How long do they live after an ischemic stroke on the left side and possible consequences. Hemorrhagic stroke. Right, left, consequences. Treatment and recovery

Stroke is one of the most serious neurological diseases that poses a direct threat to the health and life of the patient. Its common cause is hemorrhage with subsequent compression of tissues by spilled blood, cerebral edema and increased intracranial pressure. There are several clinical forms of stroke, each of which has its own characteristic features, and below we will talk about hemorrhagic stroke with right-sided lesions.

What is a hemorrhagic stroke?

Hemorrhagic stroke is an acute disorder of cerebral circulation in which blood from burst vessels enters the cranial cavity. It is considered one of the most dangerous forms of the disease, as it often leads to cerebral edema and death of the patient. According to statistics, hemorrhagic stroke accounts for about 10-15% of stroke cases, and half of the patients die within the first day. The prognosis depends on the age and general health of the patient, as well as which hemisphere of the brain was damaged.

Damage to the left and right hemisphere: what is the difference?

The brain is without a doubt the most complex part of the human body, with each half controlling sides of the body in mirror image and also responsible for individual functions.

In other words, hemorrhage in one or another hemisphere of the brain gives different symptoms and leads to different consequences. It is believed that a hemorrhagic stroke on the right side gives a person a better chance of recovery, but its symptoms are usually not so pronounced, so patients seek medical help quite late.

Symptoms of a right-sided stroke

Right-sided hemorrhagic stroke may present with the following symptoms:

• paralysis and decreased sensitivity on the left side of the face and limbs;
• disturbances in the perception of one’s own body: a person may feel that the arms and legs are alien or, conversely, that there are too many of them;
• memory loss;
• disturbances in the perception of the surrounding space: it is often difficult for patients to orient themselves in a room, estimate distances, or put on clothes and shoes correctly;
• depression, psychological passivity, inappropriate behavioral reactions;
• in some cases - hearing impairment.

It is important to note that speech disorders, which are the most striking sign of the disease, are not observed in right-sided hemorrhagic stroke (the exception is left-handers, in whom the left hemisphere of the brain is responsible for speech skills).

First aid to the patient

The first thing that needs to be done to help a person with signs of a stroke is to call an ambulance, and you should explain in detail to the dispatcher what happened to the victim. While waiting for medical attention, you can take the following measures:

• raise the patient’s head by 30%, placing a blanket or clothing under the back of the head;
• provide fresh air and remove or loosen tight clothing;
• when vomiting occurs, you need to lay the person on his side, and after the attack ends, help him clear his mouth of vomit;
• measure blood pressure and record the indicators.

Diagnosis of hemorrhagic stroke on the right side

The main diagnostic methods for determining hemorrhagic stroke of the right side are magnetic resonance imaging, spiral or conventional computed tomography of the brain. They allow you to determine the location and volume of the internal hematoma, the presence and extent of hemorrhage, and the area of ​​edema. These indicators are the most informative over time, so CT studies will need to be repeated after some time.

In addition, it is very important to carry out a differential diagnosis of hemorrhagic stroke with ischemic stroke, as well as with other diseases accompanied by intracerebral hematomas. This requires a number of studies that can be carried out exclusively in a hospital setting. Among the signs characteristic of hemorrhagic stroke are meningeal symptoms and a slow increase in cerebral disorders. In addition, in case of ischemic stroke, the cerebrospinal fluid taken for analysis usually has a normal composition, but in the hemorrhagic form of the disease, blood impurities are observed in it.

Treatment tactics for hemorrhagic stroke depend on the degree of brain damage, as well as the characteristics of the body and the general condition of the patient. To combat the manifestations of the disease and normalize the vital functions of the body, drug therapy is used, surgery, physiotherapy, folk remedies.

Drug treatment

The primary goal of conservative treatment is to eliminate cerebral edema, stop bleeding, and speedy rehabilitation of the patient. To stop bleeding, it is necessary to normalize the pressure, for which Gemiton and Dibazol are used.

If there is no positive effect, the patient may be prescribed Novocaine and Aminazine.

In order to increase blood clotting and reduce the permeability of vascular walls, a solution of vikasol, calcium preparations, rutin, and a solution of ascorbic acid are used. In order to eliminate cerebral edema and reduce intracranial pressure in hemorrhagic stroke, Lasix and Mannitol are prescribed.

In addition, cardiotonics can be used to normalize vital functions, Amidopyrine or Analgin solution can be used to eliminate hyperthermia, and in case of pulmonary edema, oxygen inhalation with alcohol vapor can be used.

Surgery

Surgery for hemorrhagic stroke is performed for the following indications:

• the presence of extensive hematomas in the right hemisphere;
• presence of blood in the cerebral ventricles;
• rupture of an aneurysm accompanied by high intracranial pressure.

