Acute cerebrovascular disease, commonly known as stroke and stroke, is characterized by sudden fainting (or not fainting), mouth-eye deviation, hemiplegia and speech difficulties.
Stroke, cardiovascular disease and malignant tumor constitute the three major diseases with the highest mortality rate today. In particular, it is difficult to diagnose cerebrovascular diseases, and there are few drugs and methods to treat them, which seriously affects health and life expectancy.
Common types of acute cerebrovascular diseases:
(1) cerebral hemorrhage;
(2) subarachnoid hemorrhage;
(3) Cerebral infarction (including cerebral thrombosis);
(4) Transient ischemic attack (called death).
Cerebrovascular diseases are divided into ischemia, including cerebral thrombosis and cerebral embolism; Hemorrhagic, including cerebral hemorrhage and subretinal hemorrhage.
Stroke patients have a history of hypertension and cerebral arteriosclerosis. Once you have a stroke, it will be more troublesome to treat. Even if rescued from danger, it will leave sequelae such as hemiplegia, which will not heal for a long time. Early detection and early measures can often prevent serious consequences. So, what are the signs of a stroke?
Stroke patients often first appear on one side of the face or hands and feet suddenly feel numb or weak, mouth askew, drooling; Sudden temporary difficulty in speaking or inability to understand what others are saying; Temporary blurred vision or blindness; Suddenly feel dizzy or unstable, or even faint; Sleepiness without obvious reasons; A sudden change in character or intelligence; Have unexplained headaches, etc. Anyone with any one or more of the above symptoms should immediately let the patient rest in bed and keep quiet, and don't be nervous, excited, afraid or fidgety. It's better to call an ambulance or a doctor for examination. If you don't have the conditions, when you need to go to a nearby hospital, you should use a stretcher to get on the bus, and you should prevent bumps on the road. The patient should lie flat with his head tilted to one side to prevent vomit from choking the trachea.
Stroke is a pathological change caused by cerebrovascular disease, and it is a manifestation of local blood circulation disorder in the brain. It can be divided into two categories: hemorrhagic stroke and ischemic stroke. Cerebral hemorrhage and subarachnoid hemorrhage belong to hemorrhagic stroke; Cerebral embolism and cerebral thrombosis belong to ischemic stroke. The clinical manifestations of hemorrhagic stroke are severe headache, vomiting, mania, lethargy, coma or hemiplegia; The clinical manifestations of ischemic stroke are hemiplegia, hemiplegia, aphasia and visual impairment.
Health guide:
1. Prevention and treatment of primary disease: The longer the hypertension time, the more obvious the arteriosclerosis, which is prone to stroke. Blood pressure should be measured frequently at ordinary times, and medication should be taken to control blood pressure within the normal range as much as possible. Coronary heart disease is often caused by arrhythmia, which reduces the pumping ability of the heart, makes the cerebral blood flow slow, and is prone to ischemic stroke. Hyperlipidemia can lead to atherosclerosis and increased blood viscosity. Diabetes will harden the arterial wall and increase blood viscosity. Both can induce stroke. Therefore, effective control and prevention of primary disease is an important key to prevent stroke.
2. Emotional adjustment: A relaxed and happy mood can effectively prevent the aggravation of primary diseases such as hypertension.
You can distract yourself by listening to light music and chatting with young people. Don't watch scary movies. Don't get angry when something happens, pay attention to the combination of work and rest. Go shopping and exercise on an empty stomach in the morning to eat snacks to prevent hypoglycemia and cerebral thrombosis. The weather changes obviously, especially the sudden cooling will make blood vessels contract and blood pressure rise, which will lead to the deterioration of the disease. You should wear more clothes to keep warm.
3. Quit smoking and avoid alcohol: Smoking and excessive drinking will further damage heart function, increase blood viscosity and blood lipid, and easily induce stroke.
4. Keep the stool unobstructed: Keep the stool unobstructed at ordinary times, and don't get angry when defecating, so as to avoid the increase of abdominal pressure, sudden increase of cerebral blood flow and cerebral hemorrhage.
5. Diet adjustment: The diet should be light. Eat more fresh vegetables and aquatic products, such as vegetables, radishes, kelp and laver.
Eat less and eat more. Eat enough dietary fiber and intestine-moistening food, fast fat meat and animal offal, and don't eat irritating onions, peppers, coffee, etc. Eat less refined sugar, honey, fruit candy, cakes, etc. The amount of salt is limited to 4 grams per day, which can prevent water retention and reduce the burden on the heart.
6. Physical exercise: Choose Tai Ji Chuan, walking, Qigong and other sports for exercise. Don't lie in bed all day. Staying in bed for a long time will slow down the blood flow and cause ischemic stroke, which is also not conducive to the gradual recovery of physical function after stroke.
