Hemorrhagic stroke is the most severe brain injury. Mortality after a stroke ranges from 50 to 90% of victims, depending on the damaged area. Thus, a stroke of the brain stem leads to almost instant death, a hemorrhage in the periphery provides more chances to survive.

The disease develops rapidly and its consequences are unusually severe.

What is a stroke

Under this name unite all cases of acute circulatory disorders. The disease is accompanied by the formation of certain neurological signs that persist or develop within 24 hours. The highest mortality is observed in the first day of the disease.

The so-called small stroke is different in that the neurological deficit regresses in 3 weeks, not a day. Mortality during this period is 35%.

There are three types of stroke depending on the nature of circulatory disorders

• Ischemic - the most frequent and not so categorically leading to death, accounts for 70-80% of cases. Ischemic stroke of the brain is, in fact, a heart attack, tissue necrosis due to blockage or narrowing of the supplying artery and death of brain tissue cells.
• - vessel rupture resulting from a cranial injury, aneurysm rupture, vascular disease, tumors, and so on.
• Hemorrhagic stroke of the brain is accompanied by bleeding. Vessel rupture occurs by two main mechanisms.

In a hypertensive crisis, the self-regulation of the arteries is disrupted: they lose their ability to narrow and only passively expand under pressure. Not only arteries are filled with blood, but also veins and capillaries, as an attempt to compensate for pressure. But if the cerebral blood flow continues to increase, the walls of the vessels simply can not stand it.

The second mechanism is associated with the opposite phenomenon - spasm or paralysis of the arterial vessels of the brain. An ischemic focus is formed, metabolic processes are disturbed in the area and in the vessels.

As a result, the walls of arterioles are permeable to plasma and red blood cells. Blood seeps through the walls and soaks the surrounding brain tissue.

Depending on the nature and distribution of spasms, the formation of one extensive or multiple foci of hemorrhagic lesions is possible.

The picture is complicated by the occurrence of an intracerebral hematoma: the blood from the vessel forms a cavity, which itself fills it. Subsequently, such a cavity forms a scar or transforms into a cyst. The consequences are severe in both cases. How long they live after such a disease depends largely on how quickly the patient receives emergency care.

It is usually diagnosed in patients over 60 years of age against the background of rheumatic heart disease, heart attack, and hemodynamic disorders. Hemorrhagic stroke occurs in the age group from 45 to 65 years. Its usual "accompaniment" is hypertension and atherosclerosis.

According to statistics, ischemic stroke is the second most common cause of death and the first cause of disability. After the disease, 70-80% become disabled, of which 20-30% require constant care.

Types of stroke

Like ischemic, hemorrhagic stroke is classified according to several signs that indicate the affected area.

• Damage to the periphery or in the thickness of the brain tissue. Refers to the most "safe" damage. Rarely causes edema. The consequences here are far from easy, but it is peripheral hemorrhage that most often becomes a stroke suffered “on the legs”, and such cases also occur.
• Venticular - an outpouring of blood in the lateral ventricles.
• Subarachnoid - the ingress of blood between the membranes of the brain. After damage to the trunk, this form has the most serious consequences.
• Combined - observed with an extensive lesion.

Distinguish between primary and secondary stroke

• Primary - a consequence or damage to the walls of blood vessels caused by constant excessive pressure. It provokes his strong emotional or physical stress with high blood pressure.
• secondary - here the real reason there is a rupture of the aneurysm, an anomaly or acquired deformation of the vessel, which led to its damage, or a violation in the permeability of the walls.

The severity of the disease does not depend on the secondary or primary hemorrhage. The consequences are equally terrible, and the prognosis is disappointing.

Symptoms of the disease

Hemorrhage occurs suddenly, is characterized by cerebral and local neurological signs. Often so unexpressed that the patient does not pay attention to the deterioration.

Threat symptoms are:

• nausea and vomiting for no apparent reason, vomiting does not bring relief;
• severe dizziness, headache;
• uneven intermittent pulse, weakness;
• the skin loses sensitivity, there is numbness of the hands and feet.

Usually hemorrhagic stroke manifests itself in the form of a sharp headache and a short-term loss of consciousness. After that, drowsiness or agitation, a state of stupor, nausea can be observed. Often the patient falls into a coma, which is one of the most terrible consequences.

The prognosis for recovery from coma is extremely unfavorable. In 16% of cases, the symptoms are similar to an epileptic seizure, which is an excellent reason to call an ambulance as soon as possible.

If the patient remains conscious and does not feel anything special, except for dizziness, weakness and some disorientation in space, there is Great chance that help will not be provided in time.

Major risk factors for stroke.

Fortunately, a hemorrhagic stroke is distinguished by several other symptoms associated with the site of damage.

• A stroke patient is unable to smile. If the right hemisphere is damaged, then the left side of the face remains motionless. If the left side is affected, the right side of the face is almost not felt.
• The victim cannot stick out his tongue - he is in an unnatural position, sinking to one side.
• When trying to repeat even a simple phrase, diction is often violated. This is an optional sign, since the hemorrhage does not always affect the speech centers.
• When trying to raise both hands, as a rule, the patient cannot keep them at the same height. Another way: you need to ask the patient to stretch his arms with his palms down and cover his eyes. If one arm begins to move sideways and down, then a hemorrhage has occurred.

If you observe at least one of the listed signs in conjunction with a headache or a short-term loss of consciousness, you should immediately contact the ambulance. His life and health literally depends on how quickly measures are taken.

