in the later stages of the disease). Traditional preparations do not help cope with pain, so taking strong medications is necessary.
• Speech problems. Immediately after a cerebral infarction, edema begins to form, which exerts a compressive effect on neighboring systems, tissues and centers. Swelling occurs in the area of ​​arterial blockage. The person’s speech is difficult, incoherent, and understanding what he is saying is very problematic. Along with speech disorders, the patient experiences a state of deafness (it seems to the patient that everything around is “in a fog”).
• Loss of orientation in both space and time. Due to compression of brain tissue by edema, patients may experience serious problems with orientation in space and time. They are often unable to understand that they are in a hospital, cannot get to the toilet, confuse day with night, etc. Against this background, various neuroses and psycho-emotional disorders develop.
• Vomiting, nausea. During the period of illness, men, as well as women, necessarily experience severe nausea and vomiting. They can be sudden. In other words, no external factors (food intake, unpleasant odors etc.) they are not provoked.
• Increased blood pressure. This symptom will be observed only in situations where blockage of arteries and blood vessels and the formation of edema have occurred in the area of ​​the brain stem. In this case, body temperature will not change, but the heart rate will increase.

With a cerebral infarction, pallor will be visually observed skin, there will be a significant decrease in blood pressure. Together with other symptoms, this allows a diagnosis to be made relatively quickly.

Usually, people, regardless of age, exhibit several of the above signs of pathology. The prognosis for survival will largely depend on the severity of the symptoms that appear and the reasons that caused the cerebral infarction. Very often, this pathological disorder is only a consequence of another disease.

Reasons for the development of pathology

The occurrence of cerebral infarction is noted exclusively against the background of blockage of blood vessels by an embolus or thrombus. Something like this can happen various reasons. Before treating this pathology, doctors urgently need to determine the root cause of the syndrome and eliminate it (otherwise any therapeutic actions will be in vain).

Potentially lead to development extensive heart attack brain may be affected by the following factors:

• Congenital disabilities of cardio-vascular system, individual vessels, myocardium (heart muscle).
• Increased level of blood clotting.
• The use of any resuscitation devices (for example, a defibrillator) that can lead to the release of blood clots.
• Long-term pacemakers.
• Heart failure (if the pathology develops in combination with reduced venous and blood pressure).
• Myocardial infarction (during its development, blood clots form in the left ventricle; they, having come off, can penetrate into cerebral arteries, blocking them and causing swelling).
• Multifocal atherosclerosis.
• Diabetes mellitus and/or obesity.
• Hematological diseases.

There are many reasons that could potentially trigger the development of a cerebral infarction. In particular, some of the factors of its occurrence are: bad habits, migraine headaches, taking hormonal drugs(for contraception purposes), hormone-dependent therapy.

Diagnostics

If a cerebral infarction is suspected, it is urgent to differentiate the pathology from hemorrhagic stroke and transient ischemic attack (they have similar symptoms, manifestations and complications). It is also necessary to clarify the area of ​​the lesion (right or left hemisphere, midbrain or medulla oblongata, brainstem, cerebellum, etc.). Main diagnostic methods are:

• CSF (cerebrospinal fluid) analysis.
• Dopplerography.
• CT ( CT scan).
• Angiography.

During the diagnostic process, doctors should also detect accompanying illnesses which could lead to the development of ischemic stroke.

Developing complications

When a cerebral infarction occurs, it affects a large number of cells and tissues, so the likelihood of developing serious complications in the first days and hours is quite high. If edema occurs, the risk of death increases significantly in the first 5-7 days. Swelling develops quite often, so doctors always take all necessary therapeutic measures to prevent the formation of severe edema.

The most dangerous and common complications also include:

• Congestive pneumonia. It develops against the background of the patient’s constant bed rest, so it is often diagnosed only 30-45 days after the stroke.
• Acute heart failure, pulmonary embolism (the development of these pathologies is noted in the first month).
• Bedsores. Lying down in patients should only occur on dry and clean beds. Patients must be systematically turned, placed as comfortably as possible, and all necessary hygiene products must be used.

