From this article you will learn: what is the prognosis for life after the transfer of ischemic stroke. What is the survival of patients, when the prognosis is favorable, and when restoration of lost functions is impossible. And also the nuances of the forecast depending on the affected area of the brain.
Contents of the article:
- What factors influence the prognosis after ischemic stroke
- Patient survival statistics
- Causes aggravating the recovery of
- When is the prognosis good?
- When function recovery is impossible( or almost impossible)?
- Prognosis for the affected area of the brain
Ischemic stroke is a rapid impairment of blood supply to the brain tissue due to narrowing of the cerebral vessels, blockage of the arteries by a thrombus or atherosclerotic plaque. As a result, oxygen deficiency develops rapidly, and a part of the brain cells die.
This very life-threatening condition is one of the main causes of death or lifelong disability of patients.
The forecast for each particular case is individual, but we will discuss the general typical cases further in the article.Possible( likely) consequences after a stroke:
- speech impairment;
- visual impairment;
- memory corruption;
- paresis( partial decrease in the volume of motion due to damage to the nervous system);
- paralysis( complete absence of arbitrary movements).
Consequences of ischemic stroke If the processes that have occurred are irreversible, the prognosis is unfavorable. Such patients are most often confined to bed, some can perform only minor actions, for example, roll over, sit on the bed, with support to move around the room.
If the lost functions are slowly but surely restored, then rehabilitation can take many years. Patients are not able to do this without help. They make out a group of disability.
The recovery after a stroke is handled by a neurologist and rehabilitologist.
The physician is engaged in the rehabilitation of the patient who has suffered a stroke What factors affect the prognosis
| Factors affecting the quality of life | Explanations |
|---|---|
| The volume and location of necrotic focus | The larger the area of necrosis of the brain tissue, the more severe and irreversible the manifestations of stroke. The probability of a lethal outcome is higher if the focus of brain necrosis is located in the area of important brain centers |
| Degree of manifestation of neurological disorders and their reversibility( severity of the stroke) | The harder the stroke, the more serious and severe its symptoms. For example, the probability of recovery of sensitivity and motor activity of the paralyzed half of the body is much less than the paresis of the hand |
| Age of the patient | In elderly and elderly people, the disease is more severe. They have a high probability of disability and death |
| Cause of a cerebral infarction | The most unfavorable prognosis for a stroke that occurred against the background of atherosclerosis( as a result of blocking the artery with a cholesterol plaque) and with the clotting of the thrombus and occlusion of the |
| vessel. The presence of concomitant serious diseases of the heart, vessels, endocrine system | The situation is complicated by the existing diseases: diabetes, heart disease, atrial fibrillation and others |
| Development of complications | In the first 7 days the probability of death is highbecause of cerebral edema, secondary ischemia of the brainstem, damage to the respiratory or cardiovascular centers, transformation of ischemic infarction into hemorrhagic, etc. |
| Timeliness and literacy of specialized medical care | The shorter the time interval between stroke and the beginning of resuscitation,the more favorable the prognosis for life |
Patient survival statistics
In the first 7-30 days, 15 to 25% of patients die. Mortality in half of cases occurs due to cerebral edema, in others - due to pneumonia, blockage of the pulmonary artery, infection of blood, renal or respiratory failure.
Up to 40% of deaths occur in the first 1-3 days, patients die as a result of extensive brain damage and edema. Of the survivors, 60-70% of people have neurological disorders that make them invalid disabled. Six months later, these disorders remain in 40% of patients, and by the end of the first year, about 25-30%.
An important criterion for the prediction is the restoration of impaired motor functions in the first 3 months.after ischemic stroke. And the functioning of the lower extremities is restored better than the upper ones. A poor prognostic sign is the absence of any motor activity of the hand by the end of 1 month. The most favorable prognosis after lacunar stroke, which occurred due to the narrowing of the small arteries of the brain.
Survival of patients in the first year after a cerebral infarction reaches 65-75%, after 5 years - 50%, up to 10 years live to 25%.A repeated stroke is observed in 30% of survivors in the first 5 years after the first episode of the disease.
Causes aggravating recovery after ischemic stroke
- Atherosclerosis;
- suffered myocardial infarction;
- available heart disease;Atrial fibrillation;
- marked cognitive impairment;
- concomitant diseases in the stage of decompensation, for example, congestive heart failure;
- acute infections;
- oppression of consciousness until confluence in coma;
- old age.
When is the forecast successful?
The probability of reversibility of disorders is high in patients:
- of a young age;
- with a small volume and "successful" localization of the focus of brain necrosis;
- with a minimum of neurological manifestations;
- while maintaining consciousness;
- when only one cerebral vessel is affected;
- in the absence of heart and vascular disease.
When is function recovery difficult or impossible?
- With extensive ischemic stroke of the cerebellum, brainstem, hemispheres, accompanied by persistent paralysis, paresis, speech disorders, swallowing, vision;
- for heart diseases in the stage of decompensation with significant violations of blood flow through the vessels;
- with coma;
- if a second stroke occurred, it is possible that the transformation of ischemic into hemorrhagic, accompanied by a hemorrhage in the brain.
According to statistics, 70% of cases of repeated stroke end with the death of the patient. The most critical are 3, 7, 9 days after the development of an acute shortage of blood circulation in the brain. The risk of repeated stroke persists throughout the rest of life due to the fact that the causes that provoked the first episode of the disease have not disappeared anywhere.
Prognosis for which part of the brain is affected
Functional areas of the brain Survival in brainstem lesions
The brain stem is a very important area of the brain. It contains a lot of nerve bundles and centers of vital activity - vestibular, vasomotor, respiratory, the center of thermoregulation. Affecting this or that vital department leads to often irreversible consequences with a high probability of death. While retaining the functions of these centers, it is difficult to make a prediction, since much depends on the patient's health and age.
Forecast for cerebellar ischemic stroke of
The coordination of human movements depends on the cerebellum, so when the cells die in this zone the patient can not control their actions, the balance and orientation in space are disturbed, the movements become chaotic, the muscle tone decreases. Anatomically the cerebellum is located near the brainstem. If in 1 day a person was not given proper medical care, then swelling begins to squeeze stem structures, which can lead to coma and death.
Prognosis for stroke of the occipital region of the brain
The cortex of the hemispheres of the occipital zone is responsible for vision. It captures and transforms information obtained through the optic nerves. If the left hemisphere is affected, the patient ceases to see what is on the right side of the field of vision, and vice versa. When changing the formation of visual images, a person loses the ability to identify objects and recognize familiar people.
Usually, after a timely treatment, the forecast is favorable, within half a year, or even earlier, vision is restored. Although the recognition of rarely observed objects and unfamiliar people may remain difficult until the end of life.
Prognosis for life after coma
Brain coma is the most difficult option, as can ischemic stroke that develops with extensive damage to brain tissue. It may be accompanied by an inability to breathe independently due to a lesion of the respiratory center, thermoregulation and impaired cardiovascular function. With these violations, the risk of death is high. The chance of partial restoration of functions is less than 15%.
In severe cases, an onset of ischemic stroke may lead to coma Premature death may occur if:
- is aged in patients older than 70 years;
- persistence for coma longer than 3 days of severe myoclonus - involuntary sudden muscle spasms, manifested by twitching, flinching, or limb movements;
- development of renal or heart failure.