Critical in hemorrhagic stroke are the first 3 hours, less often 6. If during this time the patient is assisted, the threat to life is significantly reduced - up to 20%. Moreover, with timely assistance received, the threat of disability also noticeably decreases, the consequences are mitigated, and even a complete restoration of brain functions is possible.

Of course, the prognosis of recovery in this case also depends on many factors: how much time has passed, which part of the brain is affected, what other diseases are in the anamnesis, but, nevertheless, it is the actions in the first 3 hours that can save a person's life.

First aid

It is useless to take the victim to the hospital on your own, since not all clinics can provide the required assistance. Treatment hemorrhagic stroke carried out in specialized institutions. Therefore, the correct action would be to call an emergency with a description of the symptoms and an indication of how much time has passed since the loss of consciousness.

• The victim must be laid in such a way that the head and neck are in line and placed at an angle of 30 degrees. Use for this pillows, folded clothes and so on.
• If the victim is vomiting, turn his head to the side.
• It is necessary to unfasten clothes, loosen the tie, and prevent the patient from making sudden movements.
• If rhythmic breathing is not observed during loss of consciousness, it is necessary to begin cardiopulmonary resuscitation. You should not pay attention to the state of the pulse.
• Do not give the patient a drink, as it is possible that as a result of a stroke, the swallowing organs are paralyzed.

Therapeutic measures

Even the most urgent care is impossible without a diagnosis. In this case, it is important to localize the affected area. The main treatment for hemorrhagic stroke starts with research.

In the first few hours, the most informative method is computed tomography. In this way, a complete picture of the blood clot can be obtained. After the start of resorption - about a day, the accuracy of tomography decreases.

At the stage of cyst formation, magnetic resonance imaging is used.

After the diagnosis is established, treatment is prescribed. Its purpose is to do the following:

• normalization of pressure - reducing the load on the vessels contributes to their speedy recovery. Adrenoblockers, ACE inhibitors are used;
• prevention or reduction of edema - taking diuretics;
• regulation of blood viscosity. The use of anticoagulants is contraindicated. correct by the introduction of platelet mass, fresh frozen plasma;
• pain relief - non-narcotic analgesics;
• neuroprotection.

The first task in a stroke is the withdrawal of blood, getting rid of the hematoma. If the size of the latter exceeds 3 cm in diameter, surgical intervention is prescribed.

Rehabilitation of patients

Effects stroke include a list of the most severe injuries. Measures taken in time exclude some of them, and some can be dealt with with the help of the right rehabilitation measures. How long they should last depends on the severity of the disease and the nature of the damage.

And even in this case, the prognosis is rarely reassuring: hemorrhagic stroke causes 70-80 cases of disability out of 100.

The most commonly observed effects are:

• violation of motor functions - lameness, paralysis of the legs or arms. No matter how scary it may sound, but these consequences are among the most acceptable, since they do not entail personality changes or impaired brain functions;
• imbalance of urination and defecation;
• change in perception, development of dementia;
• violation in speech, counting, writing;
• memory impairment, loss of orientation in space and time;
• change in behavioral complexes - suspiciousness, aggression, delayed reaction;
• epilepsy;
• vegetative coma.

This condition is the least treatable. Although medical statistics recorded cases of unexpected exit of patients from this kind of coma and the restoration of most functions. However, this is really rare.

Rehabilitation of patients after a stroke should by no means be considered as a desirable but optional event. No matter how long the recovery takes, even a partial restoration of functions is impossible without appropriate procedures and treatment.

• Physiotherapy is a complex of various measures aimed at restoring motor abilities and sensitivity. Various forms of paralysis are common consequences of a stroke.
• Swallowing correction- After a stroke, such a disorder is often observed. Patients are fed small portions and control the process of chewing and swallowing.
• Speech correction - classes in reading and counting skills.
• Ergotherapy - a set of measures for the rehabilitation of the hand.
• Psychological help - the specialist does not just provide emotional support, but helps to restore lost personality structures, helps the patient to adapt after a severe shock.

Hemorrhagic stroke is one of the most severe brain lesions, it is a real brain catastrophe that requires immediate measures to save a person's life. Despite its severe consequences, practitioners are confident that with a timely operation, support from relatives and efforts from the patient himself, it is possible to restore all functions within 1-2 years.

Hemorrhagic stroke of the left side of the brain refers to acute diseases. They affect up to 20 percent of patients with disorders of the circulatory system of the brain. As a result of the disease, according to statistics, up to 60 percent of patients die, and most of the survivors become disabled. The chance of death increases with age.

As a result of rupture of the walls of blood vessels, an extensive hemorrhage occurs in the tissues of the left hemisphere of the brain with the formation of hematomas. The breakdown products of blood components cause edema, inflammation and necrosis of the nervous tissue in the area of ​​hemorrhage, compression of brain tissues and increased intracranial pressure, which leads to disruption of its functions.

The main cause of the disease is hypertension. It causes sclerotic disorders in the small blood vessels of the brain - their lumen and elasticity decrease. A sharp increase in blood pressure leads to their rupture.

Less common are blood diseases (for example, poor clotting), tumors, inflammation in the blood vessels of the brain. It can also be caused by the reaction vascular system for infectious and allergic diseases, hemorrhagic diathesis, head injuries, uremia and sepsis.

Symptoms

Severe damage to the left hemisphere of the brain as a result of hemorrhagic stroke is accompanied by characteristic features- partial or complete paralysis of the right side of the body and Broca's aphasia - incoherence and speech defects caused by paralysis of the facial muscles.

Important! can be seen before it occurs. If you apply medication during this period, you can avoid its onset.

