Update: October 2018

Currently, a huge problem is not only mortality from strokes, but also a high percentage of disability. Rehabilitation for people who have suffered a stroke is very important, as it can reduce this percentage, as well as reduce the depth of neurological deficit.

Rehabilitation measures can reduce the patient’s dependence on outsiders, which improves his quality of life and is also important for his relatives.

In this article we will look at what exactly the consequences of a stroke may be, and what opportunities exist for their correction. You will become aware of the benefits of undergoing rehabilitation measures in a hospital, as well as what contraindications exist for this and what you can do at home.

Neuroplasticity or why you can recover after a stroke

The goal of neurorehabilitation is restoration or, in the absence of the possibility of complete recovery, partial compensation of impaired functions of the nervous system.

This is based on complex mechanisms of neuroplasticity. Neuroplasticity is the ability of nervous tissue to undergo restructuring following damage.

It should be remembered that the area of ​​the brain that was damaged as a result of an ischemic or hemorrhagic stroke is not restored. Those nerve cells that have died will not recover. New neurons also do not appear. Therefore, restoration is possible only due to the fact that other neurons take over the function of the lost ones. This occurs due to those neurons located near the lesion in which irreversible changes have not occurred. This process is long, during which time various changes occur both at the structural and biochemical levels. It is also necessary to take into account that if the brain is severely damaged, one should not expect a complete recovery, since the potential of neurons for neuroplasticity is not unlimited.

It is believed that these processes can continue throughout the year after a stroke, most actively in the first months. Therefore, rehabilitation measures should begin as early as possible, even in the acute period of a stroke, already in the first days, as far as the patient’s condition allows.

Restoring lost functions

The consequences of acute cerebrovascular accident can be different, depending on where the focus of the brain lesion is localized. If the centers responsible for movement are affected, the ability to move the limbs on the side opposite to the lesion will be completely or partially lost. If the speech center is damaged, speech will be impaired or may be completely absent. The same principle can be used to correlate all other neurological disorders that appear as a result of a stroke. Next, we will take a more specific look at possible neurological syndromes.

• Hemiparesis or hemiplegia is a disorder of motor function.
• Hemiparesis is a partial loss of strength in the limbs on one side (only on the right or only on the left).
• Hemiplegia is a complete loss of the ability to move the limbs on one side.

Impaired motor function may manifest as muscle weakness, leading to limited range of motion up to complete immobility in the affected limbs. In mild cases, impaired motor function may be manifested by awkwardness of movements and rapid fatigue.

Muscle atrophy may often develop in the affected limbs. This is due to the fact that the muscles of these limbs do not have the necessary load, as a result of which they atrophy, which complicates the rehabilitation process. Therefore, from the first weeks it is necessary to carry out active or passive gymnastics, if it is impossible to carry out active gymnastics due to deep paresis, cognitive impairment or impaired level of consciousness. The best option to carry out such gymnastics is a physical therapy doctor.

Spasticity is also a motor dysfunction. This is an increase in muscle tone in the affected limbs. This aspect also requires attention, since it has bad influence for the implementation of movements, restoration of walking and self-care.

With severe spasticity, the usual pathological position of the limb is formed. With increased muscle tone, it is difficult to straighten a limb or, for example, fingers. This also threatens the appearance of flexion contactures—limitation of passive movements in the joint. If this problem is identified, regular therapeutic exercises are necessary to prevent the formation of the usual position of the limb, for example, if, due to spasticity, the fingers of the hand are constantly bent, it is necessary to straighten them with a healthy hand or with the help of an outsider and fix them in this position. The use of orthoses is also effective.

In some cases, your doctor may prescribe certain medications to help temporarily reduce increased tone muscles, but this will be ineffective or not effective at all with formed contractures.

Most often, with a hemispheric stroke, restoration of movements occurs first in the lower limb, then in the upper, and most recently in the hand, this is due to the peculiarities of the blood supply to the brain. But this pattern is not 100 percent. Everything can be individual. Restoration of movements can begin already in the first days after a stroke. However, if there is no dynamics for a month, then the prognosis for further restoration of movements is very doubtful. The most effective time for motor rehabilitation is the first 3-6 months from the onset of a stroke.

Basic methods of motor rehabilitation

Physiotherapy

Therapeutic gymnastics includes physical exercise, aimed at general training of the body, training tolerance to physical activity, as well as special exercises aimed at restoring lost functions.

A set of physical exercises performed by a physical therapy doctor is selected individually based on the motor deficit of a particular patient. The exercises are aimed at increasing muscle strength, increasing range of motion in joints, reducing muscle tone, improving coordination, learning to stand and walk.

Restoration of walking takes place in several stages: imitation of walking while lying down, sitting, learning to stand and maintain balance, learning to walk with a 4-support cane within the ward, learning to walk on stairs, walking outdoors. During the restoration of walking, an important point is the correct positioning of the foot. Often, as a result of a stroke, the ability to walk is lost; in this case, it is necessary to control the position of the foot, knee and hip joints. Physiotherapy doctors know how to do this correctly.

You should not expect that a person with profound impairment of motor functions will be able to walk immediately. This requires a long time, the work of specialists and the work of the patient himself. Restoring walking function is not always possible; it depends on many factors - from the motivation of the patient himself to the extent of brain damage. It is not uncommon to meet a person who, years later, still walks poorly after a stroke; often the deficit can persist for life. But rehabilitation helps reduce this deficit to the minimum possible.

Verticalization

Verticalization involves bringing the patient into an upright position as far as the motor deficit allows. The minimum level of verticalization is considered to be raising the head end of the bed. Next is a half-sitting position in bed, then a sitting position in bed, then sitting in a bed or chair with legs down. It is necessary to begin verticalization from the first days and continue it continuously if the general condition of the patient allows this.

The importance of these events is difficult to overestimate. When staying in a horizontal position for a long time, the muscles of the back and limbs do not work, the tone of the blood vessels changes, and the longer the patient is only in a horizontal position, the more difficult it will be in the future to teach him to sit and “accustom” his vessels to a vertical position.

Orthosis therapy

Orthosis therapy is the use of special fixing functional devices. They are necessary for temporary immobilization of individual segments of the musculoskeletal system. Effective in the treatment of contractures, as well as to facilitate the restoration of movement and provide stability while improving gait function, for example to protect the knee joint or ankle joint. The need to use this method is determined by the physical therapy doctor.

Massage

Massage can help combat spasticity in the limbs, as well as improve tissue trophism. But this method is only auxiliary. Since it has been proven that those methods used in rehabilitation in which the patient does not actively participate have practically no effect.

Physiotherapy

Physiotherapy includes electrical stimulation. This method is used to prevent atrophy and reduce spasticity. Provides a training effect. This method will not teach muscles to contract voluntarily; it only prevents muscle tissue atrophy. This should not be assumed to restore movement.

Full or partial restoration of motor functions is possible with working together patient, physical therapy doctor and neurologist.

Hypoesthesia - loss of sensitivity

When the area of ​​the brain responsible for sensitivity is damaged, hypoesthesia develops - a decrease in sensitivity. Its decrease will manifest itself in the limbs opposite to the side of the lesion.

Sensitivity, as a rule, takes longer to recover than movements in the limbs, this is due to the structural features of sensitive nerve fibers.

To restore sensitivity, tactile stimulation can be used - irritation cold temperature, vibration, pressure. Therapeutic gymnastics also plays a certain role, promoting awareness of the position of the limb in space.