Lack of treatment or incorrectly prescribed therapy can affect the occurrence of various complications. Treatment of cerebral infarction should begin with establishing the root cause of the pathology, as well as its elimination. Patients who have a severe form of ischemic stroke are extremely vulnerable, so during therapy, doctors monitor the functioning of all organs and systems. This is due to the fact that in short term After a heart attack, almost the entire body is drawn into the developing pathological process.

Particular attention should be paid to the patient's diet. Nutrition should be balanced: proteins, fats, and carbohydrates are important. Patients are prescribed a special regimen of fluid intake (depending on the presence or absence of edema). In some cases, a person cannot feed on his own (unconsciousness, numbness or loss of sensation in the limbs, difficulty swallowing), so they resort to tube feeding with special mixtures.

Treatment

For the treatment process special influence has many factors at the same time:

• Localization of the pathological focus in the head (depending on which part of the brain and what functions were impaired, appropriate therapy is prescribed).
• The volume of the pathological focus, the prospects for its development or self-removal (here it is important whether compression of adjacent tissues occurs).
• Current condition of the patient (normal wakefulness, stupor, stupor, coma).
• Individual characteristics of the patient (age, presence chronic diseases cardiovascular system, relapses, micro-strokes or transient ischemic attacks in history).

The patient's likelihood of survival will depend on these factors. With developing edema and unconscious the patient has a high probability of death. Modern medicine is able to cure patients in a coma, but not in all cases.

Traditional therapy includes the use various medications and medicines. Medications allow for normal level keep the work vital important functions, and also prevent the development of somatic diseases. In particular, the macropreparations and micropreparations used (depending on the indications and doctor’s prescriptions) are necessary for the following:

• Bringing basic respiratory functions back to normal (if this is not possible, doctors perform long-term artificial ventilation).
• Supporting the normal functioning of the heart and cardiovascular system as a whole, adjusting blood pressure levels if indicated (especially important for elderly patients).
• Regulation of homeostasis processes (glucose levels, acid-base balance, water-salt balance and so on.).
• Support normal temperature body (allows an increase to values ​​of no more than 37.5 o C).
• Reducing the size of swelling in the brain structures (if it develops). The ideal is to completely get rid of it in the first few weeks of treatment.
• Elimination of manifestations and symptoms of the disease as they appear.
• All necessary preventive actions that will not allow complications to occur (bedsores, thrombosis, pneumonia, fractures, pathologies gastrointestinal tract etc.).

If the patient has sclerotic and atherosclerotic changes (which usually occurs against the background of problems with lipid metabolism), then already during the stay in intensive care or hospital the patient is prescribed statins. Treatment with their help should be carried out both after discharge during the recovery period and during rehabilitation (regardless of whether manifestations of sclerosis and atherosclerosis remain or not).

During therapy, it is especially important to take medications (antiplatelet agents, anticoagulants, etc.) aimed at restoring blood flow mechanisms in the pathological area. But often even the most strong drugs cannot give the desired effect.

• The issue of using anticoagulants is particularly acute. When using them, it is necessary to constantly monitor the degree of blood clotting in the patient, as well as to prevent the development of a number of complications.
• Antiplatelet agents (most famous drug group - Aspirin) are one of the most important therapeutic agents in the treatment of cerebral infarction.

In every special case medications for treatment are chosen by the doctor strictly individually. In the situation of cerebral infarction, there are no universal solutions that could suit most patients. Therapeutic tactics are selected in accordance with many criteria.

Considering the high severity developing complications, the special location of the pathological focus and other factors, doctors may also decide to perform an operation. Surgical intervention for ischemia is a common solution all over the world, therefore, if there are indications, surgery is mandatory. Timely surgery under appropriate conditions can reduce mortality.

Treating cerebral infarction at home using folk remedies is strictly prohibited.

Encouraging Cases

Separately, doctors diagnose “minor” ischemic stroke, which is considered mild form cerebral infarction. With the development of this pathology, the occurrence of severe disorders and disorders is not observed. With this pathology full recovery person occurs in 2-3 weeks. The patient's life is also not in danger.

