Hemorrhagic stroke left side consequences how long do they live - Heart. Hemorrhagic stroke: what is it - consequences and how long do they live?

Hemorrhagic stroke brain is an acute pathological condition in which the patient experiences hemorrhage inside the skull. It appears due to 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 hemorrhage. It develops mainly in patients 35-50 years old, although even infants are not immune from it. Failure to provide medical care in a timely manner often leads to death.

With a hemorrhagic stroke, blood is released into the brain tissue (sometimes up to 100 ml or more). In this case, its cells are damaged, a hematoma appears, and the brain swells. If the patient was not provided with assistance within the first 3 hours, the changes will be irreversible.

Reasons for the development of pathology

Hemorrhagic stroke differs from ischemic stroke in that it is faster, more complex and more dangerous to human life. The following factors can provoke a pathological condition:

• Stable, prolonged increase in blood pressure caused by disease of cardio-vascular system.
• Accumulation of amyloid (pathological protein) on the walls of veins and arteries.
• Vascular cerebral aneurysm.
• Congenital defects development of arteries and veins, as well as their damage caused by atherosclerosis.

• Erythremia.
• Thrombophilia.
• Inflammation of the vascular walls.
• Too frequent use medications promoting blood thinning.

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

• Blood clotting disorder.
• Impaired cardiac functionality.
• Cerebral vasculitis.

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

Neurosurgeon, Professor Sergei Petrikov will tell you more about the pathology in Elena Malysheva’s program “Live Healthy!”:

Poor nutrition, excessive body weight, smoking and alcohol and drug abuse can increase the likelihood of developing a hemorrhagic stroke. The age of the patient and the nature of the work are of great importance. Constant stress and prolonged exposure to direct sunlight also take their toll. If you accurately determine the causes of hemorrhagic stroke, then more effective help can be provided to the person.

Symptoms

Most often, the development of the disease occurs in daytime, after exposure to a negative factor. The acute form is characterized by the following signs of hemorrhagic stroke:

1. Significant pain in the head. Over time it only grows.
2. Vomiting and nausea.
3. Sensation of fluid spreading inside the skull.
4. Unpleasant sensations when looking at the 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 speech clarity.
4. Manifestations of facial asymmetry.
5. Increased temperature, impaired respiratory function.
6. Direct the patient's gaze towards the lesion.
7. Sharp redness of the face.
8. Intermittent pulse, arrhythmia.

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

Since cerebral swelling occurs during a hemorrhagic stroke, the victim develops strabismus, different pupil sizes, and a critical decrease in blood pressure. Depending on what part of the brain is affected, 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 a person’s chances of survival are close to zero. This department is responsible for the functioning of the heart and respiratory system.

Diagnosing a hemorrhagic stroke on the right is quite difficult, since the centers of orientation in space and sensitivity are located in this part. 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, a clear relationship can be traced: for example, if the functionality of the right half of the brain is impaired, left-hand side and vice versa.

If the left side is affected

This lesion is characterized by disruption of the right side of the body. The patient experiences complete or partial paralysis, and not only the leg and arm are affected, but also half of the tongue and larynx. Such patients develop gait disturbances, a characteristic posture right hand(folded like a boat).

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

The victim experiences deterioration in memory and speech, and the ability to clearly express thoughts is impaired. Damage to the left hemisphere of the brain is characterized by problems with recognizing the time sequence; it cannot decompose complex elements into components. Impairments in written and oral speech appear.

Types of hemorrhagic stroke

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

• Trunk damage. It leads to the rapid death of the victim, since life-supporting centers (cardiac activity and respiration) are located in it.
• Hemorrhage in the thickness of brain tissue or the periphery of an 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 multiple areas of the brain.

Intracerebral hemorrhage is much more dangerous than peripheral hemorrhage. It provokes the appearance of hematomas, the spread of edema, and subsequent tissue necrosis. According to the location of hematomas, they 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 extend beyond the cerebral cortex and spreads only to one 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 due to an aneurysm, hemangioma, or congenital anomaly.

How to recognize pathology in a timely manner, and what first aid does the victim require?