Coordination problems

When the cerebellum is damaged, coordination disorders develop - accuracy and consistency of movements. They can manifest themselves in different ways: impaired stability when standing or walking, impaired coordination of movements, tremor. A number of patients experience severe impairment of walking function due to damage to the cerebellum. In this case, the strength in the limbs can be completely preserved, the range of movements is full, but when performing purposeful actions (walking, standing up, trying to independently bring a spoon to the mouth), significant impairments are revealed.

Rehabilitation of such patients consists of motor activation, balance training, motor skills training, and fine motor skills training. A large role in solving this problem is given to therapeutic exercises. A special set of exercises is used aimed at:

• Increased precision of movements
• Improved coordination of movements
• Balance training and walking training
• Training fine motor skills and various hand grips

For concomitant dizziness, drug therapy is used to improve blood circulation in the brain and suppress the excitability of the vestibular centers. The drug, dose and dosage regimen are prescribed exclusively by a doctor.

Speech disorders

It is often possible to encounter the fact that a person does not speak after a stroke; speech disorders appear in most patients, to one degree or another. Speech disorders occur when the speech areas of the cerebral cortex, subcortical structures or pathways are damaged.

There are different types of such violations:

• Aphasia– a systemic disorder of speech activity that occurs when the speech center of the left hemisphere is damaged in right-handed people and the right hemisphere in left-handed people. Aphasia is often accompanied by impairments in writing (agraphia) and reading (alexia). Aphasias are also divided into several types; this article will indicate only the main, most common ones:
• Motor aphasia- a violation of speech activity, manifested in the difficulty or impossibility of pronouncing sounds, syllables, words. Secondarily, it may be accompanied by a violation of understanding the speech of another person.
• Sensory aphasia– manifested by a violation of the discrimination of specific speech sounds, respectively, manifested by a lack of understanding of the speech of others. As a result, the patient answers the questions posed incorrectly, speech is disorganized, and consists of a set of unrelated words.
• Amnestic aphasia– violation of the naming of objects, a person can describe why a given object exists, but does not remember its name.
• Dysarthria– impaired pronunciation of words due to insufficient innervation of the speech apparatus. The speech system does not collapse, but the clarity of sound pronunciation, articulation, phonation and intonation coloring of speech suffers. The disturbances can be severe to the point that others cannot understand the patient’s speech.

The rehabilitation of such patients should only be carried out by a professionally trained speech therapist. Experts conduct correctional classes with such patients, selecting exercises individually based on the type of speech disorder. In some cases, “disinhibiting” and stimulation techniques are necessary, in others, on the contrary, it is necessary to slow down some processes. In parallel with speech restoration classes, reading and writing restoration exercises are also carried out. A speech therapist teaches correct articulation and speech understanding.

Gymnastics of the muscles of the pharynx and pharynx, articulatory muscles, massage of these muscles, and training in the coordination of respiratory movements can also be performed.

Rehabilitation measures to correct speech must begin as early as possible, even in the acute stage of the disease. This promotes faster speech recovery. You should be prepared for the fact that in case of severe violations, the restoration of speech function is a long process. If the patient does not speak after a stroke, then a lot of time will be required; recovery will not be limited to the time spent in the hospital, but will also require the involvement of specialists at the outpatient stage. Classes are possible at home or in a clinic with a frequency of at least 2-3 times a week.

Swallowing disorders

Dysphagia is a violation of the act of swallowing, accompanied by choking when taking liquid or solid food.

This problem is very relevant for patients who have suffered a stroke, but it is not always given enough attention. A condition when a patient does not swallow after a stroke or swallows with difficulty is dangerous with a number of complications, which will be discussed below.

When the swallowing center is damaged, dysphagia of varying degrees occurs and requires different measures to correct the disorder and ensure patient safety.

Swallowing assessment should be performed in every stroke patient. In difficult cases, endoscopic techniques can be used to diagnose dysphagia.

In case of choking or any discomfort that occurs while drinking or eating, it is necessary to consult a specialist and select an individual diet.

The diet consists of a certain consistency of food suitable for a particular patient. When choking on the thickest food, a nasogastric tube is installed and feeding occurs only with its help. Special food mixtures are used. In this case, you should not take anything by mouth! The patient receives all food and drink only through a tube. In the absence of correction of the disorder, surgical techniques are used for a long time, and a gastrostomy tube is installed.

For swallowing disorders of average or mild degree The consistency of food and drink is selected and strictly observed. Soups can be in the form of cream or puree, drink in the form of jelly, if this consistency is suitable according to the results of an examination by a specialist. If necessary, special thickeners can be added to food to create a thicker consistency.

If you have dysphagia, you should never give regular liquid (water, tea, juice) without a thickener!

The great importance of this issue is associated with the possibility of drink and food getting into the respiratory tract - aspiration. Choking indicates aspiration.

Complications associated with dysphagia include:

• Tracheobronchitis
• Pneumonia
• Empyema of the lung
• Breathing problems
• Exhaustion, dehydration
• Sinusitis

In conditions of multiple stroke, especially if the patient’s condition does not allow him to actively move independently, the likelihood of inflammatory complications occurring is very high. That is why great attention should be paid to the nutrition of such patients. Cooking food for them should take into account the degree of dysphagia and be selected by a specialist.

Rehabilitation of patients with dysphagia does not have big amount opportunities. These include:

1. Individual selection of food and liquid consistency.
2. Exercises aimed at training the muscles of the pharynx, mouth, and larynx, which should be carried out by a specialist.
3. Physiotherapy – electrical stimulation of the muscles involved in the act of swallowing.

The possibility of changing the consistency of food consumed is determined by the doctor or swallowing specialist, and not by the patient or his relatives!

Cognitive impairment

One of the consequences of a stroke is impaired cognitive function. The frequency and depth of such disorders correlates with the age of the patient. If a cerebrovascular accident occurs against the background of an existing cognitive deficit, then there will be a worsening of existing symptoms and, probably, the appearance of new ones.

Impaired cognitive functions include:

• Attention deficit, impaired ability to quickly orientate in a changing environment.
• Decreased memory, often short-term.
• Rapid exhaustion of mental processes.
• Slowness of thinking.
• Narrowing the range of interests.

There are 3 degrees of cognitive impairment:

1. Mild degree – minimal cognitive deficit, the patient follows instructions, is oriented in place and space, controls his behavior, but there are disturbances in concentration, memorization of new material, and decreased mental performance.
2. Moderate degree - orientation in place and space may be impaired, moderate decrease in working memory, errors in following two-step instructions.
3. Severe degree - dementia. Severe impairments of memory, intelligence, attention, social maladjustment.

A neuropsychologist examines such patients more thoroughly and selects the necessary exercises to train memory and thinking for a particular patient. If necessary, anti-dementia drugs that require long-term use may be prescribed.

Emotional-volitional disorders - post-stroke depression

Depression is often one of the consequences of a stroke. Many relatives of patients consider this problem to be insignificant or deny its existence altogether; for them it is much more important that movements and speech are restored. But such an attitude to this problem entails consequences. Very often, against the background of depression, restoration of lost functions is slow, and exercises become ineffective. With depression, motivation decreases to the point of its complete absence, existing cognitive impairment intensifies, the patient cannot and does not want to understand tasks and instructions. The patient becomes adynamic and inhibited. With the passive participation of the patient, the effectiveness of rehabilitation is minimal.