7. Seek medical attention in time: If you find yourself walking unsteadily, one limb is weak, your mouth is crooked, your lips are numb, or you may have cerebral vasospasm or slight stroke while holding things on the ground, you should seek medical attention in time to prevent the disease from developing further.
Speech Recovery after Stroke Chief Physician Li Shan
More than half of stroke patients can't speak or speak clearly, or they can speak spontaneously, but they don't understand what others are saying. These are all language disorders caused by stroke. Medically, language disorders of stroke patients are divided into aphasia and dysarthria. The former is divided into motor aphasia, sensory aphasia, mixed aphasia and named aphasia.
Motor aphasia is also called expressive aphasia. Although patients can understand other people's languages (spoken and written), they can't express themselves orally or in writing. If the patient can't speak at all, it is called complete motor aphasia; If the patient can only speak simple sentences and can't speak complex sentences, it is called incomplete motor aphasia.
Sensory aphasia is also called receptive aphasia. Patients have the ability to speak, but they can't understand other people's words and their own words. The content of the speech is chaotic or intermittent, and it is often irrelevant to answer questions and use wrong words, which makes it impossible to have a normal conversation.
Mixed aphasia includes both motor aphasia and sensory aphasia. The patient can neither understand what others mean when they speak, nor speak.
Named aphasia patients can say the purpose of the object, but can't say the name of the object. Sometimes you occasionally say the name of an object, but you forget it in an instant, so it is also called amnesia.
The focus of aphasia is in the language center of cerebral cortex. At present, there is no specific drug that specifically acts on the language center. The aphasia of most patients can gradually recover with the improvement of the primary disease. Special functional training is very important for the smooth rehabilitation of aphasia patients. At present, it is believed that the earlier the rehabilitation treatment for language disorders, the better. Recover quickly within 3 months after illness, and it is difficult to recover after one year. Functional rehabilitation training includes pronunciation training, phrase training, conversation training, reading training, sentence retelling training, character recognition, pointing out the name of an article, executing commands, matching pictures with objects, etc.
Rehabilitation training for patients with complete aphasia should start with learning pronunciation, like teaching children to speak, such as making patients pronounce "ah" or whistling with their mouths to induce pronunciation. Then talk about common words, such as eating, drinking, doing, etc. Or show a card and let the patient read the words on it. Then teach disyllabic words, phrases, short sentences and long sentences in turn. During training, speech is combined with visual stimuli, for example, when eating, it is combined with food, or by looking at pictures, speech is combined with pictures. Patients with incomplete motor aphasia can speak some words, phrases, sentences or are not fluent. Patients are often poor in vocabulary, slow in speech and repetitive in language. We should teach these patients patiently, read stories repeatedly, practice flexibility and practice language skills.
The training of patients with sensory aphasia is more difficult than that of patients with motor aphasia. Training can adopt visual logic method and gesture method. For example, give the patient a face plate, put a towel away and tell him to "wash his face". Although the patient doesn't understand the meaning of the word "wash his face", he will logically understand that you are asking him to wash his face. After many days of repetition, language and vision are combined for a long time, and the language function is restored. Gesture means that family members or caregivers train patients with gestures and language. If the patient is allowed to "eat" and the trainer demonstrates the action of eating with chopsticks many times, the patient will soon understand and take the initiative to eat with chopsticks.
Functional training for patients with mixed aphasia is more difficult, and it must be repeated by combining speaking, watching and listening. If the patient is asked to wear a sweater, he should not only say "wear a sweater" for the patient to listen to, but also point to the prepared sweater and make a gesture for the patient to see.
Another language disorder caused by stroke is dysarthria, which is mainly manifested in inaccurate pronunciation, unclear articulation, abnormal intonation, speech speed and rhythm, and excessive nasal sound. The rehabilitation method must carry out pronunciation training as soon as possible, including beginning pronunciation, continuous pronunciation, volume control and tone control. Exercise training of pronunciation organs, such as lip and tongue movement and soft jaw elevation; Pronunciation rhythm training includes stress training, intonation training and pause practice. Such patients often have excessive muscle tension, including laryngeal muscle tension. Reducing the muscle tension of laryngeal language through relaxation therapy such as breathing training and breathing control can lay the foundation for breathing and pronunciation. Relaxation therapy to reduce the tension of language and muscles through psychological behavior or drugs is also one of the important rehabilitation methods for such patients.
Free hospital network Tian Tian healthy newspaper editorial department
Cerebrovascular accident, that is, stroke, is a cerebral blood circulation disorder caused by cerebrovascular disease. It is characterized by ipsilateral hand-foot paralysis, that is, hemiplegia. Severe coma, convulsions and even death.