First, headaches appear, recurring with increasing force. Then there are bouts of vomiting, blood rushes to the face, the pulse drops, sweating increases. A person's vision deteriorates sharply, visual hallucinations begin. Memory lapses and loss of orientation in space are possible. Soon there is numbness of the muscles of the right side of the body.

You can diagnose a stroke on the left side of the brain based on the results of simple tests offered to the victim:

• raise your hands in front of you at the same time - the right hand will obey the commands of the brain much worse;
• make an attempt to smile - the right corner of the mouth will be beveled down due to paralysis;
• show the tongue and move it - the tip of the tongue will sink to the right, and the tongue itself will have an asymmetrical "humped" appearance;
• pronounce your last name, first name and patronymic - the speech will be weaving and incoherent.

In patients under 45 years of age, the disease may be the result of a hematoma that occurs when a hemorrhage occurs in the space between the arachnoid and pia mater. In this case, the symptomatology of the disease coincides with a brain aneurysm and disorders in the development of the circulatory system. To exclude them, instrumental diagnostic methods are used - cerebral angiography, computed tomography, echo encephalography.

Effects

Damage to health from hemorrhagic stroke depends on the lesion and resembles the consequences ischemic stroke. The most common complications are:

• violations of the speech apparatus - the work of the facial muscles is difficult;
• loss of ability to logical reasoning;
• paralysis or paresis of the right side of the body with clearly expressed disorders - weak muscle tone and a low level of general sensitivity, swallowing reflex is difficult;
• severe pain;
• paralysis of limbs, respiratory and facial muscles;
• anxiety and depression.

As a result of a hemorrhagic stroke, more than 70% of surviving patients become disabled.

How long do people live after a stroke

After a severe stroke, up to 35 percent of patients die in the first month and about 50 percent die during the first year. Mortality after hemorrhagic stroke is high among pensioners and people suffering from chronic diseases of cardio-vascular system.

Treatment

Treatment includes first aid, surgical treatment during and after an attack, and measures aimed at restoring the patient's motor and speech functions.

If necessary:

• put the victim in a reclining position, raising the upper body at an angle of at least 30 degrees - to reduce the rate of blood flow to the brain;
• turn the head of the victim to one side - to prevent death from ingestion of vomit into the respiratory system;

Provide good ventilation of the room - to prevent lack of oxygen and reduce the risk of hypoxia.

Surgical treatment

Surgical treatment includes surgery. It is necessary in the presence of extensive hematomas in the brain tissues. In most cases, a hematoma is punctured through a small burr hole - it makes up about 70 percent of operations. Open brain surgery is performed with superficial hematomas or in case of extensive hemorrhages in deep areas of the brain, accompanied by the patient's most difficult condition - up to 30 percent of the number of surgical interventions. Also, in the course of surgical treatment, in case of violation of the respiratory reflex, oxygen inhalations and artificial ventilation of the lungs are used.

Treatment in the acute phase and after it

It is aimed at stabilizing the condition and eliminating complications. The general treatment plan includes:

1. A decrease in blood clotting in the first hours after a stroke significantly reduces the likelihood of paralysis. Actovegin is successfully used for these purposes.
2. Decreased blood pressure. Arterial pressure should not exceed 150/90 mm. rt. Art. For this, drugs of non-prolonged action are used - clonidil, magnesium sulfate, captopril. If the pressure on the contrary falls, then vasopressor drugs are used - for example, mezaton and caffeine, norepinephrine.
3. The alignment of the heart rhythm is carried out with the help of cardiac glycosides - corglycol, erizimide, strophanine.
4. Decreased general swelling and elimination of cerebral edema. For this, diuretics are used - mannitol, furosemide, hormonal preparations antihistamine action - for example dexamethasone.
5. Prevention and elimination of pulmonary edema and infectious pulmonary diseases. Antibiotics are injected, jars are placed, mucus is sucked out of the lungs, and the patient is turned from side to side every 2 hours. This measure also prevents the formation of bedsores.
6. Normalization of body temperature - with the help of standard drugs - amidopyrine, analgin, ibuprofen, paracetamol.
7. Maintaining water-salt metabolism and preventing blood clotting. For this purpose, up to 2.5 liters of isotonic sodium chloride solution and about 0.5 liters of plasma-substituting solutions are administered daily to the patient.
8. Prevention of cerebral hypoxia with the help of antispasmodics - no-shpy, stugeron, papaverine hydrochloride.
9. Carbohydrate nutrition. In case of violation of the swallowing reflex - special intravenous solutions or feeding with a nasogastric tube.
10. Stabilization of blood glucose levels in the range from 2.8 to 10 mmol / l. To reduce use insulin, to increase - 10% glucose solution.
11. Withdrawal pain with the help of injections of analgesics - analgin, tramal, baralgin.

Revitalizing treatment

Many patients who have had a hemorrhagic left-sided stroke in the absence of rehabilitation procedures become disabled. Therefore, after discharge of patients, therapy is aimed at restoring the affected areas of the brain, strengthening its circulatory system, motor and speech functions.

Attention! Relatives and friends of patients should understand that a complete recovery after a stroke does not occur, and the duration of the recovery period and the completeness of the restoration of body functions entirely depends on their perseverance and patience.

In addition to drug treatment, patients are prescribed classes with a speech therapist and psychologist, physiotherapy, special massage and physiotherapy. Patients learn to lie, sit, stand and walk again with the help of special simulators. The recovery process often takes several months.

Exercise complexes physiotherapy exercises developed individually. Main principles of exercise therapy is a gradual increase in load and the alternation of passive exercises with active ones.