Appetite may also decrease, but if the patient does not eat after a stroke, this leads to nutritional deficiency, which also complicates the rehabilitation process.

The cause of post-stroke depression can be either damage to certain areas of the brain or awareness of the depth of the problem with preserved criticism.

In this situation, not only the help of a psychologist is required, but also the use of antidepressants. The course of treatment should last at least 6 months.

Occupational therapy

Ergotherapy is an area of ​​physical rehabilitation that helps a person adapt to environmental conditions, as well as restore movements in the upper limbs, by working with special exercise equipment and game tasks (constructors, mosaics, “laces”). Also, the task of the occupational therapist is to teach lost everyday skills.

A person who has suffered a stroke and has insufficient strength and range of motion in the hand is limited in everyday activities, which negatively affects the quality of his life. Therefore, restoring the functions of the upper limb, and especially the hand, is one of the most important tasks.

The ergotherapist teaches the skill of dressing independently; this is possible even with complete absence of movement in one hand. She also teaches how to eat; cutlery and dishes are adapted for such patients. They learn everyday hygiene skills - washing, shaving, brushing teeth. Using familiar objects also requires attention - mobile phone, pen (learning to write, practicing handwriting), iron, remote control. Training is carried out taking into account the capabilities of each patient. Occupational therapy allows the patient to adapt to environmental conditions, taking into account the existing neurological deficit, which reduces dependence on others and improves the quality of life.

Pain syndrome

Sometimes you may encounter a complaint that after a stroke a paralyzed arm hurts or a paralyzed leg hurts. Pain can be either central in origin or due to the formation of contractures. If in the first case only certain types of drugs prescribed by a doctor can help, then the formation of contractures can be prevented by early initiation of exercise therapy. If contractures begin to form, then it is necessary to continue physical therapy or start if for some reason exercise therapy was not started earlier. In their free time from exercise, the patient himself or his relatives can passively make movements in the joints where the contracture is formed, this will help get rid of it more quickly.

How to recover after a stroke at home

At the beginning of this paragraph, I would like to immediately draw your attention to the fact that complete or significant recovery is impossible only at home!

Restoring lost functions as a result of a stroke is possible only in a hospital setting, where many specialists will work with the patient.

All opportunities for rehabilitation treatment must be used. Only a doctor can determine the presence of rehabilitation potential and the point of application of work.

Having completed all possible courses of treatment, the patient returns home; unfortunately, recovery does not always occur completely; moreover, some kind of deficiency almost always remains.

In this situation, we need to talk about the possibilities of home care.

• If motor functions are impaired, the task of the relatives is to activate the patient as much as possible, not to let him lie down for a long time, to sit him in a chair for as long as possible, to perform exercises, and if possible, to walk - to move as far as the patient can.
• In case of speech disorders, help complete the tasks of the speech therapist (a set of exercises should be given home), continue classes with the speech therapist on an outpatient basis.
• It is also very important to prevent various complications that can occur in bedridden patients, such as bedsores, pneumonia, nutritional deficiency, constipation. To prevent bedsores, special mattresses are used, or the patient is turned over every 2 hours and activated as much as possible.
• To prevent pneumonia, follow the recommended consistency of food if swallowing problems persist, and if swallowing function is normal, use breathing exercises and percussion chest massage.
• The diet should be complete and varied, but subject to certain restrictions (reduced salt content in food, animal fats, etc.).
• Laxatives can be used to prevent constipation.

Relatives also need to contact Special attention to comply with the doctor’s recommendations for taking medications, including for the prevention of recurrent stroke. Such drugs must be taken in strictly specified doses, constantly, without skipping. If the patient cannot cope with this on his own, then relatives should ensure that medications are taken in a timely manner.

In conclusion, I will say that in modern medicine much attention is paid to the problems of stroke and recovery after it. The possibilities for neurorehabilitation are great, but it is worth remembering that much depends on the patient’s condition, his concomitant pathologies, and the extent of brain damage, so many patients do not recover completely, but any opportunity for rehabilitation treatment must be used.

One of the serious diseases that often occurs as a result of hypertension, as well as cerebral atherosclerosis, is stroke. Treatment of this disease, if successful, can prolong a person's life activity. The danger of a stroke lies in the high probability of negative consequences, because Quite often the consequence is disability.

Among older people, stroke is the most frequently reported cause of death.

A stroke is characterized by an acute circulatory disorder of the cerebral cortex, which results in damage and death of nerve cells.

Stroke is a series of other pathological conditions, among which:

• Brain hemorrhage;
• Cerebral infarction;
• Subarachnoid hemorrhage.

There are two types of strokes:

• Ischemic;
• Hemorrhagic.

Not only do they differ in origin, but each of them is treated according to a different scheme.

Peculiarity ischemic A stroke is a disruption of the blood supply to certain areas in the cerebral cortex due to blockage of an artery by a thrombus or atherosclerotic plaque.

Hemorrhagic A stroke occurs when an artery ruptures and subsequent hemorrhage occurs. The cause of this type of disease is a rupture in an enlarged section of the artery due to a congenital pathology of the vessel, called an aneurysm, or a rupture of the artery, the background of which may be high blood pressure.

Types of strokes

A stroke of any kind requires immediate action, medical attention and treatment. The clinical picture of hemorrhage develops so rapidly that the ability to cure the disease is limited by time. Only with timely provision of qualified assistance can brain damage be minimized, preventing complications from occurring in the future.

Stages of treatment

In order to know how to treat a stroke, it is necessary to imagine the sequence of the main stages of this process, consisting of:

• Emergency care;
• Inpatient treatment;
• Rehabilitation or sanatorium therapy.

Signs of a stroke

In order to promptly recognize the symptoms of a dangerous illness in a person, it is necessary to firmly remember them.

Signs of a stroke are:

• Sudden weakness;
• Paralysis or partial numbness of the muscles of the face or limbs (most often only on one side);
• Speech disorders;
• Deterioration of vision;
• The appearance of a strong and sharp headache;
• Dizziness;
• Loss of balance and coordination, gait disturbances.

A stroke often takes a person by surprise and at this moment it is very important that people around them show attention and provide first aid.

If you notice a passerby on the street behaving unnaturally, you should not think that he is drunk before a stroke check is performed according to the following plan:

Actions before the ambulance arrives

If there is a suspicion of a stroke, which can occur at any time - at home or on the street, You should do the following as quickly as possible:

• Place the patient on his back, try not to touch his head;
• Provide free access to fresh air, the source of which may be an open window or a fan. For the same purpose, it is necessary to exclude any compression of the body from a tight tie or collar or belt;
• If the patient shows signs of vomiting, it is necessary turn his head in any direction to avoid vomit getting into the bronchi area;
• If possible a cold compress will help, placed on the head or a heating pad with ice;
• The patient, if he is conscious, can ask about his hypertension and give him a pill under the tongue (often hypertensive patients hold the necessary medicines in the pocket);
• Preliminary blood pressure measurement- one of the useful actions that can be performed with a special apparatus at hand;
• A distraction procedure that can be performed at home is placement of mustard plasters in the calf area of ​​the legs.

Help and first actions of medical workers

In the first minutes after arriving at the location of a person suffering from a stroke, the ambulance team specialists assess the severity of the patient’s condition. Their main task is to transport the patient to a hospital equipped with an intensive care unit.

During transportation the following is carried out:

• Blood pressure measurements;
• Administration of drugs that correct the functioning of the cardiac and respiratory systems.