But when similar attack ischemia, you need to think about changing your lifestyle, because a “small” ischemic stroke is almost always a harbinger of something larger and dangerous.

Some people experience a so-called “micro-stroke”, which cannot be. This pathological phenomenon is characterized by ischemic transient attacks, as well as certain circulatory disorders in the structures of the brain. The symptoms of a micro-stroke are fully consistent with transient attacks and circulatory disorders: a state of stupor, nausea, vomiting, dizziness, difficulties with orientation in space. This type of pathology is not fatal (you don’t die from it), but it can also be considered a harbinger of a major stroke.

If you have a history of a “minor” ischemic stroke or micro-stroke, you need to think about your lifestyle, because with such manifestations the body makes it clear that something is going wrong. It is recommended to refuse bad habits, stabilize your blood pressure (if it is low or high), normalize lipid metabolism.

Consequences

The consequences of a cerebral infarction can be many, depending on the focus pathological process, vital centers affected, the patient's current condition and other factors. The prognosis will almost always be favorable if, after an ischemic stroke, a person remains conscious, is able to take care of himself (at least partially), and can exercise control over his natural needs.

In these cases, the patient can be treated as an inpatient at a local hospital, and his recovery occurs at home under the supervision of a neurologist at his place of residence. The patient is prescribed an appropriate diet, therapeutic exercises, and procedures to develop numb or paralyzed limbs. With a cerebral infarction, any development of events, except death, is favorable (even if the patient’s disability is registered).

By their nature and clinical manifestations, it is customary to diagnose two main types of stroke: hemorrhagic and ischemic (cerebral infarction). The first diagnosis is extremely unfavorable and often ends in death, paralysis of the patient, loss of speech and other functions.

Infarction or cerebral ischemia, in most cases, can be treated with medication, and the patient gradually recovers lost functions. Ischemic stroke is a damage to brain tissue in which there is an acute disruption of the blood supply to the brain as a result of blockage of blood vessels, through blood clots or emboli.

Cerebral infarction - what is it?

With a small localized lesion, a small cystic formation, which does not affect the basic functions of the body. The consequences of a severe stroke affect speech and motor functions and also cause death.

Stages and types of ischemic stroke

It is customary to distinguish the following types ischemic lesion brain:

There is also a clear division, depending on the location of tissue damage:

• Left-sided ischemic stroke - manifests itself in pronounced mental disorders and the occurrence of diseases associated with emotional disturbances. As a rule, there is a deterioration in speech functions. At the same time, the ability to recognize and understand the speech of others remains.
• Extensive ischemic stroke of the right hemisphere of the brain is difficult to treat with medication. The patient has a disorder motor functions, usually on the opposite side of the damaged area.
• Ischemic stroke in the vertebrobasilar region - complications depend on the location and degree of tissue damage. The most unfavorable prognosis is for disorders in the brainstem region. This department is responsible for respiratory functions and heart function. Pathological changes are severe and lead to death in 70% of cases.

Serious complications in hemispheric ischemic stroke can be avoided, subject to early diagnosis, emergency care and adequately prescribed therapy. The prognosis of the disease is influenced by the first few days after ischemia.

What causes a cerebral infarction?

• Diseases of the cardiovascular system – various pathologies and heart diseases, especially valves, lead to cardioembolic and atherothrombic ischemia.
• Arterial hypertension leads to the development of lacunar stroke. The insidiousness of the disease lies in the fact that ischemic manifestations are observed in patients who did not believe that they had problems with high blood pressure and did not have medical history diseases, neurology.
• Atherosclerosis – clinical picture ischemic stroke is associated with obligatory degeneration of blood vessel tissue. This happens due to blockage of the internal lumen by a thrombotic plaque. A gradual increase in pressure in the artery cavity leads to thinning of the wall and, as a result, a stroke.

Signs and warning signs of stroke

A stroke can be recognized by the following symptoms:

1. Dizziness.
2. Periodic numbness, sudden weakness in an arm or leg, or paralysis of one side of the body.
3. Headache.
4. Facial distortion.
5. Speech impairment is short-term and goes away on its own.