Hemorrhagic stroke of the left side of the brain has clear diagnostic signs - paralysis of the limbs and muscles of the right side of the body, speech disorders. It proceeds mainly acutely, overtakes hypertensive patients and people of retirement and pre-retirement age and is characterized by high mortality. The disease can be prevented if the signs preceding it are noticed in time. Treatment is aimed at eliminating foci of hemorrhage, eliminating the consequences of its action on brain tissue. How quickly recovery will occur and how long the patient will live depends on the implementation of restorative therapy after discharge.

Hemorrhagic stroke of the brain is an acute pathological condition in which the patient has a hemorrhage inside the skull. It appears as a result of spontaneous rupture of a blood vessel. The disease is not diagnosed very often, but it is more severe than ischemic stroke, and can also cause serious (often irreversible) complications.

Despite the fact that the manifestations of the disease are specific, it is not always possible to quickly and accurately determine the hemorrhage. It develops mainly in patients aged 35-50, although even infants are not immune from it. The untimeliness of the medical care often leads to death.

In hemorrhagic stroke, blood is ejected into the brain tissue (sometimes up to 100 ml or more). At the same time, its cells are damaged, a hematoma appears, and the brain swells. If the patient was not assisted within the first 3 hours, then the changes will be irreversible.

Reasons for the development of pathology

Hemorrhagic stroke differs from ischemic stroke in that it is faster, more difficult and more life-threatening. The following factors can provoke a pathological condition:

• Stable prolonged increase in pressure, provoked by diseases of the cardiovascular system.
• Accumulation of amyloid (abnormal protein) on the walls of veins and arteries.
• Vascular aneurysm of the brain.
• Congenital malformations of arteries and veins, as well as their damage, provoked by atherosclerosis.

• Erythremia.
• thrombophilia.
• Inflammation of the vascular walls.
• Too frequent use of medications that thin the blood.

• Significant physical activity or stressful situation, a strong emotional experience.
• Brain injury.
• Avitaminosis.
• Severe intoxication of the body.

• Violation of blood clotting.
• Violation of cardiac functionality.
• Cerebral vasculitis.

• Pathology of the spinal cord.
• Malignant or benign tumor.
• Diabetes mellitus (this disease is always accompanied by vascular damage).

The neurosurgeon, professor Sergey Petrikov will tell more about the pathology in Elena Malysheva's program “Live healthy!”:

An unhealthy diet, excessive body weight, smoking and alcohol and drug abuse can increase the likelihood of developing a hemorrhagic stroke. The age of the patient, the nature of the work is of great importance. Constant stress, prolonged exposure to direct sunlight also do their job. If you accurately determine the causes of hemorrhagic stroke, then a person can be provided with more effective assistance.

Symptoms

Most often, the development of the disease occurs in daytime after exposure to a negative factor. For acute form typical symptoms of hemorrhagic stroke:

1. Great pain in the head. As time goes by, it only grows.
2. Vomiting and nausea.
3. Sensation of fluid flowing inside the skull.
4. Discomfort when looking at light.
5. The appearance of red circles before the eyes.
6. Gradual depression of consciousness, followed by the patient falling into a coma.

1. Loss of orientation.
2. Paralysis or paresis of the arms and legs.
3. Loss of clarity of speech.
4. Manifestations of facial asymmetry.
5. Fever, impaired respiratory function.
6. The direction of the patient's gaze in the direction of the lesion.
7. Sharp reddening of the face.
8. Intermittent pulse, arrhythmia.

A video from emergency doctors will help you deal with the symptoms (theoretical part 00:30, signs of a stroke 03:05):

Since cerebral edema occurs during a hemorrhagic stroke, the victim develops strabismus, different pupil sizes, and a critical decrease in pressure. Depending on which part of the brain is affected, the symptoms may be focal.

If the right side is affected

The difference between this type of disease and damage to the left side of the brain is expressed in the consequences, as well as clinical manifestations. The most dangerous is damage to the brain stem, in which the chances of a person to survive are close to zero. This department is responsible for the functioning of the heart and respiratory system.

It is quite difficult to diagnose a hemorrhagic stroke on the right, since in this part there are centers of orientation in space and sensitivity. This lesion is determined by speech impairment in right-handed people (in left-handed people, the speech center is located in the left hemisphere). In addition, there is a clear relationship: so if the functionality of the right half of the brain is impaired, the left side suffers and vice versa.

If the left side is affected

Such a lesion is characterized by a violation of the work of the right side of the body. The patient has complete or partial paralysis, and not only the leg and arm suffer, but also half of the tongue and larynx. These patients develop gait disturbances, a characteristic posture right hand(folded in a boat).

As can be seen from the figure, the stroke affects the opposite side of the body.

The victim has a deterioration in memory and speech, the ability to clearly express thoughts is impaired. Damage to the left hemisphere of the brain is characterized by problems with recognition of the time sequence, it cannot decompose complex elements into components. There are violations of written and oral speech.

Varieties of hemorrhagic stroke

Depending on the location of the affected area of ​​the brain, hemorrhagic stroke can be of different types:

• Stem injury. It leads to the rapid death of the victim, since life-supporting centers (heart activity and respiration) are located in it.
• Hemorrhage in the thickness of the brain tissue or the periphery of the organ.

• Damage to the lateral ventricles (ventricular).
• Damage to the space between the arachnoid, hard and soft membranes (subarachnoid).
• Extensive hemorrhagic stroke. It spreads to several areas of the brain.