The operation should be performed by a qualified neurosurgeon within the first three days from the onset of the disease. During this procedure, the doctor removes accumulated blood from the hematomas, due to which the pressure in the brain tissue and skull is significantly reduced. Typically, the patient’s prognosis for life improves after the intervention, but in some cases, recurrent bleeding and other complications are possible.

Physiotherapy

Physiotherapeutic measures belong to rehabilitation techniques, and, as practice shows, they have a positive effect on the body of people who have suffered a stroke. These include:

• darsonvalization (exposure to tissue with pulsed high-frequency currents);
• balneotherapy (mud therapy) and hydrotherapy;
• faradization (use of low-frequency alternating current);
• acupuncture;
• phototherapy.

Folk remedies

Traditional medicine recipes for the treatment of hemorrhagic stroke can only be used as an auxiliary therapy after consulting a specialist. The following remedies are considered the most popular and effective.

1. Peony infusion. One tsp. Steam the dried and crushed roots of the plant with boiling water, leave for an hour and filter well. Drink one tablespoon four times a day.
2. Bay leaf oil tincture. Take 30 g of bay leaf, pour a glass of vegetable oil, leave for two months. Next, strain the tincture, boil and rub into the paralyzed areas.
3. Remedy made from bay leaves and spruce needles. To prepare the product you will need spruce needles (1 tsp), butter (12 tsp), bay leaves (6 tsp). Mix everything well and rub into paralyzed areas.
4. Alcohol tincture pine cones . Rinse a liter jar of opened pine cones (you need to take only whole cones that are not affected by rot or insects), fill to the top with vodka and leave in the dark at room temperature for two to three weeks. After this period, strain the product (you should get a tincture of a rich dark red color) and use 1 tsp. two to three times a day.
5. White foot tincture. White steppe (also called paralysis herb) is considered one of the most effective medicinal plants for the treatment of hemorrhagic stroke. To prepare the tincture, you need to take a tablespoon of well-chopped roots, pour in 300 ml of vodka, and leave for a week in a dark place. Strain and take 25 cups in the morning and evening, dissolved in water.

Despite the fact that hemorrhagic stroke is considered a very serious and dangerous neurological disease, with timely consultation with a doctor and competent treatment tactics, the patient has every chance of survival and rehabilitation. To prevent its development it is necessary to get rid of bad habits, lead a healthy lifestyle, and regularly monitor blood pressure.

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Causes of stroke

A stroke occurs when blood flow to some part of the brain is stopped. The functioning of the bloodless area stops 10 seconds after the blood flow is disrupted; after 5 minutes, the cells in the lesion begin to die and the consequences become irreversible. Therefore, if a stroke is suspected, minutes and seconds count.

Statistics show that stroke affects men more often. This is partly due to the greater prevalence of bad habits and increased injuries among men.

The prevalence of strokes among the elderly is associated with the accumulation of pathophysiological and age-related changes in the body, atherosclerotic changes in blood vessels and arterial hypertension. In young adults, adolescents and children, stroke can occur if there are congenital vascular defects.

Depending on the causes, strokes are classified as hemorrhagic, ischemic or mixed. Hemorrhagic stroke develops when one or more blood vessels rupture and local hemorrhage occurs in the tissue. Oxygen starvation of tissues is aggravated by their mechanical compression. Damage to the vascular walls occurs against the background of an abrupt increase in blood pressure. Due to the cessation of blood flow, nerve cells do not receive required quantity oxygen and glucose and begin to rapidly die off. Another cause of necrotic changes is swelling in the lesion caused by blood clots. Hemorrhagic right-sided stroke is a more dangerous condition, since the lesions in the case of hemorrhage affect a larger area.

According to statistical data, the distribution of causes of right-sided stroke looks like this:

• Atherosclerotic lesions of the cerebral arteries (about 40% of cases);
• Hypertensive crises (30%);
• Thrombotic complications of cardiac diseases (25%);
• Diseases associated with disorders of blood clotting and capillary circulation.

Sometimes circulatory disorders in the right hemisphere are caused by lesions of the main veins of the right side: vertebral or carotid.

According to the mechanism of development, strokes are divided into:

• Lacunar, arising from lesions of small arteries;
• Hemodynamic, developing against the background of blood pressure disorders;
• Thromboembolic, associated with blockage of a vessel by a blood clot and/or a foreign body carried through the bloodstream.
• Hemorheological, in which blood clots form directly in the vessels of the brain.

More often pathological changes have characteristics of more than one type.

Features of the course of a stroke in the right hemisphere

The right hemisphere is responsible for orientation in space, perception of the surrounding world, analysis of information coming from the senses. In left-handers, the right hemisphere controls speech functions.

Symptoms of the acute period of stroke:

• Complete or partial paralysis (paresis) of the left side of the body;
• Changes in facial expressions (dropping of the corner of the lips, characteristic movement of the lips, the so-called “sailing”, smoothing of the nasolabial fold);
• Attention disorders;
• Short-term memory disorders;
• Disorders of orientation in space;
• Speech disorders in left-handed people.

