The whole truth about hemorrhagic stroke of the brain: the more dangerous it is and how to treat it

Stroke is a sudden and rapidly developing cerebral vascular accident.

Is ischemic and hemorrhagic. Differences in the mechanism of appearance explain the development of the disease and the prognosis.

Forms of the disease

Ischemic strokeappears as a result of blockage of the vessel and as a result, there is a significant deterioration or complete cessation of the blood supply of a separate region of the brain. It develops gradually, time noticed, can be cured with minimal losses and residual effects.

Hemorrhagic strokethe brain is the result of damage to the vessel wall and hemorrhage. It develops rapidly and has severe consequences, often even despite adequate treatment.

Survival statistics

Brain ischemia is 5 times more common than hemorrhage. But the consequences are much more serious in a hemorrhagic attack.

In contrast to cerebral ischemia, hemorrhagic stroke is not only experienced by elderly people: with defects in the formation of blood vessels,hemorrhage can occur at any age. Men are more prone to this disease.

Stages of development

Like any disease, this develops in time and qualitatively.Passes in stages:

• prodromal period: damage has already begun, fluid from the vessels begins to flow into the brain tissue;
• developed or demonstrative stroke - all the symptoms that indicate a brain damage of one degree or another are clearly pronounced;
• an accomplished stroke: the hemorrhage is over, the destruction of tissues does not spread to neighboring areas;
• rehabilitation: restoration of the functions of the damaged parts of the brain.

The form of hemorrhagic stroke directly depends on the area of ​​the lesion.

Classification of species by foci of defeat

Depending on the place of origin, the hemorrhage happens:

• intracerebral- when a vessel is ruptured inside the brain or in the trunk, it most often occurs because of the increased pressure in individual brain centers, it can be localized (without blood entering the cerebrospinal fluid) and is limitedly diffused;
• subarachnoidal- localized in the sphere of the Willis circle between the cerebral membranes, occurs in 80% of all cases of hemorrhage;

• extensive- develops with reduced blood coagulability or misdiagnosed diagnosis with the introduction of anticoagulants, or with multiple vascular ruptures in hypertensive crisis in different parts of the brain;

Consequences of damage to the right and left sides

Right hemisphere- in the case of hemorrhage in this part of the brain, violations occur in the left half of the body and the functions of abstraction, synthesis and analysis of information are disrupted, physical self-perception is disrupted (alienation of limbs, sensation of multiple parts of the body), speech is practically not broken, but memory determine the size, mathematical ability.

Left hemisphere- a pronounced violation of speech, the skills of reading, writing are lost, paralysis or paresis of the right half of the body occurs, the depressive component of the disease becomes more pronounced.

Causes and risk factors

In the vast majority of cases, the causes of hemorrhagic stroke are two:

• Hypertonic disease. Provokes 80% of all cerebral hemorrhages. It can develop gradually: a systematic and prolonged increase in blood pressure gradually thins out the walls of the vessels, creates microcracks in them, through which the fluid seeps, expanding the holes.

  After micro-eruptions, a vessel may suddenly burst in a significant area. Sometimes a hemorrhage occurs simultaneously, without preliminary minor lesions, usually during a hypertensive crisis.

• Malformation of vessels. Intrauterine or acquired irregular structure of cerebral vessels with areas of enlargement (aneurysm) or narrowing (stenosis).

  A defect creates tension in various parts of the vessel, even at normal total arterial pressure, during a small physical exertion, which leads to rupture of the aneurysm. Young men and middle-aged men are more often affected.

The formation of these causes contribute to some of the body's conditions, such as:

• atherosclerosis- deposition on the walls of the bloodstream of cholesterol plaques, narrowing the lumen of the vessel and reducing its elasticity, and, hence, the tendency to rupture;
• amyloid angiopathy- the deposition of protein compounds on the walls of the vessels, which has the same consequences as atherosclerosis, as well as causing dementia and Alzheimer's disease;
• low blood coagulability- hemophilia;
• encephalopathies(inflammation of the brain) of different origin;
• diabetes- with a prolonged course of the disease, vascular damage occurs without fail;
• brain tumorsof various origins.

These states can be caused by someprovoking factors, the exclusion of which from the lifestyle reduces the level of risk:

• abundant consumption of fatty foods;
• sedentary lifestyle;
• disorderly order of work and rest;
• unhealthy habits: smoking, alcohol abuse, use of illegal drugs;
• head and spinal injuries;
• constant nervous tension (stress);
• prolonged exposure to the sun in hot weather;
• heavy physical work.

Symptoms and signs

A few hours (or even days) appearsevere headaches, localized or generalized, not removed by analgesics. This sign can be both a harbinger and an indicator of the development of pathology. Often the pain is accompanied by nausea and vomiting, which does not bring relief.

Pain in the eyes when looking at the bright light and on the sides, red circles in front of the eyes, instability of the visual picture: doubling, blurry image - these are signs of a hemorrhage that has begun.