We do not transport patients who:

• They were found in a coma;
• If they have circulatory disorders in the brain in terminal states of various pathologies internal organs or tumors.

Patients with such deviations are provided with symptomatic care, after which the call is transferred to the clinic.

Which department is a stroke patient admitted to?

After hospitalization of the victim, treatment of cerebral stroke in hospital begins with his placement in the intensive care unit or intensive care unit. This requires the presence of an appropriate department in the clinic, equipped with special equipment and qualified personnel.

Patients are examined by a neurologist. Consultation with a neurosurgeon may be required. The treatment regimen, as well as which department the patient will be in, is determined by the doctor depending on the established type and severity of the disease. The main tasks of the hospital depend on the type of disease.

Treatment in a hospital. Drugs.

Treatment for hemorrhagic stroke.

To treat the brain in the development of hemorrhagic stroke, therapy should include a number of specific tasks, these are:

• Elimination of swelling in brain tissue;
• Reduced intracranial and blood pressure;
• Treatment aimed at increasing blood clotting and the density of vascular walls.

During all actions of the medical staff, a certain position of the patient on the bed is observed. For this, a functional bed with a raised headboard is used. Ice is placed on the patient's head and warming pads are placed on the patient's feet. Relaxing the muscles will help ensure that the popliteal bend is created. For the same purpose, you can place a cushion under your knees.

Drug treatment includes the use of the following drugs for intravenous drip use:

• Magnesium sulfate;
• Dibazol;
• Aminazine;
• Pentamin.

Due to the increased risk of decreased blood clotting, medications that activate thrombosis in blood vessels can be administered. This type of therapy should be carried out under the supervision of a laboratory blood test for a coagulogram.

In the first 2-3 days the following are prescribed:

• Calcium chloride;
• Vikasol;
• Aminocaproic acid.

In cases where on the third day after a stroke there are pronounced signs of atherosclerosis and subarachnoid hemorrhage, proteolytic enzymes can be prescribed:

• Gordoks;
• Kontrikal.

One of the effective modern means, used in the treatment of cerebral stroke, is Etamsilate. It allows you to stop blood loss, improve microcirculation in damaged areas of the brain, and normalize vascular permeability. At the same time it serves as an excellent antioxidant.

If cerebral edema has pronounced meningeal symptoms, a spinal puncture should be performed with caution, during which cerebrospinal fluid is extracted in small quantities.

Treatment for ischemic stroke

In case of the second type of brain stroke, the actions of specialists will be aimed at solving the following problems:

• Improving blood supply to tissues;
• Formation of increased resistance to oxygen deficiency;
• Introduction of drugs to improve metabolism in surviving cells.

The patient's position in bed should be comfortable, but his head should not be raised as high as it should be for a hemorrhagic stroke.

For ischemic stroke, treatment must necessarily include vasodilators. To a greater extent, collaterals are used, which are auxiliary capillaries that can partially replace natural ones.

For this purpose, the following products are used in the form of solutions for intravenous drip:

• Eufillin;
• No-shpa;
• Papaverine;
• A nicotinic acid;
• Complamin.

Used medicine to improve hemodilution - Reopoliglucin, which improves blood supply by reducing blood clotting.

Medical monitoring and treatment includes careful measurement of the volume of fluid administered, which in excess amounts can pose a risk of increased tissue swelling. The use of diuretics also requires caution, especially if there is hypertension.

Anticoagulants are used simultaneously with fibrinolytic agents. The important term “golden hour” is used in stroke therapy. It serves as an indicator of the maximum effectiveness of administering medications to reduce blood clotting, as well as for prognosis of the disease.

Due to too long transportation to the clinic, it becomes difficult to determine the difference between different types of stroke and provide the correct assistance in treatment, and its optimal time is missed.

First day ischemic stroke treated by administering a solution of Fibrinolysin with Heparin.

After this, the treatment regimen includes:

• Intramuscular injection of Heparin;
• After 3-5 days, it is recommended to switch to Phenilin and Dicoumarin.

When treating young patients and middle-aged people, Pentoxifylline is used, which helps improve blood density.

Elderly patients are prescribed for treatment:

• Parmidine;
• Xanthinol nicotinate;
• Anaprilin (with existing tachycardia);
• Cavinton, Cinnarizine (allows you to improve vascular tone).

Medicine has found that in case of ischemic stroke, the combined use of Curantil and Aspirin will help reduce the risk of re-development of the pathology.

The patient's agitation syndrome can be cured by prescribing barbiturates. Metabolic failure should be treated with drugs of the metabolite class (Piracetam, Aminalon, Cerebrolysin), which also help to increase the resistance of cells to a lack of oxygen.

Surgical methods

Sometimes a stroke can be overcome with surgery. If a patient has been diagnosed with a hemorrhagic stroke, then surgical treatment methods can only be used if they are young or middle-aged, and also if lateral hematomas and hemorrhages in the cerebellar area have been diagnosed.

Indications for the operation are:

• Impossibility of relieving cerebral edema by other means;
• The appearance of signs of compression by a hematoma;
• Suspicions of the possibility of repeated hemorrhage in the area of ​​the brainstem or hemispheres.

The best time for surgery is 1-2 days. The hematoma is opened and removed. If ruptures of a cerebral aneurysm are detected, the vessel is ligated.

Surgical treatments for ischemia are used in rare cases. Indications for surgery are the diagnosis of narrowing of the carotid, vertebral or subclavian arteries causing pathology.

Patient care

In order to recover from a stroke, it is very important to provide proper care to the patient.

Care measures during inpatient treatment include:

• A certain diet, including juices, liquid high-calorie meals;
• In a comatose state, nutrition is provided using a tube;
• Prevention of congestion in the lungs and bedsores, for which the patient is turned over every 2-3 hours, a rubber circle is placed in the sacral area, and dense rings are placed under the heels;
• Maintain cleanliness bed linen, do not allow high humidity;
• The skin should be treated with a weak solution of manganese, camphor alcohol or solcoseryl ointment;
• The oral cavity is treated with boric acid;
• A catheter is used to drain urine, and for constipation, laxatives are given and an enema is administered.

Rehabilitation

The consequences of a stroke can be safely eliminated with well-organized rehabilitation.

Help for a brain stroke survivor should include the following measures and actions:

• Gentle massage of the limbs from the second week of illness;
• Therapeutic exercise, promoting the restoration of motor functions with a gradual increase in intensity.
• Kinesiotherapy, developing fine hand movements, helping the patient with self-care in new conditions;
• Water procedures aimed at stretching muscles, oxygen baths, hydromassage.

With correctly taken therapeutic measures for stroke, as well as well-organized rehabilitation, up to 70% of people who have suffered a cerebral stroke return to independent life.

The best period for rehabilitation measures and assistance is the first three years, during which you need to be patient and have faith in success.

Video

Hello, dear readers and guests of the site dedicated to neurorehabilitation. Let's talk today and take a closer look consequences of a stroke– ischemic and hemorrhagic, as well as everything connected with it.

Consequences of a stroke.

Disturbances in any functions after a stroke are directly dependent on its severity, and the severity, in turn, on the size of the lesion and its location in the brain.

The nature and persistence of the consequences of a stroke depend on the size of the lesion in the brain and its location.

Of course, it would be fair to note that the size of the lesion and its localization are not all the factors that determine the persistence and depth of neurological disorders that resulted from a stroke, the consequences of which (the nature and their severity) can vary significantly, depending on the specific case. What does this depend on?