During the recovery period after a stroke, psycho-emotional disorders appear: causeless sudden mood swings, loss of a sense of tact and proportion, etc.

With extensive lesions, symptoms increase rapidly. Patients experience:

• Dizziness;
• Severe headaches;
• Movement disorders;
• Nausea, vomiting;
• Loss of consciousness.

In some cases, difficulty swallowing and speaking may occur.

On the background diabetes mellitus or arterial hypertension, a lacunar stroke may develop. Lacunar strokes are asymptomatic for a long time. General cerebral symptoms are mild. In about half of patients with lacunar stroke, the left side of the face loses sensation and there is weakness in the left arm and leg. Just over a third of patients experience loss of tactile and pain sensation. In 10% of cases, lacunar stroke leads to loss of ability to move independently and is accompanied by severe dizziness.

Symptoms of a stroke

Stroke often develops suddenly. Among the first acute symptoms stroke:

• Sudden severe headache;
• Abrupt increase in blood pressure;
• Feeling of numbness throughout the body;
• Sudden deterioration of vision;
• Partial or complete loss of sensation on the left side of the body;
• Slow breathing;
• Speech impairment;
• Nausea, possible vomiting;
• Loss of consciousness;
• Convulsions.

To confirm the assumption of a possible stroke, you need to perform a few simple tests:

• Ask to smile or stick out your tongue. With a stroke, the smile will be asymmetrical, the tongue will be distorted.
• Talk to the victim, ask any question. If a person has a stroke, they will either be unable to respond or their speech will be slurred.
• Ask to raise your arms, if possible, and your legs. If there is noticeable difficulty lifting one of the limbs, this indicates a high risk of stroke.
• Ask to name the date, name, place where you are. With a stroke on the right side, the ability to navigate is lost.

If one or more signs are detected, you must immediately call an ambulance, informing the operator of a suspected stroke. The faster doctors arrive, the greater the chance of saving the patient’s life.

First aid

Before the doctors arrive, you need to provide the victim with an influx of fresh air and lay him down with his head raised about 30 degrees. If the urge to vomit begins, it is necessary to turn the victim on his side. If possible, measure the pressure.

A stroke requires emergency hospitalization. If the patient is not provided with appropriate assistance within 10 minutes from the onset of the attack, the risk of death or complete paralysis increases significantly.

The more time has passed since the onset of stroke symptoms, the higher the likelihood of the patient falling into a coma. It is impossible to predict how long this condition will last. In 85% of cases, patients die without regaining consciousness. If the patient can be brought out of the coma within 48 hours, he still has a chance of survival.

Diagnostics

To determine the location, type and size of the lesion, brain tomography, heart ultrasound, ECG, and x-ray are performed. chest. Additionally – general tests urine and blood, blood pressure measurement. Based on the data obtained, treatment tactics are developed.

Treatment

Treatment of right-sided stroke includes basic and specific courses.

Basic treatment means:

• Supporting the functioning of vital organs and systems;
• Stabilization of blood pressure at a safe level. It is carried out gradually, since sharp fluctuations in blood pressure will only aggravate the patient’s condition;
• Prevention and elimination of cerebral edema;
• Temperature normalization;
• Elimination of seizures, heart rhythm disturbances and other symptoms;
• Prevention of thrombotic and other possible complications.

Specific therapy includes the following measures:

• Thrombolysis. If no more than 6 hours have passed since the first manifestations of a stroke, the patient is injected into a vein with a drug that dissolves blood clots. The earlier the procedure is performed, the more effectively the affected area can be reduced, which increases the patient's chances of survival and recovery after a stroke.
• Improving blood flow, necessary to prevent recurrent thrombosis. For this purpose, antiplatelet agents and anticoagulants are administered.
• Neuroprotection. Protection of viable nerve cells.

Consequences of a stroke

Even under ideal circumstances, a stroke does not go away without leaving a trace. After an ischemic stroke, the following are possible:

• Partial or complete paralysis of the left side of the body;
• Amnesia of varying severity;
• Impaired perception of space;
• Distortion of the oval of the face due to paralysis of the facial muscles;
• Depression;
• Left-handers have speech disorders.

After a hemorrhagic stroke, vision loss occurs, persistent disorders of the vestibular apparatus, swallowing disorders, epilepsy, sleep disorders, and mental disorders develop.

Damages to the right hemisphere lead to loss of ability to imaginative thinking, a holistic perception of the surrounding world, a person cannot perceive other people's emotions, music, artistic figures of speech.

Forecast

In addition to the consequences, it is important for the patient’s relatives to know how long they live after a stroke on the right side. Unfortunately, the prognosis in most cases is unfavorable, since fatal relapses of the disease cannot be excluded. According to statistics, after an ischemic stroke, about 5% of patients die within a month, the same number of deaths are recorded within 2 weeks after the hemorrhagic form of the pathology. The development of coma leaves almost no chance of survival.