Intracerebral hemorrhage is much more dangerous than peripheral. It provokes the appearance of hematomas, the spread of edema, and subsequent tissue necrosis. By localization, hematomas are as follows:

1. Medial (if the thalamus is affected).
2. Lateral (with damage to the subcortical nuclei of the white matter).
3. Lobar (hemorrhage does not go beyond the cerebral cortex and extends to only one of its lobe).
4. Mixed.

Hemorrhagic stroke can also be primary or secondary. In the first case, hemorrhage occurs due to a sharp increase in pressure and thinning of the vascular walls. The second is to blame for an aneurysm, hemangioma, or congenital anomaly.

How to recognize the pathology in a timely manner, and what first aid is required for the victim?

If a person has symptoms of a hemorrhagic stroke, it is necessary to call an ambulance as soon as possible. Any delay is fraught with dire consequences. You can determine the primary signs of a stroke yourself. To do this, you need to conduct a small test:

• Ask the person to smile. If there is a problem, the patient's lips will be twisted. Also, one half of the face remains motionless.
• When you try to show the tongue, its unnatural curvature will be noticeable.

• If a person is asked to raise his hands, he will not be able to do it at the same time. Also, the patient will not be able to keep the limbs at the same level.
• Hemorrhagic stroke is also indicated by the patient's inability to say at least one simple sentence (ask for his name). Depending on the location of the hemorrhage, a part of the speech apparatus will be paralyzed.

Also, a sick person is unable to walk straight, complains of an intense manifestation of symptoms of pathology (especially severe headache, dizziness). Naturally, such a patient requires immediate qualified assistance from doctors. That is, the first action is to call a team of doctors with clarification of the proposed diagnosis. Emergency care for hemorrhagic stroke includes the following actions:

1. A person must be laid so that his head is significantly higher than the level of the body.
2. It is necessary to remove from him all the clothes that hamper his movements, presses, and prevents the normal access of air.
3. To prevent the patient from choking on vomit, you need to turn his head to one side.
4. All windows must be open in the room to allow air fresh air was constant.
5. It is strictly forbidden to give the patient any drugs on his own - this will worsen his condition and complicate the diagnosis.

Check out the article that tells what is a subdural hematoma of the brain - what causes it, how it appears and why it is dangerous.

Elena Nechaeva, an ambulance doctor, will tell you about the algorithm of actions in case of a suspected stroke:

With the right and quick actions, it is possible to restore the functionality of the affected brain regions as much as possible. Emergency assistance must be provided within the first 3 hours.

Diagnosis and treatment of pathology

In order to start the treatment of the disease as soon as possible, it is necessary to correctly diagnose it. The patient should be examined by a neurologist. For diagnosis, an MRI of the brain with or without a contrast agent is used. You will also need an angiogram. The quantity and quality of diagnostic tools is determined individually for each patient.

If necessary, other specialists are also involved: an endocrinologist, a cardiologist, an ophthalmologist, a rheumatologist. Mandatory laboratory analysis blood. The diagnosis is also made on the basis of the clinical picture.

The focus of hemorrhage in hemorrhagic stroke on MRI

Treatment of hemorrhagic stroke is carried out in a hospital, in which there is an intensive care and neurosurgical department. The fight against pathology is primarily carried out with the help of surgical intervention, since it is necessary to eliminate the hematoma. The patient also requires strict bed rest. He is prescribed glucocorticoids, calcium antagonists. You will also need antiseptics and antibiotics (in the presence of a traumatic brain injury).

Undifferentiated treatment includes:

• Respiratory resuscitation in order to normalize the functionality of the system.
• Regulation and control of cardiac activity.
• pressure stabilization.
• To protect the nervous system, "Semax", "Ceraxon", "Cerebrolysin" are used (for starters, intravenously).
• To improve the activity of the affected part of the brain, antioxidants are used: Actovegin, Mildronate.
• To stabilize blood microcirculation, vasoactive drugs will be needed: Terntal, Sermion.

Proper treatment of pathology will help to avoid irreversible consequences. After a hemorrhage, a person can live long enough. It all depends on which part of the brain is affected, how quickly the victim was helped.

What is the prognosis and consequences?

Many are interested in the question of how long patients live after a hemorrhagic stroke of the brain. Most of the victims die during the first 1-2 days after the hemorrhage and 1 year after the elimination of the pathology. If a person managed to pass a critical moment, then he manages to survive. Although the quality of his life will be significantly worsened. We can distinguish the following consequences of hemorrhagic stroke:

1. Hearing loss (partial or complete).
2. Unilateral paralysis of limbs and face.
3. Persistent irreversible violation of mental operations, as well as confusion.
4. Dementia.

1. Memory impairment.
2. Loss of the ability to reproduce speech, perceive information.
3. Coma and vegetative state. This outcome is very common. Most of the victims may experience some emotion, fear. However, over time, in the absence of a positive effect of rehabilitation, the brain will gradually lose all its functions.

1. Rapid onset of death. Such a prognosis is possible with hemorrhagic stroke, covering the brain stem.
2. Deep disability. Despite the viability of the organism, its ability to move and communicate is oppressed; mental processes do not function normally.
3. Violation of the swallowing reflex.
4. Problems with orientation in space.
5. Behavioral disorders. The patient has unreasonable fear, serious hallucinations appear.
6. Inability to maintain control over the fulfillment of natural needs.
7. Epilepsy.

As a result of hemorrhagic coma, a second stroke can occur. Relapse usually happens a few days after the first attack. To avoid this, the patient will have to undergo surgery.