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

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

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

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

1. The person must be positioned so that his head is significantly higher than the level of his body.
2. It is necessary to remove all clothing from him that restricts his movements, puts pressure on him, and prevents normal access of air.
3. To prevent the patient from choking on vomit, you need to turn his head to the side.
4. All windows in the room must be open so that there is a constant flow of fresh air.
5. It is strictly forbidden to give the patient any medications on his own - this will worsen his condition and complicate diagnosis.

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

Elena Nechaeva, an emergency doctor, will tell you about the algorithm of actions if a stroke is suspected:

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

Diagnosis and treatment of pathology

In order to begin treatment of the disease as quickly as possible, it is necessary to correctly diagnose it. A neurologist should examine the patient. For diagnosis, MRI of the brain is used with (or without) a contrast agent. An angiogram will also be needed. The quantity and quality of diagnostic instruments is determined individually for each patient.

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

The focus of hemorrhage in hemorrhagic stroke on MRI

Treatment of hemorrhagic stroke is carried out in a hospital setting, which includes an intensive care unit and a neurosurgical department. The fight against pathology is primarily carried out with the help of surgery, since it is necessary to eliminate the hematoma. The patient also requires strict bed rest. He is prescribed glucocorticoids and calcium antagonists. You will also need antiseptics and antibiotics (if you have 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, and Cerebrolysin are used (to begin with, intravenously).
• To improve the activity of the affected part of the brain, antioxidants are used: Actovegin, Mildronate.
• To stabilize blood microcirculation, you will need vasoactive medications: Terntal, Sermion.

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

What prognosis and consequences are possible?

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

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

1. Memory impairment.
2. Loss of the ability to reproduce speech and perceive information.
3. Coma and vegetative state. This outcome is very common. Most victims may experience some emotions and 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 a hemorrhagic stroke involving the brain stem.
2. Profound disability. Despite the vitality of the organism, its ability to move and communicate is depressed; mental processes do not function normally.
3. Violation swallowing reflex.
4. Problems with orientation in space.
5. Behavioral disorders. The patient experiences unreasonable fear and serious hallucinations.
6. Inability to maintain control over the fulfillment of natural needs.
7. Epilepsy.

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

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

With left-sided cerebrovascular accident, the patient is left with the following consequences: problems with the functioning of the facial muscles, inability to think logically, paralysis and loss of sensitivity on the right side of the body. There are difficulties with the swallowing reflex. Severe attacks of headaches and paralysis of facial and respiratory muscles appear. The patient exhibits prolonged depression, depression, anxiety, and sleep problems.

If the right side of the brain is affected, the consequences may be as follows: severe dysfunction of the vestibular apparatus, paresis and paralysis of the left side of the body. The patient experiences visual impairment, up to complete blindness. Neuropsychiatric disorders are also noted.

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

Rehabilitation process

Timely treatment is just the tip of the iceberg. The main time will be spent restoring the functionality of 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.
• To stabilize emotional state a person needs consultation with a psychologist and psychotherapist.
• Therapeutic exercise. At first, it provides only passive movements, and then independent exercises. This treatment helps restore neural connections in the nervous system.

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

• Exercises on simulators. Physiotherapy suits can also help to help restore motor function.
• Electrical neurostimulation.
• Visit to the pool and massage in the water.
• Color therapy.
• Vibration effect on biological points located on the feet.

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

Stroke ranks first among neurological pathologies. According to statistics, the attack affects about six million people every year. The danger of a stroke lies in its consequences; many patients who have suffered an attack remain crippled for life. Approximately 20% of them die in the first month after the crisis. From this article you will learn what an ischemic stroke on the left side is, the consequences, how long they live after an attack.

Classification and causes of pathology

A stroke is characterized by severe damage to the brain of the head caused by ischemia or rupture of the organ’s vascular system. Depending on the causes, the disease is divided into ischemic stroke of the left hemisphere - formed as a result of vascular occlusion, and hemorrhagic - caused by rupture of the arteries. Hemorrhagic stroke has a poor prognosis and is most often fatal.

The formation of pathology of both types is facilitated by such factors as: arterial hypertension, cerebral atherosclerosis, cardiovascular complications, diabetes, abuse bad habits, excess weight, cerebral aneurysm, .

The anomaly also differs in place of origin - a stroke of the right cerebral hemisphere and a stroke of the left cerebral hemisphere of the brain. The symptoms of a stroke on the left side of the head are significantly different from the symptoms of a stroke on the right side. Left-sided ischemic stroke is very severe and has a poor prognosis, since the left hemisphere is dominant over the right in many people.