The persistence of the consequences is strongly related to the time and volume of treatment and rehabilitation performed, but we’ll talk about this a little later, read on.

The degree of dysfunction after a stroke is not always permanent. At low stroke consequences may be minimal or even absent, but this does not happen very often. We will discuss cases when these consequences exist and they are persistent. Let’s take a closer look at what exactly the consequences of a stroke are and how they are expressed. Listed below are the most significant dysfunctions of the body that occur after a stroke.

Right-sided and left-sided hemiparesis

One of the most common lasting consequences of a stroke is decreased strength in half the body. As a rule, after a stroke, there is a decrease in muscle strength in one of the sides of the body, which is opposite to the damaged hemisphere of the brain: if the persistent consequence is hemiparesis of the left side of the body, the stroke occurs in the right hemisphere. The same principle applies to hemiparesis. right side body, in which a stroke is observed in the left hemisphere. That is, the focus of the infarction in the brain is in the hemisphere opposite to the affected half of the body.

It also happens that a stroke leads to a complete lack of muscle strength in half of the body, which is called hemiplegia. With hemiparesis, a person experiences difficulty moving; with hemiplegia, the difficulties are even more significant. Simply put, hemiplegia is paralysis in half of the body (complete lack of movement).

Normal movements in the body are disrupted, and many people have to learn to perform normal daily activities again in order to be able to take care of themselves, be able to eat, change clothes and walk. In general, do everything that before the illness was considered extremely simple and ordinary to do. It is the decrease in muscle strength in half of the body that is the main cause of disability in a person after suffering a cerebrovascular accident. It is because of this that patients lose the ability to move independently - either they lose this ability completely or it is significantly impaired.

As you have already described, gait after a stroke can often be disrupted, and the person begins to move with great difficulty. In some cases, you may need auxiliary devices - a special walker, a support cane or a crutch. The characteristic Wernicke-Mann posture develops when walking. Parts of the body may be affected without affecting the entire half of the body. Depending on the affected half of the body, left-sided and right-sided hemiparesis are distinguished.

Central prosoparesis

Fig.1. Central paresis of the facial muscles (central prosoparesis)

The next, one of the most common consequences is the so-called central prosoparesis, in which the facial muscles suffer, resulting in facial asymmetry, as in Figure 1. In this case, a decrease in strength is observed not in the entire half of the face, but only in its lower part, involving the mouth, cheek, and lips.

With this paralysis of the facial muscles, the eyelids and eyes remain unaffected, despite this the distortion is quite noticeable and causes discomfort not only when eating or drinking. Central prosoparesis regresses with recovery from stroke.

With central prosoparesis, eating and drinking fluids is difficult. A person experiences obvious discomfort when performing some actions with facial muscles. It is more difficult to express habitual emotions; due to a decrease in strength in the facial muscles, sound production is disrupted and speech begins to suffer.

The defect itself brings noticeable inconvenience, purely from a cosmetic point of view. Facial distortion causes great emotional discomfort, especially when communicating with other people. This can cause withdrawal and withdrawal from communication with others and cause deep depression.

Speech Impairment

Speech disturbances after a stroke are also quite common, and at the same time they are one of the very first signs of an impending cerebrovascular accident. Speech impairment is the result of damage to the speech centers of the brain, which is a partial or complete loss of the ability to speak and perceive other people's speech, called aphasia.

According to statistics, such disorders are observed in a quarter of all people who have suffered a stroke, and their consequences can be quite persistent. Sometimes, it is difficult for a person to speak due to a violation of the speech apparatus, and the speech of such people is unclear, as if “porridge in the mouth,” but this disorder is called . Dysarthria more often occurs with a brainstem stroke or localization of this focus in the cerebral cortex. The next speech disorder is aphasia.

Aphasia is a complete absence of speech. Aphasia can be of several types, let's name some of them: when the speech center responsible for pronunciation of speech is damaged, motor aphasia develops. When the focus of the stroke is located in the speech center responsible for its perception, so-called sensory aphasia develops. With sensory aphasia, a person does not understand what is said to him and does not understand what he needs to answer. If both centers are affected, mixed or sensorimotor aphasia occurs. The “pure” form of aphasia is extremely rare, and with a stroke, the mixed form is most often found.

There are other types of speech disorders after a stroke, which we will discuss in detail in the following articles on speech disorders. Now let’s move on... In addition to the listed violations, the following also occur: consequences of a stroke.

Impaired motor coordination

Poor circulation in the parts of the central nervous system responsible for coordinating movements and as a result of a stroke can lead to coordination of movements, which is called ataxia. Impaired coordination of movements more often occurs with a brainstem stroke and this is due to the fact that the centers of coordination of movements in our body are located in the stem part of the brain.

It comes in varying degrees of severity. In the most favorable case, these vestibular disorders disappear within the first day from the moment of acute cerebrovascular accident. In other more severe cases, unsteadiness when walking and dizziness persist for a longer period and can last for months.

Visual impairment

There may be visual impairments of a wide variety of nature. Visual impairment depends on the location of the stroke and the size of the lesion. Most often, visual impairment manifests itself in the form of loss of visual fields(hemianopsia). In this case, as you may have guessed, half or a quarter of the visual picture is missing. If a quarter of the picture falls out, it is called quadrant hemianopsia.

Other consequences

• Impaired hearing (hypoacusia), sense of smell (hypo-, anosmia), loss of movement skills while maintaining strength in them (apraxia) and other disorders that can and should be treated; rehabilitation in this case is very important and should be carried out in a timely manner.
• Sensory impairment after stroke. Sensory impairment after a stroke can be of a different nature, but most often it is a loss of the ability to feel pain, recognize heat, cold, and a part of the body as such. It is also possible for a pain syndrome to appear, of a very diverse nature and localization. Most often, there is a decrease in sensitivity in some parts of the body, this phenomenon is called hypoesthesia.

These dysfunctions may well manifest themselves as the first signs of a stroke at the very onset of the disease and persist for an indefinitely long time in the absence of active restoration of impaired neurological functions.Please note that the severity of all these changes and their persistence directly depend on the size of the lesion and the nature of the stroke. Read more about the factors that play the main roles in the development of ischemic stroke and the formation of its consequences.

Depression

Depression– another consequence of a stroke that can negate any efforts of the doctor and loved ones to restore lost functions. According to some reports, up to 80% of stroke survivors suffer from depression to varying degrees. This is a rather serious consequence that can and should be treated.

In addition to the mood for recovery, an additional no less important “bonus” of eliminating depression will be the analgesic effect. It has long been proven that depression can increase pain in a person, and with a stroke, pain is not a rare occurrence. Prescribing antidepressants can help solve this problem.

It is extremely important to prescribe the “correct” antidepressant, since some of them can cause an “inhibitory effect,” which in some cases can also reduce a person’s desire to follow the doctor’s recommendations and become more active for better rehabilitation.

Stroke, the consequences of which remain after a course of treatment in the hospital, is a common occurrence. Such people need a course of full rehabilitation, which often begins in the hospital. The rehabilitation course itself is prescribed individually, depending on the severity and persistence of the consequences, as well as on the time that has passed since the stroke and the general condition of the patient.

If the hospital was unable to fully restore a person after a stroke, then further treatment It is advisable to carry out it in a specialized rehabilitation center.

Read about an example of this rehabilitation center in the article.

Stroke is a serious disease that has a detrimental effect on a person’s normal functioning. The brain center loses its properties - nerve cells of the brain associated with coordination, motor, speech and visual functions die. Rehabilitation after a stroke at home occupies an important place in the treatment of pathology.