On the video you can see how the neurosurgeons of the Federal State Budgetary Scientific Institution “Scientific Center of Neurology” perform endoscopic removal of hematomas resulting from a cerebral stroke:

With a left-sided violation of cerebral circulation, the patient has the following consequences: problems with the work of the facial muscles, the inability to think logically, paralysis and loss of sensitivity of the right side of the body. There are difficulties with swallowing reflex. There are severe attacks of headaches, paralysis of mimic and respiratory muscles. The patient manifests prolonged depression, depression, anxiety, problems with sleep.

If the right side of the brain is affected, then the consequences can be as follows: a pronounced disorder in the functionality of the vestibular apparatus, paresis and paralysis of the left side of the body. The patient has visual impairment, up to complete blindness. Neuropsychiatric disorders have also been noted.

Due to prolonged paralysis of the patient, he develops septic processes, arthropathy, hydrocephalic syndrome. Recovery after a hemorrhagic stroke is extremely slow and is not always characterized by positive dynamics.

The rehabilitation process

Timely treatment is just the tip of the iceberg. Most of the time will be spent on restoring the functionality of the damaged areas of the brain. Rehabilitation after a hemorrhagic stroke begins from the end of the acute period. It includes the following actions:

• Breathing exercises. It is necessary to prevent the development of pneumonia in bedridden and sedentary patients.
• Classes with a speech therapist to improve speech function.
• For stabilization emotional state a person needs consultations with a psychologist and psychotherapist.
• Therapeutic exercise. At first, it provides only passive movements, and then independent exercise. Such treatment contributes to the restoration of neural connections in the nervous system.

We present you a wonderful video by neurologists of the Rehabilitation Center of the Administration of the President of the Russian Federation on an integrated approach to the recovery of patients who have suffered various strokes:

• Gym exercises. Physiotherapy suits that help restore motor function can also help.
• Electroneurostimulation.
• Access to the pool and massage in the water.
• Color therapy.
• Vibration effect on biological points located on the feet.

The prognosis of recovery depends on how large the area was covered by the hemorrhage, as well as on how qualified the actions of doctors and rehabilitators were. Hemorrhagic stroke is a very complex pathology, the consequences of which are unlikely to be completely eliminated. Supportive treatment and rehabilitation last a very long time.

A stroke is a violation of the blood supply to the body, resulting in extensive damage to the vessels of the brain and destabilization of the central nervous system. Hemorrhagic stroke is characterized by a sudden onset. The existing classification of the disease is divided into ischemic, hemorrhagic and mixed types. Hemorrhagic is typical for the older generation. However, there is currently a younger age group people who are prone to stroke due to external environmental influences.

Ischemic stroke is a consequence of the blockage of cerebral vessels by cholesterol fatty plaques (thrombus formation).

How does a stroke manifest?

The consequences of hemorrhagic are dangerous for human life. It is preceded by a rupture of a blocked vessel with a hemorrhage in the meninges, accompanied by a sharp pain syndrome like a sharp blow.

Depending on the location of the injury, right-sided and left-sided brain damage is distinguished. Severe consequences of right-sided location are due to the lack of regenerative ability of the cells of the right hemisphere of the brain.

According to statistics, one of the fundamental causes of the formation of the disease is arterial hypertension. Slowly flowing under atypical conditions, hypertension provokes a crisis, which in 75% is the starting point for the development of hemorrhagic stroke. A causal relationship between the disease and congenital pathology of the structure of the vascular branch of the brain, aneurysm, and acquired malformation is not excluded.

Diseases predisposing to the development of hypertension and vascular deformities

• Pathology of blood coagulation.
• Excessive use of thrombolytics.
• Deposition of cholesterol in violation of lipid metabolism in the vessels of the brain (atherosclerosis).
• Hidden inflammatory processes in the brain.
• Arterial deposition of beta-amyloid protein (amyloid angiopathy).
• Modifications of immunopathological vascular inflammations of the brain (vasculitis, arteritis).
• Diseases of the heart, spinal cord.
• The presence of tumors.
• Diabetes.
• Pathological narrowing of the carotid arteries (cerebral stenosis).

Factors contributing to the formation of vascular blockage

• Rheumocarditis.
• Atherosclerosis of cerebral vessels.
• Atypical increase in blood pressure.
• Vascular pathologies of the brain.
• Arterial protrusion of thinned vascular walls.
• Abuse of alcohol, drugs, smoking.
• Myocardial infarction.

Conditions contributing to the development and progression of the disease

• Severe intoxication.
• Prolonged physical overstrain, psycho-emotional depression.
• Constant avitaminosis manifestations.
• stressful situations.
• Physical injury.
• Obesity 3-4 severity.
• Age-related changes in the body.

The presence of one of these factors is a serious reason to think. To avoid adverse consequences, control signs of deterioration, undergo a medical examination in a timely manner, and follow the recommendations of your doctor.

Spontaneous hemorrhage under the cerebral cortex is a point sudden cessation of blood supply to brain cells, swelling of damaged areas of the brain, pathological changes subcortical nodes, ventricles, thalamus. These processes are detrimental to the synchronous activity of the organism, therefore, they are irreversible or difficult to recover.

Uncontrolled penetration of the blood flow into the cerebellum or brain stem cells leads to immediate cardiac arrest (clinical death).

People with congenital defect heart, hereditary blood diseases, the endocrine system are prone to hemorrhagic stroke.

Symptoms of a stroke

The suddenness of a hemorrhagic stroke is due to the sharp appearance of characteristic primary symptoms.