Symptoms

The brain can be called personal computer person. After all, it is he who gives commands to perform various vital functions of our body.

Therefore, the symptoms of the disease are directly related to its functional tasks.

When an ischemic stroke occurs on the left side of the brain cells, the patient experiences the following symptoms:

• panic;
• cardiopalmus;
• failure in the functional work of the facial muscles, the corner of the mouth and eyelid on the left goes down;
• speech dysfunction, the patient speaks indistinctly, it is difficult to understand words;
• Strong headache;
• shortness of breath;
• dry mouth;
• dizziness;
• partial or complete loss of consciousness;
• disorientation in space, inadequate perception of one’s body;
• general weakness of the lower or upper extremities. The patient cannot raise his legs or arms at the same time. Paralysis of the left side is characteristic of a right-sided stroke;
• problems with vision and short-term memory;
• vomiting caused by pathology, not food poisoning.

Features of the signs of the disease depend on which hemisphere the pathological modifications have formed: with a stroke, partial or complete paralysis occurs on the left side right side torso. Since impulses emanating from the left cerebral hemisphere give direction to the right side of the human body. If after a stroke the left side is paralyzed, then the right cerebral hemisphere of the head is damaged.

With hemorrhagic stroke, the symptoms develop rapidly; it develops after aggressive physical activity and against the background of an unstable psycho-emotional state. Ischemic left-sided stroke manifests itself gradually, mainly it overtakes the patient in the morning or at night.

Assistance to the patient

In case of a stroke, the patient must be urgently hospitalized since the first 3 hours are decisive. The longer a patient goes without medical care, the higher the likelihood of coma. Knowing the three basic rules of left-sided stroke, anyone, even without medical education, will be able to identify the pathology.

Rule No1. Make the patient smile.

Rule No2. Start talking to the patient if his speech is incoherent and difficult to understand, this signals a stroke with paralysis of the left side.

Rule No3. Ask to raise both hands up at the same time.

If the patient has difficulty following these rules, immediately call an ambulance. The dispatcher should explain the situation in detail. The patient's head should be elevated until the ambulance arrives.

In the room where the patient is located, it is necessary to open the window and facilitate the access of air to the victim’s lungs (unfasten the top buttons, if there is a tie, remove it). Measure blood pressure and record the readings. If vomiting occurs, it is necessary to turn the person on his side. The main thing is to remain calm, to do everything clearly and consistently; the further development of events largely depends on the correctness of actions when providing first aid.

Diagnosis of the disease

It is not difficult to detect a stroke on the left side of the brain. Specialist based on clinical picture quickly determines what happened to the patient. It is much more difficult to establish the type of stroke, in which hemisphere the pathology developed, and what its size is. Because these indicators are fundamental for effective therapy.

For an accurate diagnosis, the patient is prescribed the following examination methods:

• consultation with a neurologist. The specialist determines the consequences of a stroke on the left side of the body, determines the severity of symptoms;
• laboratory tests (general and biochemical analysis of urine, blood, blood clotting);
• CT, MRI, and these instrumental examination methods make it possible to assess the lesion, establish the type of stroke and its location;
• ECG, ultrasound of the heart, monitoring blood pressure to exclude the development of complications caused by concomitant diseases.

Treatment

A hemorrhagic stroke on the left side, with hemorrhage, requires emergency surgical intervention; neurosurgeons bear responsibility for the patient in this case. Some forms ischemic stroke, also need surgical help.

Surgical intervention in this case consists of removing atherosclerotic plaques and blood clots to restore natural blood flow.

If the circulatory disturbance was not intense and a small part of the brain cells of the head are subject to necrosis during an ischemic stroke on the left side, the consequences will be insignificant, and the patient can count on 90% restoration of brain impulses. However, this requires timely and correct treatment, as well as strict adherence to the instructions of the attending physician during the rehabilitation period.