1. Numbness of the skin of the face or hands - manifestations appear in the early morning.
2. Loss of control - the patient cannot understand where he is or clearly express his thoughts. At the same time, the ability to understand the speech of others is preserved.
3. Double vision, hallucinations.
4. Nausea and vomiting that does not bring relief.

• The doctor will ask the patient to smile - regardless of the cause of the cerebral infarction, the patient will not be able to do this fully. Another diagnostic test is that the tongue of a person suffering from ischemia will be curled when it is protruded from the mouth.
• A clear indicator that the patient has suffered a cerebral infarction is the inability to speak coherently and say even the simplest sentence.
• During a cerebral infarction, the simplest motor functions are impaired, so if you ask the victim to raise both arms up, tension will be noticeable, and in case of severe damage, a complete inability to fulfill this request.

The favorable period for treating a patient suffering from a cerebral infarction is the next 3-6 hours after the injury. Early diagnosis and prevention reduce the likelihood of stroke consequences.

Why is a cerebral infarction dangerous?

The consequences of a cerebral infarction on the right side are manifested in paralysis of the limbs. If the damage is localized to the areas responsible for breathing and heart function, death occurs.

A second ischemic stroke results in death in 95% of cases. Therefore, after the first heart attack, special attention is paid to the prevention of the disease and rapid recovery basic functions of the body.

First aid for stroke

How is an ischemic stroke different from a hemorrhagic stroke?

Cerebral infarction occurs due to tissue hypoxia. The small volume of the cranial cavity does not make it possible to store oxygen in reserve. As a result, even small oxygen starvation leads to serious consequences. Ischemia occurs due to acute oxygen deficiency. As a result, the tissue of the damaged area of ​​the brain dies.

What is more dangerous, ischemic or hemorrhagic stroke? Tissue damage as a result of bleeding poses a greater danger to the patient’s life and takes more time. You can recover from an ischemic stroke much faster than from hemorrhagic disorders. Consequently, cerebral tissue infarction is less dangerous.

Repeated cerebral infarction

1. Preventing complications.
2. Prevention of the development of secondary ischemia.
3. Reducing the likelihood of developing hemorrhagic stroke.

How to avoid another cerebral infarction

Depending on the patient’s condition, he will have to adhere to the following rules:

• Regular use of antiplatelet agents, statins and medications to maintain normal pressure after a stroke. Patients with atherosclerotic plaques undergo thrombolysis, a procedure aimed at reducing the volume of blood clots and removing them from the body. Antiplatelet agent for secondary prevention ischemic stroke is taken for the rest of your life.
• Taking a course of vitamins to maintain heart function, as well as taking medications containing potassium. Doses of medications are selected individually, depending on the patient’s condition.
• Changing life habits. Alcohol after a stroke leads to a possible relapse of disorders. Under the influence of alcoholic drinks, the blood vessels of the brain dilate, and after the end of the action they sharply narrow.
  At coronary disease Both the first and second manifestations are harmful. Smoking after a stroke is also prohibited. Resins and other harmful substances provoke a narrowing of the lumen in the arteries, which can cause multiple cerebral infarctions.
• Diet after a stroke - complete and healthy eating is an integral part of rehabilitation and prevention of relapse of the disease.

Consequences of a recurrent stroke

The etiology and pathogenesis of disorders indicates the need to take effective measures to prevent a possible relapse. Post-stroke attacks may occur during the first four years of prophylaxis. Over time, the lost brain functions will gradually be restored, neurological disorders and other adverse symptoms will completely disappear.

Prevention of ischemic stroke

Along with dispensary observation Patients at risk are advised to adhere to the following recommendations:

• Reducing the amount of alcohol consumed - the safe limit is about 0.5 liters. beer, or 200 ml of wine.
• Fighting obesity - physical exercise and exercise, weight loss by 5-10 kg, reduce the likelihood of developing ischemia by 25-30%.
• Taking prophylactic medications – WHO recommends taking preventative medications ascorbic acid, clopidrel, cyclopidine, etc. For some patients, the doctor may recommend taking a course of milgamma, a drug to improve blood supply to the brain.