The duration of rehabilitation after a stroke depends on the location and size of the lesion in the “gray matter”, the time from the development of the pathology to the time of treatment. medical care. Forecasts are disappointing if the values ​​of the listed indicators are quite high. Such patients have to be cared for throughout their lives to prevent deterioration.

How long does it take to recover from a stroke?

1. Ischemic pathology with minimal damage to the nervous system, consequences - slight paralysis of the arms and toes, impaired movement, dizziness, damage to the visual organ. Partial rehabilitation up to 2 months, complete rehabilitation up to 90 days.
2. Various types of stroke with severe deficits (persistent incoordination, severe paralysis). Preliminary treatment takes longer than for mild brain damage and takes six months; the patient sometimes fails to fully recover.
3. Severe hemorrhagic and ischemic pathologies with persistent damage to the nervous system (disability, other disorders). Partial rehabilitation with the ability to sit without assistance – up to 2 years; most often it is impossible to fully recover.

The duration of rehabilitation and complex therapy depends on the severity of the stroke. Patients who have suffered need longer and more serious treatment in a hospital setting.

In case of severe damage to the nervous system, it is not always possible to guarantee complete restoration of vital functions, for the reason that some brain cells die and neighboring healthy neurons cannot replace them. Therefore, rehabilitation after a stroke will require a long time; in most cases, patients undergo treatment throughout their lives.

The duration of rehabilitation depends on many factors

The patient's chances of a full recovery

Whether or not you can recover from a stroke depends on the location and its size. If the pathology is one-sided and affects only one part of the brain centers, the patient partially loses the ability to lead a normal lifestyle - he sees poorly and is not oriented in what is happening.

A fundamental role in the return of lost ability to work is played by timeliness, as well as the correctness of first aid for acute stroke. From the moment of blockage of the vessel and the cessation of nutrition to the brain until tissue necrosis takes place about 2-3 hours. If the blood circulation process is not normalized during this time, the chances of restoring motor functions are minimal.

When rehabilitation in a hospital or at home after a stroke is unlikely:

• with damage to active epicenters of the brain, especially the nerve stem bundle. In this situation, coma or death occurs;
• with significant lesions - lacunar stroke more than 5 mm;
• elderly patients over 70 years of age;
• in patients with severe chronic diseases, in poor health due to the use of alcoholic beverages and drugs.

After a stroke, your chances of recovery depend on your medical care. To maximize the result, the doctor will recommend strictly following the treatment regimen so that the consequences of the attack are minimal.

To minimize the consequences of an attack, you must strictly follow the treatment regimen.

Fundamental principles of therapy

Exercise therapy after a stroke begins in the very first days of rehabilitation, as soon as the person’s condition allows for light physical exercise. The recovery period is a set of procedures aimed at returning the patient to lost functions as a result of the disease.

Principles of treatment of patients after a stroke:

1. Early rehabilitation, which is carried out from the first day of the attack (if the patient’s condition allows) to accelerate the restoration of lost functions and prevent the formation of secondary consequences (thrombophlebitis, pneumonia, bedsores, muscle tissue dystrophy).
2. Treatment begins in the neurology department and continues in a specialized center.
3. Patients and relatives should participate in the recovery process, including doing exercises and recommendations at home.

The prognosis for the rehabilitation of patients with stroke is determined by the location, size of the injured area of ​​the “gray matter,” as well as the completeness and accuracy of the procedures recommended by doctors.

Stages of recovery after an attack

Doctors distinguish between several periods of treatment - the first three months, up to six months and from 6 months to a year. You need to understand the role that medical rehabilitation plays in providing psychological support, measures to restore vital functions, brain activity, motor system, and memory.

Therapeutic measures for the first 3 months

Treatment of the disease in the early stages consists of stabilizing the patient’s physical and emotional state. As soon as the human body overcomes the first consequences of the attack, relatives will be able to take the patient home. At first, he will need full care and rest.

Patients who have suffered a stroke must be immediately accustomed to the correct daily routine; vital functions are better restored in the first weeks after the attack:

• sit down on your own, then stand up. By the end of the first period, the patient must partially dress and take care of himself;
• At this time, the main place is occupied by physical rehabilitation - gymnastics for bedridden patients, massage. If a limb is paralyzed, it must be exercised 2-3 times a day to restore its mobility;
• by the end of the second month, a person begins to stand up and maintain balance. It is necessary to buy him a walker or other support; he should not walk without it.

A set of exercise therapy exercises is shown for extension and flexion of joints, various movements of the shoulder and knees. Facial gymnastics also plays an important role in case of paralyzed muscle tissue.

Therapeutic measures from 3 months to six months

When the patient has learned to partially manage without assistance, he can move on public transport, move away from home at a certain distance. The patient continues to perform exercises for the arms and legs after the stroke. He is allowed to take long walks in the fresh air, but with a mobile phone.

At the end of this stage of rehabilitation, the patient needs to refuse outside help when moving, walkers, should learn to use tableware and writing utensils, and perform exercises after a stroke at home to strengthen muscle tissue.

Treatment measures after six months

The rehabilitation program is already producing results: the body, psychological condition The patient is gradually recovering, he can move freely, the injured arm functions normally. Speech is still a little slower, but not as confused. Memory recovery after a stroke will also take some time.

The best physical exercises at this time are the development of fine motor skills: washing dishes, fastening buttons, knitting, embroidering.

According to statistics, after an attack, 85% of patients return to their normal lives after 1.5 years. Of these, more than half of the people recovered after 4 months, subject to systematic self-care and proper treatment.

Required big job above oneself

Patient care at home

It is necessary to prepare for the arrival of the patient, as he needs peace and a comfortable environment that will help the healing body feel comfortable. What items will the patient need for normal activities:

1. Diapers, bedpan.
2. Medical diapers.
3. Mattresses, circles against bedsores.
4. Comfortable chair, support near the bed.

Several times a day a person needs to be washed, helped to brush teeth, treat mucous membranes, and clean the ears. The bed should be without folds, this will help prevent bedsores. The body can be lubricated with cream or solution (a glass of vodka, a liter of clean water, 200 ml of shampoo). Every 3 hours, the position of the body should be changed.

In the absence of a swallowing, chewing reflex, food is ground into a paste and given to the patient through cocktail sticks; baby purees are also suitable. You cannot force feed a person, this will cause a gag reflex. If there is no appetite, you can offer your favorite food in small portions 6 times a day.

If a person moves without assistance, first of all he needs to sit more often. The first 2-3 days – a few minutes, with a gradual increase in time. The second stage is to take an upright position, take walks, and perform exercises to recover from a stroke. You should move with the help of a special support.

If the swallowing and chewing reflex is difficult, the food is crushed

Food and therapeutic diet

The patient should eat only nutritious, healthy foods. His daily diet during the rehabilitation phase includes:

• vegetable oils – soybean, rapeseed, sunflower, olive (no more than 120 g/day);
• seafood – at least 2 times/week;
• fresh fruits, vegetables, saturated with folic acid and fiber from 400 g/day;
• water – up to two liters (in the absence of contraindications);
• blueberries, bananas;
• fish, meat, and dairy products are consumed in small quantities; preference should be given to low-fat varieties.

A serious disease associated with impaired brain function - stroke - only a qualified doctor can tell you exactly how it is treated. The entire body as a whole must recover after an attack.