Group of drugs for the treatment of ischemic stroke:

1. Fibrinolytic drugs - treatment with these medications begins in the first three hours after a stroke. Complete paralysis of the left side when taking this group of drugs is reduced to zero.
2. Anticoagulant drugs - direct action (heparin sodium, nadroparin calcium, dalteparin sodium, enoxyparin sodium), and indirect action drugs (Phenilin, Warfarin Nycomed), treatment of the patient with drugs from this group begins 2 weeks after a left-sided stroke.
3. Antiplatelet drugs - Lamifiban, Clopidogrel, Ticlopidine, Aspirin.
4. Vasoactive drugs to strengthen the walls of blood vessels in the brain, as well as to improve blood flow. Myotropic antispasmodics - No-Shpa, Cinnarizine, antioprotectors - Alprostadil, Anginin;
5. Antihypertensive drugs - used for high blood pressure. ACE inhibitors (Captopril), or calcium antagonists (Nicardipine).
6. Neuroprotectors - focused on protecting brain cells from pathogenic factors. Glutamate receptor blockers (magnesium preparations), nootropic drugs (Semax, Ceraxon) that improve blood circulation in the brain (Tiklid, Trental), antioxidants (Niacin, Mexidol), adaptogens (Eleutherococcus tincture, Chinese Schisandra tincture).

Rehabilitation period

With a stroke on the left side, the consequences of the disease depend on the patient’s actions in recovery period. The more desire a patient has to get better, the higher the chances of surviving and returning to a full life.

Experts advise strictly adhering to the following principles:

• bed rest;
• massage of paralyzed limbs;
• passive exercises every 4 hours, performed by a nurse or the patient’s relatives. To do this, it is necessary to bend and straighten the victim’s limbs. Gymnastics should begin with parts of the body susceptible to paralysis, then move on to healthy ones.
• breathing exercises;
• gradual change of position using improvised means;

During the rehabilitation period, the patient requires moral support from loved ones, since the recovery process can drag on for many months. It is very difficult to learn to walk, write, and read again, and if the patient does not have a sensitive, responsive person next to him, he may simply stop trying. And remain crippled for life.

Possible consequences and prognosis

With an ischemic stroke on the left side, the consequences and how long patients live also depend on the extent of damage to the nerve endings of the brain. The percentage of survivors after a stroke on the left side is 50% of the total number of patients with this pathology. The prognosis for a stroke in the left cerebral hemisphere is more favorable than that of the right.

Full recovery occurs in 60% of patients after suffering a left-sided attack.

The factors on which the rate of brain cell regeneration depends include: timely and adequate treatment, speed of emergency medical care, the age of the victim, the patient’s desire, and the absence of concomitant pathologies.

In case of a stroke of the left hemisphere of the brain, the consequences will be as follows:

• partial or complete paralysis of the right side;
• impaired sensitivity to external stimuli on the right, with right-sided brain damage on the left;
• speech problems;
• loss of reading and writing skills;
• memory failures;
• inability to think logically and adequately assess the situation;
• disturbance of eye movements;
• a person becomes withdrawn, basic self-care skills are lost, inadequate perception of the outside world and one’s body;
• causeless laughter or crying;
• epilepsy attacks.

A stroke of the left-sided cerebral hemisphere can not only cause disability, but also the attack contributes to a deterioration in the patient’s quality of life. A loss mental abilities, memory, negatively affects emotional background patient, which leads to prolonged depression and complete loss of interest in what is happening. The support of relatives is an invaluable assistant during the rehabilitation period. Encouraging and instilling confidence in the patient will help him recover faster and return to a full life.

In contact with

Given the annual increase in stroke cases by more than at a young age, the problem is urgent. Doctors have not come to a clear decision on which specialist should solve this problem. This is due to the fact that the disease affects the leading systems of the human body: cardiovascular and nervous.

Therefore, treatment is carried out by several specialists simultaneously (vascular surgeons, neurosurgeons, cardiologists, neuropathologists).

Stroke is one of the most common diseases in the world and is one of the leading pathologies leading to disability.

What is a stroke, types

Stroke is a sudden or acute disruption of the blood supply to the brain. The condition cannot be called a complete cessation, because in some types the blood supply is small, but remains.

The classification is based on the mechanism of problem formation:

• Without blood leaving the bloodstream into the tissue and cavity of the brain;
• Rupture of the vessel wall and hemorrhage into the intrathecal areas or into the brain tissue.