Is it possible to give birth after a stroke?

The child who is born will not be observed pathological disorders and developmental abnormalities. If the situation develops unfavorably, there is a possibility that newborns will develop brain hypoxia. But with due medical control, this possibility is reduced to almost zero.

How and with what to treat ischemic stroke

How to identify a stroke

Medicines for cerebral infarction

• Fibrinolytic therapy - the patient is prescribed drugs to restore normal blood flow. Used in combination with blockers calcium channels.
• Thrombolytic therapy is especially relevant in the treatment of acute period ischemic stroke. The medications reduce the volume of the blood clot or atherosclerotic plaque, and as a result increase blood flow to the brain. To increase the effect, droppers are prescribed.
• Metabolic therapy - Actovegin and similar medications are prescribed to improve metabolic processes. The drug Actovegin is new in the treatment of stroke and, as practice shows, is successfully used in maintenance and restorative therapy.
• Reperfusion therapy is aimed at maximizing the enrichment of blood with oxygen. As a result, maximum brain hyperoxia occurs.

Duration of the therapeutic window until symptoms begin to appear irreversible changes, 3-6 hours from the time of defeat. If the disorders that caused ischemia are mechanical in nature, surgical treatment is prescribed.

Traditional medicine for stroke

Traditionally used:

Before taking any traditional healing methods, you should consult your doctor. Treatment of ischemic stroke folk remedies does not replace drug therapy and is used exclusively as an adjuvant.

Hirudotherapy for stroke

Often in first aid centers for cerebral infarctions, along with traditional medicines, prescribe attendance at hirudotherapy sessions.

Herbal medicine for stroke

Rehabilitation after ischemic stroke

Where to go for rehabilitation

In Ukraine you can contact the following medical institutions:

• Universal clinic "Oberig" - located at Kyiv, st. Zoological 3. The medical center deals with all types of neurological disorders. Implemented complete care for the patient, assistance is provided in registering disability.
• Sanatorium "Koncha-Zaspa" - a boarding house specializing in the rehabilitation of patients with pronounced neurological manifestations and psychoneurotic disorders.

• "Three Sisters" - private rehabilitation center, characterized by a warm, informal atmosphere. Located far from the metropolis. Approximately 30 km from the Moscow Ring Road.
• The Medical Center of the Russian Ministry of Health is an institution that cooperates with leading neurosurgery specialists. Address: Moscow, Ivankovskoye Shosse, 3.

Physical rehabilitation

Over time, movements acquire greater range and load. The patient gradually begins to walk.

After a stroke, a disability group is given, depending on the ability to independently perform the necessary daily tasks. The specialist’s goal is to reduce the patient’s need for outside help, to a minimum.

How to restore speech after a stroke

Methods of recovery are determined depending on what specific disorders caused the dysfunction. There are two types of pathological changes:

1. Sensory aphasia.
2. Motor dysfunction.

Massage for stroke

If during the procedure the patient’s body temperature rises or a feeling of discomfort appears, it is necessary to immediately stop the therapy session and refer the patient for a consultation with the attending physician.

Nutrition after stroke

• Mandatory foods to eat - after a stroke you should eat vegetables, legumes, potatoes and meat, as well as berries, especially blueberries.
• Recommended foods: your diet should include fish, peanuts, walnuts and almonds. Steamed dishes are ideal.
• Prohibited products - absolutely not to be consumed bakery products, margarine, butter, alcoholic drinks(an exception can be made for a small amount of red wine). The amount of salt should also be limited.

Cerebral infarction (ischemic stroke) is damage to brain tissue due to acute cerebrovascular accident. The cessation or obstruction of blood flow to one or another part of the brain leads to disruption of its functions. An ischemic stroke is accompanied by softening of an area of ​​brain tissue (cerebral infarction).

Causes

Cerebral infarction can be caused by insufficient blood supply to a certain area of ​​the brain due to decreased cerebral blood flow, embolism, thrombosis associated with diseases of the heart, blood vessels, and blood.