Another 10% of patients die within the first year after a stroke; by 5 years the mortality rate exceeds 50%. Statistics show that approximately 20% of survivors cross the seven-year mark, and only 10% of stroke survivors live 10 years or more.

80% of patients of any age become unable to work and about 20% require constant care.

Rehabilitation

During the acute period of a stroke, the patient is in the intensive care unit, after which he is transferred to the general ward. The patient is prescribed treatment aimed at normalizing blood circulation, preventing thrombosis, and normalizing the functions of the cardiovascular system and brain. Approximately three weeks after the acute period of the disease, the patient’s rehabilitation begins, which continues after discharge and can last from several months to several years. The degree and quality of restoration of physical and mental activity patient after a stroke.

The rehabilitation program is compiled individually and usually includes the following activities:

• Speech restoration. Complete restoration of speech function is very difficult; in most cases, speech returns only partially. This is done with the help of a speech therapist.
• Psychological rehabilitation. The patient is referred for consultation to a psychotherapist or psychiatrist; in addition to the help of specialists, he needs the support of family and friends.
• Exercise therapy. To restore motor activity, the patient is prescribed a set of therapeutic exercises. The complex is developed by an instructor based on physical condition patient. While the patient is in a hospital or other medical institution, classes are conducted by an instructor; later, gymnastics must be done independently, under the supervision of family or friends.
• Massage. Carried out for recovery fine motor skills and body sensitivity. Therapeutic massage sessions are conducted by a specialist, but it is quite possible for the person who will care for the patient after returning home to master the basics of massage.
• Diet. Spicy, fried, fatty foods, canned food. Specific recommendations on nutritional habits are given by the attending physician.

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Characteristic

It's called a stroke most dangerous disease, caused by a violation of cerebral blood supply, which in turn leads to vascular damage and destabilization of the central nervous system. Translation from Latin (insulto - jump, gallop, attack, blow) fully reflects the moment of occurrence and the nature of a person’s pain.

There are ischemic, hemorrhagic, mixed types of stroke. Ischemic stroke of the right hemisphere occurs due to disruption of blood flow from blockage of brain vessels with cholesterol and fatty plaques. Hemorrhagic - characterized by a sharp, “explosive” nature of the painful blow due to the rupture of a vessel in the brain. An accurate diagnosis of “hemorrhagic stroke of the right side of the brain” can only be established by a doctor after a comprehensive examination. Stroke can be right-sided or left-sided, with damage to the right side considered worst option

compared to its left-sided “brother”. The secret of the “inequality” of strokes is simple - the cells of the left half of the brain are more resilient and recover better.

Signs

• With a heart attack in the right hemisphere of the brain, the following are observed:
• complete loss of control over one’s actions (possible loss of consciousness);
• nausea, dizziness, severe right-sided headache;
• breathing problems - shortness of breath, respiratory rhythm disturbance;

external signs: change in facial expression, immobility of the left side of the body. The hemorrhagic form of stroke has similar symptoms, but in a more pronounced form. It is possible to understand that what happened is an ischemic stroke on the right side by some specific features of the patient’s condition. If there is partial immobility or paralysis of the left side of the body, it means that the central part of the brain is affected on the right side. When the area of ​​the parietal part of the right side of the brain is affected, many problems arise with the sense of touch, a violation of sensitive factors is noted: there is no sensation of ambient temperature, the person stops responding to pain, and loses the ability to navigate in space and time. Right-sided strokes are especially hard for left-handed people because their speech center is located on the right side.

In a right-sided stroke, a loss of functional manifestations of the organs on the left side of the body occurs: there may be a lack of response to external stimuli in the left arm or leg, and there may be no hearing in the left ear. The most important thing that characterizes a right-sided ischemic stroke is a distortion of the patient’s psychophysical state, in which anagosia occurs (lack of reaction to what is happening around).

Damage to the right part of the brain has characteristics in old age: against the background of atherosclerotic encephalopathy, disturbances in cognitive processes appear - thinking slows down, memory and attention decrease, volitional apathy, and a decrease in intellectual and emotional manifestations are observed. An elderly person needs time to sense an impending disaster and call for help. The destruction of the volitional sphere is especially dangerous, since the recovery period requires precisely the efforts of the will in exercise therapy classes.

Risk factors

The following have an increased risk of formation:

• Rheumatism of the heart;
• Atherosclerotic damage to cerebral vessels;
• High blood pressure;
• Vascular tumors;
• Depressed psycho-emotional state;
• Cerebral aneurysm;
• Taking narcotic drugs;
• Alcoholism;
• Tobacco smoking;
• Previous myocardial infarction.

If one or more of the listed factors is present, you need to be alert in order to respond in time to the deterioration of the condition and urgently call an ambulance. Timely treatment will help avoid fatal consequences.