There are 2 types of disease based on the mechanism of formation:

1. Ischemic stroke (due to blockage or stenosis);
2. Hemorrhagic (due to the release of blood from a vessel).

According to the international classification of diseases used by doctors, there is the following classification:

1. Transient cerebrovascular accidents:
   • transient ischemic attacks;
   • cerebral hypertensive crises.
2. Acute hypertensive encephalopathy.
3. Meningeal hemorrhage:
   • subarachnoid (subarachnoid);
   • epi- and subdural
4. Brain hemorrhage:
   • parenchymal;
   • parenchymal-subarachnoid;
   • parenchymal-ventricular;
5. Cerebral infarction (non-embolic):
   • due to pathology of the main arteries of the head;
   • in case of pathology of intracerebral vessels;
   • of a different genesis.
6. Embolic cerebral infarction:
   • cardiogenic;
   • of a different genesis.

According to the location of the lesion:

1. Hemispheres of the cerebrum.
2. Brain stem.
3. Ventricles of the brain.
4. Subarachnoid.
5. Multiple focus (several zones).

Causes of stroke

In the development of stroke, reliable and probable causes can be identified.

Possible ones include:

• Smoking and alcohol abuse;
• Poor nutrition;
• Stress;
• Obesity;
• Sedentary work;
• Oral contraceptives;
• Metabolic disorders;
• Hormonal disorders;
• Diets.

Reliable ones include:

• Hereditary predisposition (not only strokes in relatives, but also the following pathological conditions and diseases);
• Myocardial infarction in the past;
• Hypertension (grades 2 and 3);
• Cardiac ischemia;
• Violations of the rhythm and conduction of the cardiovascular system (blockades and arrhythmias);
• Increased cholesterol in the blood;
• Vasculitis (inflammation of the walls of blood vessels);
• Aneurysms and anomalies of cerebral vessels;
• Blood diseases;
• Varicose veins;
• Rheumatism.

Signs of a stroke attack

The prognosis depends on the type of stroke and the severity of the lesion. The main recovery leap is the first 3-6 months. The next critical moment is a year after the attack. The more time has passed, the less chance of recovery of function.

In essence, a hemorrhagic stroke is a hemorrhage into the brain parenchyma, which is accompanied by severe circulatory impairment of the organ, complete or partial loss of functions of the affected area and the development of pathogenesis with a high risk of death.

Experts distinguish several types of the above-mentioned brain stroke:

1. Hemorrhagic with hemorrhage into the brain parenchyma.
2. Subarachnoid with hemorrhage into the cortex of the organ.

This disease is more complex and traumatic than , since at the same time, during the development stage of the problem, inflammatory-necrotic non-negotiable processes occur, compression of surrounding vessels, as well as degeneration of the periphery of the brain nucleus.

The localization of hemorrhagic stroke can be very diverse - from the lobar and putamenal areas to the cerebellar, pontine, mixed and global location. The likelihood of a problem occurring increases significantly with age; most often it is observed in men suffering from hypertension, as well as women over 35 in the labor/postpartum stage, if it is associated with multiple disorders of the cardiovascular system.

Causes of hemorrhagic cerebral stroke

The following factors are considered to be the officially proven causes contributing to the development of the disease: diabetes, arterial hypertension, obesity, smoking, sedentary lifestyle, atrial fibrillation, carotid artery stenosis, dyslipidemia, sickle cell anemia, various diseases of the cardiovascular system. The above problems provoke hemorrhagic stroke in ¾ of cases.

The remaining 25 percent of cases have an unrecognized or unclear etiology. Any person who independently and promptly adjusts their own lifestyle can reduce the risk of stroke by 25–30 percent.

Precursors of a possible hemorrhagic stroke are usually considered partial loss of vision, severe pain in the eyes, a sudden loss of balance with tingling and numbness of the limbs/body parts, as well as difficulty understanding and reproducing speech. However, as practice shows, the above conditions may not manifest themselves in at least half of the patients, or may be mild.

The disease itself manifests itself suddenly and most often its catalyst is severe stress or extreme emotional stress. If a person remains conscious, he may feel a strong heartbeat, a rapidly increasing headache, vomiting with nausea, light intolerance, paresis or paralysis of the limbs with difficulty reproducing/understanding speech.

After some time (from one or two minutes to half an hour), a regression of consciousness begins, accompanied by an epileptiform seizure (up to a quarter of all cases); the person gradually moves into the stage of first stunned, then somnolence, then stupor with a weak reaction of the pupils and preservation of the swallowing reflex. The final stage may be coma. The sooner the patient is provided with emergency qualified health care, the higher the chances of avoiding death!