The order of cooking must be correct, as well as rehabilitation methods:

1. Food is boiled, stewed or steamed.
2. All fat is removed.
3. The diet should be supplemented with legumes.
4. Potatoes and meat are allowed to be consumed no more than 3 times a week; they are baked.
5. Cereals – oatmeal, rice (brown), wheat, bran.
6. Avoid spicy smoked foods, bread, sweets, and pastries (they increase cholesterol levels).

It is possible to recover after a stroke at home, provided you follow all the doctor’s recommendations. You should avoid salt completely or reduce its amount. Alcoholic drinks are completely prohibited. Your doctor may recommend drinking homemade red wine, but within safe limits.

After a stroke, the brain functions with disturbances, nerve cells are damaged, which manifests itself in loss of memory, speech, and other psychological and motor dysfunctions.

Treatment methods for various forms of strokes are selected by the doctor individually for each patient, as are recommendations for care. Proper care will help prevent the negative consequences of the disease.

How to recover after a stroke for a patient:

• avoid excessive loads;
• if your arm or leg becomes numb during sleep, you should place a cushion or pillow under it;
• use the paralyzed limb more often;
• It is better to do exercises in silence, without strangers.

For the first 7-14 days after discharge from the hospital, unless otherwise prescribed, training should consist only of changing body position. Afterwards, passive gymnastics is recommended, the goal of which is to prepare and relax the muscles.

When a person begins to move independently, physiotherapeutic methods of recovery after an ischemic stroke are applied to him - manual therapy, massage, heat treatment, laser therapy, magnetic therapy, a course of group gymnastic approaches.

A set of exercises after a stroke includes:

1. Warm up – squats, gentle stretches on your toes, bending over.
2. Alternating loads – running, race walking.
3. A set of exercises on an exercise bike.

Therapeutic exercises after a stroke are performed according to an individual scheme. You cannot make adjustments on your own; a relapse is possible. Exercises that increase spasticity of muscle tissue - squeezing the ball, rings are prohibited.

Sexual desire returns approximately a few months after the illness. In some situations, an attack has a positive effect on a person’s libido, center and hypothalamus, which is responsible for the release of hormones. Some patients lead a full sexual life even before speech is restored, but after consultation with a doctor.

Key Points in Physical Rehabilitation

The main task of the recovery stage is the return of motor activity to the limbs, which are limited to neurological functions during a stroke. It is necessary to start rehabilitation from the first days after the attack.

Gymnastics and restoration of motor function

Gymnastics after a stroke at home is characterized by the following points:

• decreased muscle tone and tension;
• restoration of microcirculation;
• prevention of muscle frigidity;
• protection against bedsores, diaper rash;
• restoration of the functioning of the nervous system;
• Before performing a new exercise, you should consult a specialist;
• Against the background of exercise therapy, even patients with the same problem recover differently, and therefore increased loads are prohibited.

When performing exercises to restore fine motor functions, you can do gymnastics from the previous stages, especially if it is aimed at strengthening muscle tissue and promoting overall development. To restore movement of the legs and arms after a stroke, it is allowed to use light dumbbells.

The patient should exercise daily so that over time the body returns to normal. Exercise therapy continues throughout the entire rehabilitation period and after it. Exercises for the face after a stroke are also shown.

Therapeutic and preventive measures for recovery

You will need classes to strengthen your arms, legs and back.

Exercise therapy for stroke is aimed at strengthening the arms, legs and back, to prepare the patient for walking and short walks. How can a patient recover quickly after a stroke on his own:

1. The man sits down and grabs the bed with his hands. As you inhale, arch your back, your torso should be stretched and tense. Relax on the way out. Charging consists of 10 approaches.
2. Exercise – the patient sits on a horizontal surface, legs at bed level. Raise your left and right leg 2-3 times.
3. Restoring a hand after a stroke. Accept sitting position. Place your hands back. As you inhale, bring your shoulder blades closer to each other and throw your head back. Relax on the way out.
4. Exercise for the hands. Make rotational movements in one direction and the other. Just 8-10 approaches.

After motor activity has been restored, you should move on to exercises that are performed in a standing position. Their main goal is to neutralize neurological dysfunctions.

Rehabilitation exercises after a stroke at the next stage look like this:

• moving a small object from the surface of a table or floor;
• standing, lower your arms, while inhaling, raise them above your head, stretching and leaning on your fingers, relax as you exhale, bend your torso down, lower (2-3 approaches);
• a simple exercise - bend your hands into a fist using an expander, moving them away from the body;
• starting position, standing, squatting, connect your feet, keep your back straight, do not lift your legs off the floor.

To restore muscle tissue, facial gymnastics is prescribed to prevent consequences such as paralysis. Sometimes rehabilitation takes quite a long time. The duration of treatment depends on the severity of the disease.

The treatment regimen includes mandatory gymnastics for the facial muscles.

Treatment and medical monitoring after an attack

Whether it is possible to fully recover after a stroke depends on the location of the lesion, its severity and the timeliness of first aid. Complex therapy of stroke includes the following medications:

1. Restoration of blood supply: Pentoxifylline, Cavinton, Cerebrolysin.
2. Starting metabolism in brain tissue: “Solcoseryl”, “Actovegin”, “Ginkor Fort”.
3. Nootropic drugs that act on active centers: “Lucetam”, “Piracetam”, “Noofen”.
4. Recovery after a stroke at home includes treatment with anticoagulants that prevent the formation of clots and thin the blood plasma - Heparin, Coumadin.
5. Other drugs that reduce the excitability of nerve centers, eliminating stiffness of muscle tissue (muscle relaxants), herbal teas, folk remedies, antidepressants (“Adaptol”, “Gidazepam”).

All patients who have undergone are observed in the hospital by a neurologist. The attack has a negative impact on Everyday life person, so prolonged depression is likely. Patients need communication, support, constant contact with the world around them.

Bedridden patients after a stroke need to be told that they will recover. During depression, they may refuse outside help, including medical consultations. In the absence of contact on his part, you should consult a psychologist and take antidepressants.

In the presence of a patient who has suffered a stroke, one cannot discuss his illness, but it is necessary to encourage his successes. Relatives, just like the patient, are shown positive emotions, relaxation in the form of meditation, sports, aromatherapy, massage. Perhaps the doctor will prescribe multivitamin complexes.

If the motor activity of the limbs is lost, only a specialist can tell you how to restore the arm after a stroke after a comprehensive diagnosis and study of the clinical picture of the course of the disease. The result of treatment depends both on the patient himself and on medical care.

Stroke is a terrible pathology that does not go away without a trace. More than 80% of people who have had a stroke remain permanently disabled. Stroke consequences and causes of the disease. How to protect yourself and your loved ones from death and disability. When to call a doctor, and what actions to take to prevent an attack from causing serious damage to the body.

Description of the pathology

What is a stroke? Many of us have heard this name more than once, but every person is sure that this disease will bypass him. Some people think that he is too young, others are sure that this is the lot of chronically ill people, and still others even believe that this disease can only appear in those who have a hereditary predisposition.

Today, doctors say that indeed, pathology most often affects older people and heredity also plays a role, and chronic diseases can cause the development of stroke. However, experts also say that no one is immune from this dangerous disease. Increasingly, strokes strike young and seemingly healthy people. What is the cause and how dangerous is a stroke?