Children's cerebral infarction: features and prospects

Over the past few years, stroke has become significantly “younger” - the disease is increasingly developing in young people. A teenager, and even a child, can get a cerebral infarction, the reason lies in individual characteristics health. The risk of stroke increases if you have birth defects heart disease, inherited blood diseases, problems with endocrine system. The symptoms have a clear localization:

• Loss of sensation on the left side of the face;
• Trembling hands, legs, cramps;
• Problems with speaking – difficulty pronouncing certain sounds;
• Loss of coordination.

If a cerebral stroke is diagnosed promptly and accurately, treatment and subsequent rehabilitation lead to a full recovery and restoration of brain activity in full.

Paralysis: symptoms and types

A characteristic complication of a stroke is paralysis - complete or partial. Paralysis of the right side is observed when the left hemisphere is damaged, and a noticeable loss of strength and decreased muscle tone are clearly expressed.

Distinctive external signs of a stroke are that on the face the right corner of the lips is lowered lower than usual, the arm is pressed to the body, the fist is clenched tightly, the foot is turned inward.

Paralysis on the right side has good prospects for the future, but there are a number of significant problems:

• Loss of control over your own body, hence complete helplessness, a feeling of dependence, deepening stress.
• Hardening of muscle mass, worsening joint immobility;
• Prolonged immobility. The result is the formation of bedsores, the formation of blood clots, and the development of pneumonia. Preventive measures - you need to turn the patient over after 3-4 hours, monitor the condition skin, ventilate the room more often. Limitation of motor activity after a stroke with complete paralysis of only the right side has serious consequences for the patient and requires long-term persistent recovery. Here you will need the help of others to rehabilitation measures were carried out systematically. It is important to remember the special danger of paralysis in this area: if the right side is paralyzed, the parts of the brain responsible for the functioning of the heart and lungs are damaged, therefore, paralysis can lead to the death of the patient at any time.

Treatment

Ischemic and hemorrhagic strokes, due to their different nature, have radically different methods therapeutic in nature.

For ischemic stroke, treatment is chosen that involves eliminating the causes of blockage of blood vessels. Ischemic stroke is treated with neuroprotective therapy drugs, thrombolytic agents, and also with drugs that can counteract the formation of blood clots in the bloodstream. Therapeutic effects all foci of ischemia formation are exposed.

With a hemorrhagic stroke, under the influence of high pressure in the brain, hemorrhage occurs - the walls of the blood vessels cannot withstand the pressure of the blood flow, they burst, soaking the brain tissue. The deep nature of the lesion requires rapid intensive care. However, the catastrophic consequences of vascular rupture increase rapidly, and death cannot be avoided.

Recovery period

After completing the treatment course, the stroke patient will have a recovery period. Recovery after a stroke is a long and complex process, depending on the depth of brain damage and the general condition of the patient at the onset of the disease. The rehabilitation process after an ischemic stroke on the right side, if the consequences allow for restorative procedures and there are no contraindications, can begin in a week.

The basis of the process is the correction of disorders of the motor system.

Treatment includes several stages:

1. Exercise therapy (set of exercises physical therapy) - the patient does special gymnastics.
2. Attendance at manual therapy procedures, massage to restore the musculoskeletal system, and the use of kinesitherapy.
3. Conducting acupuncture and reflexology sessions.
4. The impact of various physiotherapeutic procedures.
5. For orthopedic problems, drug treatment or surgical intervention is used (to eliminate the consequences of immobilization).

Besides, rehabilitation period after a stroke, it includes classes with a speech therapist (to restore speech), psychological assistance (to assess the degree of destruction of brain activity, as well as the speedy socialization of the patient).

Treatment procedures for hemorrhagic hemorrhage include the prescription of drugs for the speedy restoration of the ruptured vessel membrane and those that have the ability to thicken the blood. In emergency cases, neurosurgery is required. The recovery period excludes even minimal physical activity. Rehabilitation can begin only after completion of the main treatment course. If after a stroke the entire right side is paralyzed, procedures should be started very carefully, carefully monitoring the patient’s condition, but not earlier than 3 weeks. The best restorative effect is provided by treatment in a specialized sanatorium, where the patient is in the conditions of the correct rehabilitation course around the clock.

Prognosis and prevention

A stroke gives rise to many questions from the patient’s relatives: what is the difference between cerebral hemorrhages, the more favorable is a stroke on the right side, what are its consequences, how many years do people who have had a cerebral infarction live? A more favorable prognosis awaits patients with small stroke “areas”; a large stroke causes complete loss of working capacity and disability.

When asked about life expectancy after a stroke, doctors do not give a definite answer: it all depends on the person’s age, the state of his body before the stroke, the presence concomitant diseases, quality of life. If you take care of your health, be attentive to the occurrence of warning symptoms, and avoid bad habits, you can live many full years without “getting acquainted” with a stroke.