Treatment of hemorrhagic stroke

A high risk of death predetermines complex treatment of stroke of the above type, which is carried out as quickly as possible.

Conservative treatment methods

The use of drugs is strictly regulated by the attending physician and cannot be carried out outside the hospital at home!

1. The use of hypotensive agents - selective, mixed and non-selective blockers, for example Atenolol, Acebutolol, Pindolol, Anaprilin, Carvedilol.
2. The use of second and third generation calcium antagonists - Nicardipine, Falipamil, Clentiazem.
3. Impact doses of antispasmodics of direct and/or indirect action - Drotaverine, Nitroglycerin, Difacil, Aprofen.
4. Use of ACE inhibitors:

• carboxyls - Quinapril, Trandolapril
• sulphihydryls - Captopril, Zofenopril
• hemostatic - Contrikal
• Phosphiles - Fosinopril
• sedatives - Elenium or Diazepam
• nootropics - Cortexig
• antiprotease agents - Gordox
• laxatives - Glaxena
• antifibrinolytics - Reopoliglyukin
• multivitamins - Calcium gluconate/pantothenate.

1. Combating cerebral edema and regulating intracranial hypertension:

• corticosteroids - Dexamethasone.
• diuretics - Lasix or Mannitol.
• plasma substitutes - Reogluman.

Surgical intervention (operation)

Surgery is usually prescribed in the case of hematomas of the trunk or cerebellum of the organ, which cause severe neurological symptoms, in case of lateral/local hemorrhages of large volume, as well as in the case of significant deterioration of the patient’s condition during dynamic diagnosis using MRI/CT.

In this case, direct contraindications to surgery may include medial hematomas and deep coma with irreversible stem dysfunctions - in in this case success surgical intervention estimated at 5–10 percent. If the patient is stable, has no neurological deficit, and only has supratentorial cerebral hematomas, doctors focus on exclusively conservative treatment.

The above indications can be revised in the direction of prescribing surgery after neuroimaging diagnostics (CT/MRI, vascular angiography) and detection of dislocations of the cerebral cisterns, deterioration of the clinical and neurological status, as well as an increase in the intravenous membrane of more than 30 milliliters.

At the moment, it is preferable operational way is considered an endoscopic microneurosurgery technique with a patient-friendly technique. The classical method is recommended only when there are difficulties in the homeostasis of brain tissue.

The process of recovery and rehabilitation of a person who has suffered a hemorrhagic stroke is quite complex and requires integrated approaches to future activities. In some cases, it can last up to two years and includes a number of rehabilitation procedures such as kinesiotherapy, therapeutic exercises, basic restoration of self-care, speech therapy, the use of reflex-loading systems, balneotherapy, etc. Moreover, the terms of rehabilitation depend on the objective condition of the patient, the success of the treatment and the person’s personal aspirations.

Prognosis and consequences of hemorrhagic stroke

Domestic figures and statistics on hemorrhagic stroke are very disappointing - up to 50 percent of patients die. Of those who survive, about eighty percent of people become disabled in one group or another. Even if you received qualified treatment on time and in full, and the form of the disease itself was not considered severe, the rehabilitation period can take up to one to two years, while only every fifth person will be able to fully restore all the basic functions of the body.

Possible and very probable consequences of a stroke include partial/complete loss of speech, motor activity due to paralysis. Often, a person acquires a neurological deficit or goes into a vegetative state, in which he cannot care for himself.

Stroke Prevention

Prevention of hemorrhagic stroke or prevention of its recurrence consists of a number of complex measures, including:

1. Regular long-term use of medications. In particular, the doctor usually prescribes anticoagulants (Warfarin, Heparin) and antiplatelet agents (Aspirin with Dipyridamole, Clopidogrel, Ticlopidine).
2. Control hypertension with immediate reduction of blood pressure if necessary. In this case, it is necessary to add potassium to the diet, limit the consumption of alcohol and salt, and sometimes it would be rational to take diuretics, ACE inhibitors, and angiotensin receptor blockers. All medications are prescribed exclusively by your attending physician.
3. Adjusting your diet to lower blood cholesterol levels.
4. To give up smoking.
5. Reduce excess eyelids by following a diet rich in vegetables and fruits.
6. Diabetes control.
7. Moderate physical activity using aerobic exercise.