The cause of cerebral stroke lies in various vascular diseases. It is the vessels that supply the brain with oxygen. Their network is spread throughout the body and they must be strong, elastic and clean. If a narrowing of the lumen of the vessel occurs, for various reasons, pressure begins on the wall, and it may not withstand it and burst. This is how a cerebral hemorrhage occurs. Its consequences are most often severe and disrupt important body functions.

Another type of stroke is necrosis of brain cells due to blockage of brain vessels due to oxygen starvation.

The most dangerous is a stroke with hemorrhage. When hemorrhage occurs, a hematoma is formed, and it is this that becomes the cause of death and disability of a person. The hematoma grows and compresses the nerve endings that are concentrated in the brain. The brain stops functioning normally. A person may lose speech motor activity, ability to breathe independently. The same consequences can develop with necrosis of brain cells, however, ischemic stroke (in which the vessel does not rupture, but only becomes blocked) is considered the most favorable in terms of prognosis and rehabilitation for the patient.

More about types of stroke

Today, doctors distinguish three main types of stroke. The life expectancy after a stroke and the possibility of maximum recovery after an attack depend on the type. The types of stroke directly depend on the nature of the damage to blood vessels and brain cells, namely:

Subarachnoid stroke. The causes of this form of pathology lie in traumatic brain injury or rupture of an aneurysm. The hemorrhage in this case is localized between the soft and arachnoid membranes of the brain. The mortality rate from this form of pathology is quite high and reaches 50%. However this type pathology is quite rare. Complications after it are the most severe. Develops immediately or within a few hours after injury.

Hemorrhagic stroke. The causes of this form of stroke are rupture of a vessel and hemorrhage in the brain. The mortality rate from such attacks reaches 33%. However, the degree of disability is very high. In this case, the hemorrhage and subsequent hematoma are localized in the ventricles and under the membranes of the brain.

An attack of this type develops rapidly and the patient can fall into a coma within a few minutes after feeling unwell.

Ischemic stroke. An attack develops from a narrowing or blockage of a vessel. The causes of vasoconstriction vary from atherosclerosis to nervous tension. This is the most common form of stroke. The mortality rate from it reaches 15%. With timely hospitalization, patients most often have a positive prognosis for recovery. The attack may develop over several days.

In addition, doctors distinguish an acute type of pathology, microstroke, extensive or spinal stroke. All these forms differ in the degree of damage and localization. Forecasts for each individual case are purely individual.

Risk factors

Despite the fact that stroke can develop in any patient these days, even in young people, there are a number of risk factors that are most often present in patients with this diagnosis.

Causes of stroke:

• Age after 50 years.
• Gender male.
• Heart diseases.
• Arterial hypertension.
• Constant nervous tension.
• Having bad habits.
• Having excess weight.
• Presence of diabetes mellitus.
• Genetic predisposition.

It is worth noting that the consequences of a cerebral stroke directly depend on the speed of hospitalization of the patient. Unfortunately, in our country, emergency hospitalization occurs in only 30% of the total number of patients with this diagnosis. Doctors are called only when it becomes clear that the situation is critical and the patient is doing very poorly. However, for example, an ischemic stroke can develop up to 3 days, and if the patient is taken to the hospital on the first day, his prognosis will be more favorable. Most often, people who lived alone are left without medical help.

Many relatives of patients ask how many years they live after a stroke. There is no clear answer to this question. With timely assistance and following all the doctor’s recommendations, the patient can live for many more years, but everything also depends on the age, as well as on the general health of the patient.

Consequences of an attack

A brain stroke invariably leads to negative consequences. In principle, there is no difference between the consequences of a stroke in women and those in men. The consequences of stroke in men can be observed more often only for the reason that this pathology develops more often in males. The most dangerous complication of a stroke is a recurrent attack.

It is from this that about 40% of patients die in the first 30 days.

The consequences of the attack begin to appear from the first minutes of the attack. The patient experiences the following symptoms, which clearly indicate the development of a cerebral stroke:

• Increased pressure.
• Increased body temperature.
• Slow reaction.
• Cramps.
• Sharp headache.
• Loss of sensation in one side of the body.
• Loss of orientation.
• Memory loss.
• Speech impairment.
• Coma.

After the attack has stopped, the patient may experience the following abnormalities:

Paralysis. The most common consequence of a stroke is paralysis of one side of the body. Paralysis develops on the side opposite to the localization of the pathology. With this disorder, the patient can no longer cope without outside help. He needs serious rehabilitation, which can last several years. Basic motor functions should be restored within a year, fine motor skills takes much longer to recover.

Loss of sensation. This deviation is characterized by a loss of sensitivity in the muscles of the body. Recovery should be accompanied by exercises to return motor activity.

With this consequence of a stroke, exercise therapy and other rehabilitation methods are actively used.

Speech disorders. Restoration of speech skills depends on the specific disorder. Speech problems occur in about a third of stroke patients. A person may experience the following speech problems:

• Impaired speech understanding.
• Impairment of own speech.
• Difficulty finding words.
• Violation of both understanding and speech reproduction.
• Complete impairment of speech perception and reproduction.

Restoration of speech functions should begin as early as possible. For this purpose, the patient is recommended to have special sessions with a speech therapist. The recovery time is quite long. As a rule, speech is restored after several years.

In addition to these consequences, the patient may encounter complications such as:

• Hypotonicity of muscles.
• Central pain syndrome.
• Trophic pathologies.
• Vision pathologies.
• Difficulty swallowing.
• Nervous system disorders.
• Loss of coordination.
• Epilepsy.

All these disorders require long-term treatment. Often the care of patients falls on the shoulders of relatives, and it is they who must monitor the implementation of all the doctor’s recommendations. How long people live after a stroke largely depends on the care of their relatives. The main task of relatives and doctors is to prevent a recurrent attack and rehabilitation of the patient, which should begin as early as possible.

Recovery forecasts

After a stroke, the prognosis for life is highly individual. Many relatives also want to know when the patient’s full recovery is possible. Doctors say that rehabilitation is influenced by many factors, including the desire of the patient himself. Most favorable forecasts recovery is predicted based on the following factors:

• Young age.
• Early hospitalization.
• Stroke of moderate to mild severity.
• Localization of stroke in the vertebral arteries.
• Complete care.
• Properly organized rehabilitation.

Life forecasts

Survival prognosis is the main thing that relatives expect from doctors when they close person ends up in the hospital with a stroke. Stroke, how long do people live after an attack, and what does this prognosis depend on? Most often, doctors do not give specific prognoses. The key, they say, is to prevent another attack within 30 days. Next, a person must live for a year, and only after this period the risk of death gradually decreases.

Recurrent stroke is the most common cause of patient death.

The development of a recurrent attack is influenced by the following factors:

• Patient's age.
• Delay in going to the hospital.
• Availability chronic diseases before the attack.
• Poor quality of care.
• Not following doctors' recommendations.
• Stress and nervous tension.

Doctors say that if negative factors are eliminated as much as possible and a competent approach to the treatment and rehabilitation of the patient, life prognosis can be favorable. Some patients are still living long life, gradually recovering and learning to live again. Of course, there is a greater chance of survival in at a young age, but even older people sometimes display such a desire to live that it surprises even doctors.

Thus, it can be argued that the prognosis depends on how much the brain is damaged, on the patient’s age, care for him and his desire to live. It is with the last point that problems often arise. Elderly people do not want to fight, they do not want to become a burden to their relatives. In this case, you need consultation with psychologists and support from loved ones. Only by reviving a person’s desire to be healthy can one count on his speedy recovery.

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