Stroke
Summary/Definition
Stroke is defined as a disease resulting from impaired brain function due to stroke (cerebral hemorrhage) or occlusion of the vessels (cerebral infarction) that provide blood flow to the areas of the brain where neurological symptoms occur. Due to the limited ability to regenerate cells in the damaged brain, immediate intensive treatment, including emergency medical care, is required. Brain ischaemia can be classified as cerebral hemorrhage, in which a blood vessel ruptures and blood accumulates, and cerebral infarction, in which an area of the brain is damaged due to blockage of the blood vessels that supply it. Cerebral infarction can be divided into three categories: infarction caused by symptoms of atherosclerosis of the cerebral vessels; cerebral infarction resulting from cardiogenic embolism; cerebral infarction caused by small changes in the cerebral vessels; and cerebral infarction resulting from other causes. The brain hemorrhage can be classified as intracerebral hemorrhage and subarachnoid hemorrhage.
Symptoms
The main clinical signs of ischaemic brain disease are hemiplegia (paralysis of half of the body), sensory disturbances, speech disorders, articulation problems, impaired muscle coordination, visual/visual deficits, double vision, dysphagia (swallowing disorders), cognitive deficits, immobility, autonomic symptoms, headaches, and others. It is difficult to diagnose symptoms at an early stage, even when the primary symptoms of chronic cerebral ischaemia are present.
Diagnostics
By interviewing the patient about his or her condition, measuring blood pressure, and performing other general clinical examinations, and assessing the level of consciousness, brain conditions are identified and diagnosed using computed tomography, magnetic resonance imaging and other imaging techniques. In addition, an assessment of blood supply disorders of the brain is performed, including measurement of blood flow intensity and blood analysis using computed tomographic angiography, magnetic resonance angiography, catheterization angiography, and other methods of analysis.
Treatment and course of the disease
When acute cerebral ischaemia develops, complications can arise in the nervous system, starting with early neurological disorders. Lack of timely medical intervention can lead to irreversible changes that require inpatient neurosurgical treatment for a patient suffering from acute cerebral ischaemia. As therapy, medication is used to restore blood supply to the vessels using antithrombotic drugs. Patients who have recently undergone cerebral vessel occlusion may be offered aortocoronary bypass surgery using antithrombotic drugs such as venous tissue plasminogen activator, which helps dissolve blood clots during this procedure. Medication treatment also includes antiplatelet and anticoagulant drugs. The majority of intracerebral hemorrhages are caused by high blood pressure and therefore require immediate assistance with blood pressure regulation, intracranial pressure control, and other emergency measures.