Useful video

Treatment of hemorrhagic stroke of the brain. Symptoms and first signs

How to quickly recover after a hemorrhagic stroke. Adviсe

Among the most common diseases in the field of neurology is stroke, characterized by impaired blood circulation in the human brain. If medical assistance is not provided in a timely manner, the pathology in most cases ends in death.

A recurrent stroke after the first ischemic attack is quite common, which can also end unfavorably for the patient.

What it is

A second stroke is a dangerous condition for human health. Not only incorrectly carried out therapeutic measures, but also their incomplete course can provoke circulatory disorders.

According to statistics, a recurrent attack occurs in 30 percent of cases of a first stroke within the first year. In this case, the probability of death increases several times, which can be influenced by numerous factors.

Types of stroke

In medical practice, there are two main types of blood flow disorders in the brain:

1. Ischemic stroke. Is a circulatory disorder acute form, resulting from complete or partial obstruction of blood vessels in the brain. This type of stroke is diagnosed in most cases. Due to this pathological condition, there is a disruption or complete cessation of blood flow to the brain cells. As a result, tissues are affected and necrosis develops.
2. Hemorrhagic stroke. It is considered a more severe but rare pathology. Its difference from ischemia lies not in the clogging of the vessels, but in the fact that their integrity is violated, in other words, they simply rupture. This condition is accompanied by bleeding in the brain, which entails more severe consequences, in which survival rates are significantly reduced.

If we talk about secondary stroke, the first form most often manifests itself pathological condition. However, even if the patient has fully recovered after the first attack, it will be much more difficult to endure the second one.

Causes

As mentioned above, after the first brain injury, the risk of a second injury increases significantly, which leads to more serious complications, as well as a reduction in life expectancy.

Among the most common provoking factors are:

• hypertension, its development and rapid progression;
• vascular dystonia;
• diseases of the liver, kidneys and lungs;
• excessive physical activity;
• frequent changes in blood pressure.
• frequent stressful conditions;
• formation of atherosclerotic plaques;
• pathologies of the heart and blood vessels;
• large body weight;
• unbalanced diet, non-compliance with a therapeutic diet;
• forced immobility, which may be due to paralysis or paresis;
• violation of metabolic processes;
• increased irritability, which can provoke a hypertensive crisis;
• drinking alcohol and smoking.

It is also worth noting that older people often suffer strokes, which are caused by changes in the body associated with old age.

Symptoms

The development of a recurrent ischemic stroke may be accompanied by the following characteristic symptoms, such as:

• pallor skin faces;
• gradual increase in feeling of weakness;
• periodic tingling or numbness in the cheeks, head in the hair growth area, forehead, upper and lower extremities;
• decreased visual acuity;
• headaches in the morning;
• decreased blood pressure;
• unexpected fainting;
• difficulties in pronouncing words.

In addition, angina pectoris or an acute heart attack may indicate a secondary attack.

Hemorrhagic stroke can be recognized by signs such as:

• redness of the patient's facial skin;
• seizures;
• increased blood pressure;
• loss of consciousness with impaired respiratory function;
• uncontrolled urine output;
• different sizes pupils.

If there is a cerebral hemorrhage, the symptoms will be much more severe. As a result of vascular ruptures, blood circulation and breathing are disrupted, which leads to rapid death.

With a left-sided stroke, problems arise with right side body, with right-sided - problems with the left side.

To determine the occurrence of a second stroke in a bedridden patient, you need to ask him:

• smile - during an attack he will not be able to do this;
• show your tongue - there should be no curvature of it;
• say a simple sentence.

If problems arise even with one of the tasks, immediate medical attention is required. It is also important to pay attention to associated symptoms which were described above.

First aid

In the presence of characteristic features First of all, you need to call an ambulance. Next, the person nearby should do the following:

1. Make the patient take a horizontal position. When vomiting occurs, his head should be tilted to the side.
2. If the patient’s consciousness is not impaired, then it is necessary to inquire if he is taking medications prescribed by the attending physician. It is strictly not recommended to use foreign means, which can provoke even more serious problems.
3. To make breathing easier, you need to unbutton your clothes. This will ensure a normal flow of oxygen.
4. If the attack occurred at home, then give 2 aspirin tablets and 300 milligrams of glycine.
5. It is important to maintain a conversation with the victim at all times. His breathing should be deep.