In the modern world, people are constantly overcome by problems, stress, and various difficulties. This leads to the acquisition of diseases, many of which pose a direct threat not only to health, but also to life. A stroke, even with a favorable outcome, can in most cases become a death sentence for a person; long-term treatment and rehabilitation will not lead to success. To maintain health, you need to protect it, protect it, take care of it - then life will be long and happy.

krov.expert

Causes of hemorrhagic cerebral stroke

The following factors are considered to be 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.

Symptoms of hemorrhagic stroke

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, 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 The success rate of surgery is 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 hemorrhage 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.

Recovery after hemorrhagic stroke

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 kinesitherapy, therapeutic exercises, basic self-care restoration, speech therapy, the use of reflex-stress systems, balneotherapy, etc. In this case, the terms of rehabilitation depend on the objective the patient’s condition, 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 and 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.
Ischemic stroke left-hand side Ischemic stroke right side

Hemorrhagic stroke on the left side of the brain is an acute disease. It affects 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 likelihood of death increases with age.

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

The main cause of the disease is hypertension. It causes sclerotic disorders in 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, and inflammation in the blood vessels of the brain. The cause may also be the reaction of the vascular system to 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 a hemorrhagic stroke is accompanied by characteristic signs - 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 noticed before it occurs. If you use medication during this period, you can avoid its onset.

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

A stroke on the left side of the brain can be diagnosed 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;
• try to smile - the right corner of the mouth will be slanted down due to paralysis;
• show your tongue and move it - the tip of the tongue will fall to the right, and the tongue itself will have an asymmetrical “humpbacked” appearance;
• pronounce your last name, first name and patronymic - the speech will be slurred and incoherent.

In patients under 45 years of age, the disease can result from a hematoma, which occurs when hemorrhage occurs in the space between the arachnoid and pia mater of the brain. In this case, the symptoms of the disease coincide with a cerebral aneurysm and disturbances in the development of the circulatory system. To exclude them, instrumental diagnostic methods are used - cerebral angiography, computed tomography, echo encephalography.

Consequences

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

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

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

How long do you live after a stroke?

After a severe stroke, up to 35 percent of patients die in the first month and about 50 percent die within 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 semi-lying 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 victim’s head to the side to prevent death from vomit entering the respiratory system;

Ensure good ventilation of the room - to prevent a 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 tissue. In most cases, the hematoma is punctured through a small burr hole—about 70 percent of operations. Open brain surgery is performed when hematomas are located superficially or in case of extensive hemorrhages in deep areas of the brain, accompanied by a severe condition of the patient - up to 30 percent of the number of surgical interventions. Also, during surgical treatment for impaired respiratory reflex, oxygen inhalation and artificial ventilation are used.

Treatment in the acute phase and after it

Aimed at stabilizing the condition and eliminating complications. The general treatment plan includes:

1. Reducing blood clotting in the first hours after a stroke significantly reduces the likelihood of paralysis. Actovegin has been successfully used for these purposes.
2. Reduced blood pressure. Blood pressure should not exceed 150/90 mm. Hg Art. For this purpose, non-extended-release drugs are used - clonidil, magnesium sulfate, captopril. If the pressure drops, 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, strophanin.
4. Reducing general swelling and eliminating cerebral edema. For this purpose, diuretics are used - mannitol, furosemide, hormonal antihistamines - for example dexamethasone.
5. Prevention and elimination of pulmonary edema and infectious pulmonary diseases. They inject antibiotics, place cups, suction mucus from the lungs, and turn the patient 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 to the patient every day.
8. Prevention of cerebral hypoxia with the help of antispasmodics - no-shpa, stugeron, papaverine hydrochloride.
9. Carbohydrate nutrition. If the swallowing reflex is impaired, use special intravenous solutions or feeding using a nasogastric tube.
10. Stabilization of blood glucose levels in the range from 2.8 to 10 mmol/l. Insulin is used to reduce it, and a 10% glucose solution is used to increase it.
11. Relieving pain with injections of analgesics - analgin, tramal, baralgin.

Regenerative treatment

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

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

Except drug treatment patients are prescribed classes with a speech therapist and psychologist, physiotherapy, special massage and physical therapy. Patients learn to lie, sit, stand and walk again with the help of special simulators. Often the recovery process lasts several months.

Complexes of physical therapy exercises are developed individually. The basic principles of exercise therapy are a gradual increase in load and alternation of passive exercises with active ones.

A hemorrhagic stroke on the left side of the brain has clear diagnostic signs - paralysis of the limbs and muscles of the right side of the body, speech impairment. It occurs mainly acutely, affects 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 and eliminating the consequences of its action on brain tissue. How quickly the recovery occurs and how long the patient lives depends on the implementation of rehabilitation therapy after discharge.

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 recurrent ischemic stroke may be accompanied by the following: characteristic symptoms, such as:

• pallor of the skin of the face;
• 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 the following signs:

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

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

If there are characteristic signs, you should first 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 need to apply something cold to the frontal part 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 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 of time.
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.