Home reminder to detect the first signs of the disease

• Change in skin color to cyanotic, curvature of the face, chin.
• Headache of versatile location.
• Rapid or weak heartbeat.
• Muffled or difficult breathing, turning into hoarse sounds.
• Atypical dilation of the pupils of the eyes.
• Violation of the swallowing reflex.
• Violent pulsation of the cervical arteries.
• Fragmentary or complete paralysis of certain parts of the body.
• Nausea, vomiting, impaired consciousness.
• Fainting, skin cold to the touch, involuntary urination.
• A sharp increase in blood pressure.

The increase in the intensity of symptoms is rapid, sometimes a few minutes are enough. With the primary signs of a stroke, it is important to find out in time the causes that prompted the onset of the disease and the tactics of providing urgent medical care.

The progression of the disease is aggravated by a decrease in the sensitive threshold of one side of the body to complete loss (complicating paralysis), convulsive trembling of the limbs, impaired or loss of spoken language, coordination movements, neurological defects, strabismus, loss of vision and hearing, memory and inadequate behavior. The degree of successive signs of the disease depends on the location of the hemorrhagic zone.

Volumetric hemorrhagic hemorrhage marks the appearance of secondary signals: brain dislocation, continuous convulsions, loss of consciousness, coma. Ventricular, cerebellar extravasation is characterized by a fatal outcome on the first day after the detection of signs of a stroke.

Differential diagnosis of hemorrhagic stroke

The faster the patient is helped, the greater the chance of recovery after a stroke.

Elementary primary diagnostics is carried out using test tasks

1. Smile. Characteristic drooping of the corner of the lips on one side.
2. Talk. Pronunciation of simple words is difficult.
3. Raising both hands. The simultaneous movement of the limbs visually reveals different lifting heights.

Urgent CT, MRI examination will allow you to quickly find out the cause and degree of brain damage. The contrast will facilitate the establishment of the volume of the lesion, localization, displacement of brain structures and edema, the degree of viability of the cells of the cortical substance.

The presence of blood in the spinal fluid is typical for ventricular or subarachnoid hemorrhage. Lumbar puncture is performed on the basis of CT data. With edema, if the biomaterial is removed, the procedure can cause partial wedging of the medulla into the occipital opening, which will lead to the inevitable death of the patient.

Examination of severe patients in a coma after a stroke is carried out using encephalography. The procedure determines the degree of life support of the cortical substance.

Medical treatment of hemorrhagic stroke

As urgent measures for the treatment of hemorrhagic stroke, modern medicine offers intubation, mechanical ventilation, and pacing.

Based on the examination of the brain, the doctor will prescribe therapeutic method treatment of hemorrhagic stroke. Complex therapy is carried out in a hospital setting. Risks of repeated hemorrhagic stroke due to an arterial defect are not excluded.

Treatment of cerebral hematoma is usually carried out with hemostatic agents and osmotic diuretics. The use of ACE inhibitors and beta-blockers affects the maintenance of perfusion pressure, so the drugs should be taken with caution. Antibiotics are used to prevent intracranial infections after a stroke. An additional tool to the complex of measures to prevent the consequences of hemorrhagic stroke is added sedatives to relieve arousal.

Surgical treatment of the disease is carried out only for health reasons with the obligatory determination of the causes of cerebral hemorrhage. Hematoma stereotaxic removal is performed by craniotomy followed by elimination of the defective vessel. The operation lasts 3-5 hours.

Treatment with folk remedies is unacceptable.

Hemorrhagic stroke - prognosis

The severity and nature of the lesion, prognosis and stages of recovery depend on the location and degree of localization of non-traumatic cerebral hemorrhage. Due to diffuse age-related changes in the body and an irreversible slowdown in recovery functions, the prognosis in older people is almost unpredictable, since it depends on the time of assistance, the degree of brain damage at the time of detection, resistance immune system organism.

Immediate medical care will affect the outcome of the disease.

After a time period (up to a week from the moment of detection), the patient develops the consequences of a hemorrhagic stroke - edema with the formation of necrotic brain tissue. The controlled work of such parts of the brain stops, while the disorder of motor functions, coordination movements, paralysis, difficulty in understanding and reproducing spoken language continue.

As a result of damage to the left hemisphere of the brain, the appearance of failures of reflex functions is characteristic - when reading, counting, writing. The disorder of swallowing movements due to illness is caused by the ingress of fluid into the organs of air circulation. Against the background of these features, emotional instability develops, disorganization of the patient, which leads to problems of perception.

Visually, the worsening of the urinary and intestinal functions can be added to the complicating consequences - uncontrolled defecation and urination are possible. The formation of epilepsy is observed in 7-20% of stroke patients. Patients who survive a stroke are given disability status.

Since impaired functions recover for a long time after a stroke, it is almost impossible to do this on your own without therapy and support from loved ones.

Hemorrhagic stroke: consequences

Primary drug therapy is aimed at stabilizing the patient, stopping intensive progression, and removing the cause of the disease.

The second stage of treatment of hemorrhagic stroke involves a recovery period that requires considerable effort. It is carried out against the background of taking drugs that reduce the permeability of the vascular walls and control measures to adjust blood pressure. Includes restoration of damaged organic functions through gymnastics and sports, a balanced diet, rehabilitation activities with the inclusion of electrostimulating agents, magnetotherapy, reflexology.

Fundamental preventive methods the fight against the disease - the constant monitoring of hypertension, the correction of blood pressure, the evolutionary atherosclerotic process.

Categorical cessation of smoking, excessive drinking, calorie management and an active lifestyle are the basic principles of restorative and preventive measures.

Prevention during the period of complex rehabilitation increases the chances of a full recovery after a hemorrhagic stroke.

A positive prognosis largely depends on the desire of the patient and the support of people close to him.