The main risk factors for ischemic cerebrovascular accidents include:

Arterial hypertension;

Elderly or senile age;

Hypercholesterolemia;

Smoking;

Atherosclerosis of cerebral, precerebral (vertebral and carotid) arteries;

Heart disease (eg, myocardial infarction, atrial fibrillation);

Diabetes.

Symptoms of cerebral infarction

There are three main signs that indicate acute disorder cerebral circulation:

A person cannot smile directly, the corner of the lips may be lowered;

The victim cannot speak normally, his speech is slow and slurred;

Weakness in the leg and arm on the affected side.

Usually an attack has a precursor - an ischemic attack. Signs of ischemic attack:

Severe dizziness;

Speech impairment;

Various severity of motor dysfunction in the leg or arm;

Intense headache;

Fainting state.

Diagnostics

Studies necessary to diagnose the disease:

Clinical blood test;

Blood plasma cholesterol level;

Urea, glucose, blood electrolytes;

12-channel electrocardiography;

Non-contrast computed tomography of the brain.

Additional research:

Cerebral angiography;

Ultrasound duplex scanning;

Magnetic resonance angiography;

Intra-arterial digital subtraction angiography;

Transthoracic echocardiography;

Magnetic resonance imaging.

Types of disease

Based on the rate of formation of neurological deficits, they are distinguished:

Transient ischemic attacks, which are characterized by focal neurological disorders and completely regress within 24 hours after their occurrence;

. “minor stroke” - prolonged ischemic attacks with a reverse neurological defect (restoration of neurological functions requires from 2 to 21 days);

Progressive ischemic stroke - gradual development focal and general cerebral symptoms for several days or hours, followed by incomplete restoration of functions;

Completed (total) ischemic stroke is a formed cerebral infarction with incompletely regressive or stable deficit.

According to the severity of the patients' condition:

Mild severity, when neurological symptoms are mild, regresses within 3 weeks of illness;

Moderate severity - characterized by a predominance of focal neurological symptoms, no disorders of consciousness;

Severe stroke - characterized by severe cerebral disorders, severe focal neurological deficit, depression of consciousness.

Pathogenetic classification:

Atherothrombotic stroke;

Hemodynamic stroke;

Cardioembolic stroke;

Lacunar stroke.

By location of cerebral infarction:

In the basin of the internal carotid artery;

In the vertebrate basin, the main arteries and their branches;

In the basin of the middle, anterior, posterior cerebral arteries.

Patient Actions

If signs of ischemic stroke appear, it is necessary emergency appeal for medical help.

Treatment cerebral infarction

In stroke therapy, basic and differentiated therapy are distinguished.

Basic therapy for ischemic stroke is aimed at maintaining basic body functions and includes maintaining blood circulation through nootropic drugs(piracetam) and other means, ensuring adequate breathing, monitoring and correcting water and electrolyte balance, reducing cerebral edema, preventing and treating pneumonia.

Most often, ischemic stroke is associated with thromboembolism or thrombosis of the cerebral arteries. In this case, thrombolysis is used, achieved by intra-arterial or intravenous administration tissue plasminogen activator.

To improve the rheological properties of blood, hemodilution is used in the form of intravenous infusions. Vasoactive drugs (vinpocetine, pentoxifylline, calcium channel blockers), as well as hemodialysates that improve the supply of oxygen to tissues, are widely used.

IN recovery period active motor, cognitive and speech rehabilitation is indicated. Rehabilitation measures are recommended to begin as early as possible and systematically carried out during the first 12 months after an ischemic stroke.

Complications

Infectious complications (urinary tract infections, pneumonia, bedsores, etc.);

Pulmonary thromboembolism;

Deep vein thrombosis of the lower leg area;

Brain swelling;

Cognitive impairment;

Disorders of urination and defecation;

Epilepsy;

Motor disturbances (bilateral, unilateral), severe weakness, paralysis;

Mental disorders (irritability, depression, etc.);

Pain syndrome.

Prevention cerebral infarction

Prevention of ischemic stroke consists of prevention, detection and timely treatment of pathology of the cardiovascular system.