Among the common causes of human death are hemorrhagic stroke. This serious brain damage can put the patient into a coma or lead to death within 3 hours.

People who have suffered a stroke subsequently practically do not restore their usual and everyday functions. In most cases, the patient remains in a vegetative state or dies after a prolonged stay in a coma.

Hemorrhagic stroke - what is it?

Brain stroke is divided into two types: ischemic And hemorrhagic.

Stages of recovery after hemorrhagic stroke, video:

Prognosis after hemorrhagic stroke

There is no need to talk about exact prognosis after a hemorrhagic stroke. Even the most experienced specialists do not resort to this, since statistics as such practically do not exist.

• If a person has retained all basic reflexes and functions after a stroke, it means that he has a much greater chance of recovery. Although everything can turn out to be an extremely opposite situation, but only with improper treatment and repeated hemorrhage.
• When a person is unconscious and his muscles are contracting, he also has a chance of recovery.
• The chances of recovery and survival rates are significantly reduced if a person falls into a coma after a hemorrhage. There are many cases where the patient dies without regaining consciousness. This is preceded by the circumstances of the incident, including timely medical assistance. We should not forget about the qualifications of the specialists who provided first aid to the victim.

Be that as it may, the life expectancy of a person who has suffered a cerebral stroke is significantly reduced. On average, a patient lives no more than 10 years after brain damage.

A hemorrhagic stroke is much more dangerous than an ischemic stroke, but its consequences can be the most unexpected: complete recovery with only partial loss of motor functions, or the death of a person.

Everyone should listen to the advice of specialists and undergo regular comprehensive examinations to prevent the occurrence of the causes of the presented phenomenon.

A stroke is a sudden and serious interruption of blood flow to the brain with hemorrhage, which is characterized by loss of consciousness and paralysis.

If there is hemorrhage in the right hemisphere, then the left side of the body is paralyzed; if the left hemisphere is affected, the right side is paralyzed. For this reason, hemorrhagic strokes in different hemispheres have certain differences and characteristics.

Stroke is divided into two types: ischemic - during its development there is blockage and compression of blood vessels, and hemorrhagic, which is characterized by destruction of the vessel, which ultimately causes hemorrhage in the brain.

What is a hemorrhagic stroke on the left side?

With the development of a hemorrhagic stroke, there is a high risk of death, especially during the first 48 hours, since there is swelling of the brain or its compression by the hematoma that forms during the lesion.

The manifestation of symptoms directly depends on the location of the lesion - right or left hemisphere. Diagnosis of hemorrhagic stroke of the right hemisphere occurs against the background proper operation muscle tissue of the heart and vascular conductivity, studies are carried out by a doctor.

If there are visible speech impairments, this is obvious signs lesions on the left side of the brain. Since the symptoms are early and pronounced, diagnosis is carried out much faster.

In addition, people susceptible to left-sided stroke seek medical help earlier, and therefore receive the necessary and timely treatment. It is important to know that it is advisable for a person to receive first aid within the first three hours, then it will be more effective.

Causes

When a hemorrhagic stroke occurs, the speed of blood flow in the skull sharply decreases, as a result of which some gray matter cells begin to die.

Many doctors and scientists compare the process of this stroke to an explosion in the cranial cavity. The volume of blood entering from the vessels (hemorrhage) reaches from 20 to 500 ml.

Most common reasons such a phenomenon is considered:

1. Unbearable physical and psychological This includes heavy physical and mental work, frequent stressful situations, climbs to heights, and frequent plane flights.
2. Genetic cause (hereditary) - can develop in the right or left hemisphere of the brain.

The occurrence of a hemorrhagic attack is characterized by impaired speech function, clouded consciousness, the person is not aware of reality, an amnesic state.

Often, upon recovery, memory returns, and a person receives memories of how he felt just before the attack: blurred vision, dizziness, movement of surrounding objects.

Symptoms

When several small hemorrhages occur, when vital areas of the brain are not affected, the symptoms are often unclear. However, then such hemorrhages tend to merge into one, resulting in a large affected area, which is characterized by severe headache, dizziness and nausea.

Such symptoms greatly complicate diagnosis. The patient is in no hurry to see a doctor, trying to independently remove such signs, using painkillers, prokinetics, antagonists and other medications to relieve symptoms. Such a heart attack is considered mild because the responsible areas of the brain are not damaged.

When large vessels rupture, significant damage to the left hemisphere is observed, the situation is worsened by the closedness of the cranium. This is expressed by the following symptoms:

• A loss consciousness.
• Strong, growing pain heads.
• Nausea and vomiting.
• Feeling pulsating in my head.
• Violation breathing.
• Pain in the eyes when light and during their movement.
• "Flies" and circles before the eyes.
• Rare pulse.
• Pale face, because the blood flow is worse.