Stroke can be divided into ischemic stroke and hemorrhagic stroke.
Ischemic stroke includes atherosclerotic cerebral thrombosis and cerebral embolism. Atherosclerotic cerebral thrombosis accounts for 60% of stroke patients. After arteriosclerosis, the blood vessels become narrow, the blood vessel wall is not smooth, and the blood flow is slow, which leads to coagulation and ischemia and necrosis of some brain tissues. This kind of stroke is common in the elderly, mostly in sleep. When I wake up, I find that my hands and feet don't work, and my condition often develops gradually after I get sick. Cerebral embolism is an "embolus" formed by other parts, which flows into the cerebral vessels with blood to block the cerebral vessels and make some brain tissues ischemic and necrotic. Common "embolus", such as thrombus falling from atrium in patients with atrial fibrillation; In patients with subacute bacterial endocarditis, the bacterial embolus fell off the heart valve; Fat embolus enters blood vessels during long bone fracture; Air embolism when suffering from diving disease, etc. Patients with cerebral embolism all have the basis of other diseases and all have sudden onset.
Hemorrhagic stroke includes hypertensive cerebral hemorrhage and subarachnoid hemorrhage. Hypertensive cerebral hemorrhage is seen in patients with long-term hypertension. When blood pressure fluctuates greatly, the middle cerebral artery and other places rupture, resulting in cerebral hemorrhage, leading to partial brain tissue necrosis. This kind of stroke is more common in patients with long-term hypertension who have not been properly treated, and often occurs in the case of drinking, excitement, anger or exertion. Patients with cerebral hemorrhage can often enter coma quickly, such as pontine hemorrhage, and often accompanied by high fever. Subarachnoid hemorrhage is mostly caused by the rupture of congenital aneurysm at the bottom of the brain. This kind of bleeding is common in young people and even children. There may be some headaches before the attack, and severe headaches, coma and convulsions will occur during the attack.
The diagnosis of cerebrovascular accident is not difficult. It is very helpful to do lumbar puncture to check whether there is blood in cerebrospinal fluid, which helps to distinguish what kind of stroke it is.
When cerebrovascular accident happens, it should be treated on the spot. For ischemic stroke, the main treatment is to improve blood circulation in the brain. Commonly used drugs include low molecular dextran, salvia miltiorrhiza, aspirin and so on. For hemorrhagic stroke, the main treatment measures are to reduce intracranial pressure and eliminate brain edema. The commonly used drugs are mannitol and dexamethasone. If a ruptured cerebral aneurysm is suspected, cerebral angiography and sometimes surgery can be performed if the patient's condition permits.
Hemiplegia of hand and foot is the main sequela of stroke, which requires timely application of acupuncture, massage and leveling therapy, and proper exercise can improve the condition.
The prevention of stroke mainly lies in the treatment of hypertension, and the blood pressure is controlled within the basic normal range. Patients should be optimistic and maintain emotional stability. Old people should do proper activities and not stay in bed for a long time. People with transient ischemic attack should take some dipyridamole or aspirin to prevent cerebral thrombosis.
What is the popular science journal of stroke medicine? Seek medical advice-it is beneficial to open books. Author: Hua
Stroke usually refers to acute cerebrovascular disease, also known as cerebrovascular accident and stroke. Stroke is often divided into ischemic stroke, hemorrhagic stroke and mixed stroke.
Ischemic stroke includes: 1. Transient ischemic attack, clinical symptoms usually disappear completely within 24 hours; 2. Cerebral thrombosis, with slow onset and progressive aggravation; 3. Cerebral embolism, the onset is sudden, mostly because the embolus outside the heart suddenly falls off and flows into the brain tissue through blood flow, blocking blood vessels; 4. Lacunar cerebral infarction is the blockage of intracranial small vessels. The patient's symptoms are not very serious or have no clinical symptoms. It is usually multiple and has a good prognosis.
Hemorrhagic stroke includes: 1. Cerebral hemorrhage, mostly caused by hypertensive cerebral arteriosclerosis, progresses rapidly, often accompanied by conscious disturbance, hemiplegia, hemiparalysis, hemianopia, aphasia and other limited signs; 2. Subarachnoid hemorrhage is mainly caused by congenital cerebral aneurysm rupture, vascular malformation and cerebral arteriosclerosis hemorrhage. The bleeding is all in the subarachnoid space on the surface of the brain. The onset is mostly severe headache or vomiting, or disturbance of consciousness, which is often transient neck stiffness without paralysis and other limited signs or not obvious.
Mixed stroke refers to the fresh cerebrovascular disease with hemorrhage and infarction during CT scanning of the head or one after another. This kind of patient is rare.
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