Fainting of consciousness, fainting, including transient, speak of the development of a defect. An epileptiform attack can be the starting point of a stroke.

Symptoms of brain trouble:

• weakening of the muscles of one half of the body or their paralysis;
• the appearance of asymmetry on the face - the unequal directions of the corners of the lips;
• impossibility of clear speaking.

These latter signs suggest that the onset of an attack is not even for specialists, which significantly shortens the waiting time for first aid.

Diagnostics

If you suspect a stroke, you can perform a series of tests (if the person is conscious and understands speech):

• appreciate the smile- In case of stroke, one side of the oak is fixed, which is especially noticeable when smiling;
• hear a speech- indistinctness, not characteristic of a given individual, is a stroke characteristic of stroke;
• to observe conscious movements of hands- Nonsynchronism of movements with directional action - precursor of the disease.
These signs are most often noticed by household members or colleagues who cause emergency medical care.


Confirm the diagnosis is required with the use of modern electronic devices: on the computer tomograph you can see the area of ​​the lesion, at a later date it is possible to confirm the diagnosis and develop methods of treatment with MRI. When entering the hospital and during the entire stay, the patient gives several tests.

Differential diagnosis is carried out with meningitis, vascular disintegration in the tumor.

Treatment

The most important prognostic factor determining the success of treatment istimeliness of assistance. In practice, it is established that it is possible that an earlier placement in a specialized hospital increases the likelihood of minimal damage at times.

Reference:For the effectiveness of care, it is necessary to begin to fight the stroke within 3 hours of the first signs. From 3 to 6 hours the probability of a favorable outcome is reduced literally every minute. And after 6 hours without help, the probability of recovery tends to zero. Therefore, the ambulance is called forth immediately.

The anti-impotence measures are organized in the ambulance:

• the patient is provided with a raised head portion of the bed;
• normalize blood pressure;
• maintain optimal heart and respiratory activity (oxygen, ventilation);
• stop bleeding from a damaged vessel - inject appropriate medications;
• reduce the amount of fluid in the body, in particular in the brain - inject diuretics;
• reduce mental agitation, create a therapeutic neutral background;
• with the help of medications prevent the appearance of convulsive reactions.

Upon delivery of the patient to the hospital, laboratory and instrumental studies are carried out, including analysis of the contents of cerebrospinal fluid.

Based on the results of an emergency survey, the treatment path is chosen:

1. Conservative therapeutic methodis to prescribe drugs that support the necessary level of life support, prevent the occurrence of complications - congestive pneumonia and pressure sores.
2. Surgical methodIt is used in cases of extensive hemorrhage in close to the beginning of the illness terms. The essence of it is to pump out excess fluid, relieve pressure on brain tissue, eliminate the source of infection - blood clots.

Learn more about the disease from the video:

And in this video, surgery for hemorrhagic stroke is presented: cautiously, not for the faint-hearted!

Rehabilitation and recovery after illness

The recovery period after hemorrhagic stroke lastsseveral months and even years. How to recover from a hemorrhagic stroke? Assign fizioprotsedury, massage, therapeutic gymnastics, sedatives, classes with the teacher. We recommend a sanatorium treatment.

With persistent, focused and regular sessions aimed at restoring lost opportunities, the results appear gradually. The best indicators for those to whom the urgent help came on time.

Terminationeven for a short time, the lack of physical activity and new impressions that cause brain work, contributes to stopping progress and stopping the dynamics of expanding opportunities.

Nutrition patientsafter a hemorrhagic stroke should be balanced and high-grade, but the diet thus fractional - 5-6 times a day with restriction of the maintenance of fats and simple sugars.

The author of this video tells about the stages of rehabilitation and recovery after a hemorrhagic stroke in the home and with the help of physiotherapy:

Prognosis of recovery and chances of survival

The most unfavorable prognosis for life is in case of extensive hemorrhagic stroke with hemorrhage into several parts of the brain. Over time, not all structures of the brain are restored.

With directed rehabilitation work partially, sometimes significantly,right and left hemispheric brain functions are restored. But there are also significant residual (residual) phenomena. The prognosis of self-service is deteriorating if the first aid was rendered untimely - the patient remains bedridden for years to come.

Prevention of occurrence and relapses

To prevent a formidable complication - a repeated hemorrhagic stroke -exclude predisposing factors. Streamlining the mode of changing vital activities, switching to proper nutrition and a healthy lifestyle with the abandonment of bad habits and sufficient physical exertion is an important component of prevention.

For rehabilitants and representatives of the risk group, veryit is important to keep blood pressure under control. You can not allow a long increase in it and short-term jumps. In the absence of organic lesions of the brain vessels, this is sufficient to avoid hemorrhage.

Thus, hemorrhagic stroke is a severe vascular accident that does not pass without a trace even in the most favorable confluence of circumstances. Healthy old age without disability is the dream of many sensible people. Strengthening the vessels is the right direction to achieve it.