Stroke hemorrhagic right side: how long do surviving patients live

An ideal set of circumstances does not guarantee the absence of a trace of an ischemic stroke. The formation of persistent complications: paralysis, amnesia, spatial dislocation, failures of the visual and vestibular nature, lack of figurative thinking in most cases leads to an unfavorable outcome. Patients in a coma are practically hopeless.

Statistical data confirm the development of fatal recurrences of hemorrhagic stroke in 5% of patients during the first six months after the disease, 10% within a year. The mortality rate of the five-year period after the disease is more than 50%.

Stroke hemorrhagic left side: how long do surviving patients live

The probability of a full recovery is minimal, however, using the regenerative feature of the cells of the left hemisphere, it is possible to compensate for the lost abilities. The functions of the dead areas of the brain are taken over by neighboring ones. The process of interchangeability is completely dependent on the time interval between the detection of a hemorrhagic stroke and the start of intensive brain rehabilitation therapy. An important aspect here is the active desire of the patient himself - to re-learn to speak, develop thinking, write and read.

The life expectancy of a person who has had a hemorrhagic stroke does not depend on the place of the disease. An important role is played by age factors, the timeliness of first aid, the appointment of the right treatment and a powerful recovery procedure after an illness.

The normal functioning and integrity of blood vessels plays an extremely important role in the activity of all organs and systems of our body. Therefore, any violations of this kind rather quickly, or even immediately, make themselves felt, provoking the development of various pathological conditions. So a violation of the patency or integrity of the blood vessels in the brain can cause a stroke. Let's talk on this page www.site about what a hemorrhagic stroke is in a little more detail. Consider what happens when the right or left side of the brain is affected, possible consequences this. In addition, we will answer the question of what should be the treatment and recovery for hemorrhagic stroke.

What is a hemorrhagic stroke?

The term hemorrhagic stroke means a clinical form of an acute disorder in the cerebral circulation. In such a pathological condition, any (non-traumatic) entry of blood into the cranial cavity occurs, which is due to rupture of blood vessels inside the brain due to their diseases. As practice shows, hemorrhagic stroke makes up from eight to fifteen percent of all strokes, it is considered as the most severe form of the disease among other acute cerebrovascular accidents.

The left hemisphere is responsible for logic and speech, while the right hemisphere is responsible for emotions, feelings, Creative skills and perception of the surrounding world. That is why new information is analyzed in the left, and already familiar - in the right.

If there was a hemorrhagic stroke (left side), what are the consequences?

It is believed that left-hemispheric stroke occurs more often than right-hemispheric. Since this part of the brain is responsible for speech and logic, when it is affected by a stroke, not only the right side of the body is paralyzed, but also language and speech disorders develop.

The victim has speech disorders, his pronunciation becomes slurred and fuzzy. The patient does not understand the speech he hears, he manages to express himself only in fragments of words or individual sounds. Sometimes the victims resemble the mute. It is worth noting that the described symptoms are typical only for right-handed people.

Left-sided hemorrhagic stroke causes rapid disorientation, provokes problems with logical thinking and powerful depressive states. The patient becomes isolated and, as it were, withdraws into himself, as his communication with others becomes more than limited.
Left-sided stroke causes paralysis right side body - partial or complete.

If a hemorrhagic stroke happened (right side), what consequences are expected?

If the hemorrhage occurred in the right hemisphere, the patient has paralysis of the left side of the body - complete or partial. Most often, this condition is accompanied by the development of persistent disorders of muscle tone, which are characterized by a spastic type. Such a problem tends to increase rapidly during the acute period. At this stage, contractures are actively formed, and the sensitivity of all types is also impaired.

In patients, pain, tactile, muscular-articular and temperature sensitivity may worsen or even disappear altogether. Eye movements may also be disturbed, in which case the entire head and even the pupils remain turned to the left.

When the right hemisphere is affected, not only left-sided spastic hemiparesis is observed, but also vestibular disorders. There may also be blindness of the left eye, diplopia on the left side. Sometimes patients may not see the space on the left at all. Symptoms can be complicated by neuropsychiatric disorders, which are accompanied by persistent sleep disturbances and even problems with swallowing.

Both right-sided and left-sided hemorrhagic strokes can cause death, coma, and severe disability.

Defeat hemorrhagic stroke - treatment and recovery of the body possible?

Treatment of hemorrhagic stroke

Therapy for hemorrhagic stroke can be conservative and operative. Doctors take measures to restore cerebral circulation, to eliminate swelling of the brain, as well as to improve the rheological properties of blood. It goes without saying that stimulation of neurogenesis plays an important role, maintaining the normal activity of other vital systems and functions.

Surgical correction helps to eliminate the hematoma caused by hemorrhage.

For those who have experienced a hemorrhagic stroke, recovery, as a process, gives faith in life

Unfortunately, hemorrhagic stroke often causes death or serious health problems. However, in some cases, doctors, together with relatives, help the patient achieve a partial restoration of health. Rehabilitation is carried out both in medical institutions and at home.

An excellent effect is given by physiotherapy (darsonvalization or electrotherapy, balneotherapy or hydrotherapy, faradization - the use of low-frequency alternating current). Also, many patients who have had a hemorrhagic stroke are shown to carry out paraffin therapy, phototherapy, and acupuncture.

An extremely important role is played by the timely and competent help of a psychotherapist and special exercises. At first, gymnastics should be passive (a nurse or relatives help to do it), but the patient can do some exercises himself (blink, bend fingers, etc.).

Of course, a healthy diet also plays an important role.

Hemorrhagic stroke is an extremely serious disorder that requires adequate timely therapy under supervision in the intensive care unit.