From this article you will learn: everything about the first signs of a stroke and the more "late" symptoms, the differences in the manifestation of different types of stroke, the test for a stroke.
Stroke is an acute circulatory disorder in the brain area. Regardless of the extent and type of lesion, stroke always poses a serious threat to the health and even life of the patient - this is the second most frequent cause of death( from diseases) among the world's population.
The course and prognosis are largely determined by the timeliness and quality of the care provided: if the first signs of the pathology of the stroke were immediately recognized and the patient received the necessary treatment, the probability of an unfavorable outcome( disability and death) is reduced 2 or more times.
The clinical picture of stroke consists of cerebral, vegetative and focal symptoms.
First we will consider the common symptoms for any type of stroke.
General cerebral symptoms
General cerebral symptoms in the development of stroke arise due to increased intracranial pressure, changes in blood circulation in the brain and irritation of the meninges. These include:
- Headache of varying severity - from constant aching to sudden, acute and painful.
- Nausea and vomiting in the background of a headache.
- Dizziness, a feeling of stuffiness and noise in the ears.
- Disorders of consciousness - from easy disorientation in space and time to complete loss of consciousness and transition to coma. With disorientation, a person can not remember( or with difficulty, after long deliberation) recalls the number, the day of the week and the place in which he is, can not find his way home, forgets his name, etc. Perhaps a stopper state characterized by stunned, retarded, a weak and slow reaction to what is happening around. At a coma consciousness is absent, there is no reaction to tactile and painful stimuli.
Since each brain region is responsible for specific processes in the body( controlling memory, attention, speech, movements in a particular muscle group, etc.), if there is a blood flow in a particular area, specificsymptoms - the so-called focal neurological symptoms.
Focal symptoms are extremely important in the diagnosis of stroke. By the nature of focal symptoms it is possible not only to judge whether a stroke occurred: a neurologist or an experienced therapist will be able to determine, by characteristic features, in which zone the blood circulation is disturbed - even before a special examination.
Feature of focal symptoms is their appearance on the side opposite to the place of localization of a stroke. So, if blood circulation is violated in the right hemisphere, then focal symptoms will be expressed on the left, and vice versa.
For certain areas of the cerebral cortex are characterized by "their" focal symptoms.
Bark frontal lobe
- Parezy - no arbitrary movements. They arise in one limb( monoparesis) or simultaneously in the arm and leg on one side( hemiparesis).In this case, hemiparesis will be right-sided if blood circulation is disturbed in the cortex of the frontal lobe of the left hemisphere, and left-sided if the stroke touches the right hemisphere.
- Speech disturbances - difficulties in constructing sentences.
- Wiggle and unstable walking.
- Changes in personality and behavior - causeless rage or, conversely, gaiety;deep apathy with a lack of reaction to what is happening around with a conserved consciousness;atypical behavior( aggressiveness or unjustified gaiety).
- Loss of smell from the side opposite defeat.
Bark of parietal lobe
- Loss of tactile sensitivity( no sensation from touching the skin).
- Loss of ability to count, write and read.
Bark of temporal lobe
- Hearing changes - deafness, decreased hearing acuity, tinnitus and auditory hallucinations, various hearing impairment defects( up to the loss of the ability to understand spoken speech).
- Memory impairments - amnesia( dips in memory), deja vu( false memories of what is happening, a feeling that it was already before).
Bark of the occipital lobe
Pathology of vision - complete loss and various visual impairments are possible:
- visual hallucinations( a person sees something that is not really there);
- visual illusions( incorrect visual perception of existing objects);
- inability to recognize the appearance of familiar objects and people.
Vegetative symptoms are caused by changes in the functioning of the sympathetic and parasympathetic nervous system. Most often when a stroke occurs:
- feeling of dryness in the mouth,
- feeling of heat.
These symptoms are nonspecific and serve as additional signs, by their presence, to judge whether a stroke occurred, and also about its form and the severity of the condition can not be.
Differences between ischemic and hemorrhagic stroke
Circulatory disturbances in the brain area can occur for two main reasons - due to insufficient blood flow( ischemic stroke) or due to hemorrhage( hemorrhagic stroke).Since the causes and mechanisms of the pathology development in these two situations differ significantly, the approaches to treatment will also be different. Therefore, it is important to know the main differences between ischemic and hemorrhagic stroke.
|Sign||Ischemic stroke||Hemorrhagic stroke|
|Age||More often elderly||Any. Hemorrhages are possible including in young people|
|Initiation of||Usually gradual, with a gradual increase in the severity of symptoms||Usually acute|
|Severity||Status of various severity||Severe and extremely severe condition|
|Consciousness||Various variants of consciousness disorder||More often loss of consciousness anddeep coma|
|Headache||Dull, gradually intensifying. It does not always happen||Sudden and very strong|
|Rigidity of the occipital muscles - a feeling of stiffness and resistance when trying to bend the patient's head and bring his chin to his chest||No||Almost always|
|General cerebral and focal symptoms||Expressed in varying degrees||Expressedbright|
The course and severity of stroke are determined by many factors. If blood circulation is disturbed in a small area of the brain( the so-called microinsult), specific focal symptoms may be absent, and the clinical picture is often blurred. For the diagnosis of stroke in vague and suspicious cases, there are special tests that are easy to conduct yourself in front of a mirror, or carried out under the supervision of relatives or health professionals.
These tests include performing a smile( teeth grin), screwing up, squeezing out the tongue. Because of the paresis of facial musculature, stroke is marked by a crooked smile( bent grin), asymmetry of facial expression, uneven squeezing and deflection of the tongue in the direction opposite to the side of the lesion.
In addition to mimic tests, apply tests for coordination and clarity of speech. The result of coordination tests in stroke is the instability of the patient in a standing position with closed eyes, a miss in the finger-nasal sample( when asked to stretch out his hands, and then the index finger first left and then the right hand to touch the tip of the nose).
To check the clarity of speech, the patient must clearly pronounce a tongue twister or a sentence of complex construction. If there is a stroke, this requirement is not feasible.
Test indications include any symptoms suspected of stroke: speech confusion, behavior change, or some strange strangeness in behavior, memory problems, retardation, etc.
Stroke is a serious condition, requiring urgent specialized medical care. Even if a patient undergoes a microstroke or has a transient impairment of the cerebral circulation( symptoms have gone by themselves within a few hours) - in the near future the risk of re-attack is higher, and in a more severe form. Therefore, for any symptoms of a stroke and even just a suspicion of it, you should immediately seek medical help - call an ambulance or take the patient to a neurological department.