If possible, you should apply something cold to the front of your head.

What is the difference between rehabilitation after a recurrent stroke?

In case of a second attack, doctors adhere to the same tactics as with the first defeat. It is mandatory that the patient be hospitalized in a clinic, where he is admitted to the intensive care unit or intensive care unit.

If it is necessary to lower blood pressure, antihypertensive drugs are administered intravenously or intramuscularly. To prevent cerebral edema, magnesium sulfate is used.

If a hemorrhagic stroke recurs, all necessary measures are taken to stop the bleeding. The patient is administered Vikasol, Aminocaproic acid or Etamsylate.

In case of recurrent ischemic stroke, treatment will consist of:

• prescribing vasodilators;
• administration of vitamin PP;
• taking Papaverine, Nosh-Py, Complamin and Eufillin;
• using Reopoliglucin solution intravenously, which will normalize the viscosity of the blood fluid;
• prescribing Cavinton and Vinpocetine to restore vascular tone.

When a secondary symptom is diagnosed, the rehabilitation period lasts slightly longer. After the patient is discharged home, he should be regularly monitored by a neurologist.

In addition, the recovery period requires constant supervision by a psychotherapist. Patients who are aware of their condition often become depressed, which contributes to slower recovery.

What could be the consequences?

A recurrent stroke can lead to the development of most complications. The most common ones include:

1. Memory loss. The patient may not even remember familiar things. He forgets the names and images of close relatives and cannot name ordinary objects.
2. Impaired motor activity. It is difficult for the patient to control the musculoskeletal system. In most cases, ischemic damage leads to loss of movement and inability to hold objects. In addition, it is possible to become completely bedridden.
3. Complete or partial speech impairment. It is possible that after an attack the patient will have difficulties with pronunciation. This is explained by a violation of the corresponding parts of the brain. With serious damage, speaking function is lost for a fairly long period.
4. Mental disorders. Aggression, apathy towards everything that happens, and depression are diagnosed.
5. Depression of intellectual abilities.
6. Falling into a coma.
7. Dementia.
8. Loss of sensation.

It is possible to restore impaired functions only in 20 percent of cases, and even then not completely.

Which people are at particular risk?

An increased susceptibility to relapse occurs in people who:

• suffered a hemorrhage after 45 years of age;
• do not adhere to the recommendations of specialists (quitting smoking, alcoholic beverages and narcotic substances);
• did not complete the full course of therapy and rehabilitation;
• do not follow dietary rules;
• are often exposed to stressful situations and emotional fatigue;
• do not receive support from relatives.

To prevent a second stroke, it is necessary to adhere to preventive measures.

Statistical data

The prognosis for life during a secondary attack is disappointing. It is difficult to say for sure how long a person will live. Statistics show that in 70 percent of cases the disease ends in death.

For patients diagnosed with a stroke over the age of 45, the likelihood of a recurrence increases by 15 times. About 30 percent of recurrent cases occur within the first year.

In addition, men are slightly more likely to have a stroke again than women.

What can be done for prevention

Your doctor will tell you how to avoid a second stroke. First of all, you need to review your diet. It is important to immediately give up animal products and fast carbohydrates.

It is prohibited to use:

• eggs;
• liver;
• pork;
• caviar;
• spicy foods and preserves;
• smoked meats;
• sausages;
• confectionery.

The menu should include:

• poultry meat;
• low-fat dairy products;
• porridge;
• fresh fruits and vegetables;
• low-fat fish.

It is important to monitor physical activity, especially when restoring performance:

• do not work at night;
• have a good rest;
• monitor your sleep patterns;
• spend more time on fresh air;
• do not expose the body to active stress, including at the dacha.

No less attention should be paid to monitoring blood pressure; it is recommended to measure indicators about three times a day.

To restore vascular activity, a specialist may prescribe Trental or acetylsalicylic acid. To normalize the energy balance of cells, regular courses of treatment with Cerebrolysin and Piracetam are prescribed.

Having a second stroke reduces your chances of full life to a minimum. It is much easier to take all measures to prevent a disease than to treat it.