A number of symptoms have also been identified that can become irreversible and lead to disability of the patient:

• Violated speech function: the patient speaks poorly, sometimes only nouns (easier form), sometimes only sounds, poorly understands speech.
• Right part of the face changes: the eyebrow, corner of the lips and eyes droop, the facial muscles are paralyzed and it seems that the right side of the face is sagging.
• In case of defeat left On the other hand, it seems to others that the patient has strabismus, his gaze is directed to the left. The pupil of the left eye is dilated and may not respond to bright flashes of light.
• Sight does not fixate on a specific object, the pupils rotate.

In addition, the patient may often break out into a sweat; with strong flushes of blood, he cannot bend his head to touch his chin. When lying down, the legs are bent because they do not extend at the knee. Symptoms increase quickly.

Sometimes stupor or coma may occur. The patient may behave inappropriately: irritability, constant movement, aggression (can become dangerous not only for others, but also for himself).

An attack similar to epilepsy is often observed: a person falls, throws his head back, foam comes out of the mouth, and the body is seized with severe convulsions. In this case, one must not allow one to bite one’s tongue and do everything possible to prevent the person from suffocating or choking on his own blood and vomit.

If such symptoms appear, you should immediately consult a doctor, since the patient may die or remain disabled for life.

Diagnostics

Knowing the symptoms that occur during a stroke, making a correct diagnosis, as a rule, is not difficult and is done immediately after the attack, but recognizing the type, location and volume of hemorrhage is quite labor-intensive work, but this is necessary for prescribing the correct treatment.

For the most accurate diagnosis, the following methods are prescribed:

• Inspection neurologist. Anamnesis is collected according to external signs, neurological abnormalities are determined.
• Laboratory tests: general and biochemical examination of blood and urine.
• Coagulogram– is carried out to determine the level of platelets in the blood, to establish the coagulation index and the body’s protective function against bleeding.
• Definition of functioning cardiovascular systems: total blood pressure, ultrasound of the heart, electrocardiogram, electroencephalography - a study of the electrical activity of the brain.
• Computer and magnetic resonance brain tomography - to determine the type, location of the lesion, the volume of hemorrhage.

Often, as an additional diagnostic method, angiography is prescribed - a study of brain vessels with the introduction of contrast agents.

Treatment

The effectiveness of the treatment received and the elimination of residual complications will directly depend on how quickly and correctly first medical aid was provided. It is highly advisable to transport the patient to the hospital within the first three hours.

Before the medical team arrives, you must:

• Place the patient on horizontal surface and raise the head, turn it to the side so that the person does not choke on vomit and blood.
• Provide good influx air.

The main method of treatment is surgery, since it is necessary to remove the accumulation of blood and thereby relieve pressure on the brain. It is carried out for large hematomas, most often a puncture is used, a small hole is made through which the hematoma is removed. This operation accounts for 70% of all cases.

Open brain surgery is prescribed in extremely severe cases. Very effective for superficial hematoma and extensive strokes in the deeper layer of the cerebral hemisphere. This operation is performed in 30% of all cases. If necessary, after surgery, a ventilator and oxygen inhalation are connected.

• Medicines that normalize blood pressure.
• Antibiotics– if the provocateur was the injury received.
• Neuroprotectors– to restore the function of neurons, improve metabolism in the brain (Cytomac, Cytochrome, Cerobrosilin and others).
• Antioxidants(Solcoserine, Actovegin vitamin E and others).
• Supporters cardiovascular drugs.
• Drugs that normalize current blood(Trenthal, Sermion).

After a left-sided hemorrhagic stroke, the recovery period is very important, during which it is necessary to eliminate as much as possible possible complications. For this purpose massage is prescribed, physiotherapy, diet - especially if the patient is overweight. During such a period, the support of loved ones and a positive attitude toward recovery are very important.

Next, the patient recovers at home, where it is necessary to take medications to improve the conduction of nerve impulses in the brain. The medications and course of treatment are prescribed by the doctor. Under no circumstances should such therapy be neglected or completed prematurely.

During rehabilitation, the patient learns to walk and talk again, and this should begin on the third day after he regained consciousness. To restore movement, you need to massage and do special exercises - this also helps to increase blood flow and prevent the formation of bedsores and muscle atrophy, which can lead to paralysis.

To normalize memory, children's cards are used; they depict letters, numbers and things that a person often encounters in everyday life.

Recently, a special device is often used that re-teaches the patient how to distribute his weight from one leg to the other (control of the center of gravity). While on the platform, you need to hit the cursor on a certain point (target) on the monitor.

Relatives and friends should support the patient’s positive attitude and communication, while excluding increased guardianship. Without receiving proper communication, a person often withdraws into himself and becomes isolated. Frequent depression indicates a stroke in the temporal lobe.

Consequences and complications

With a hemorrhagic stroke on the left side, hemorrhage is correspondingly observed in the left hemisphere of the brain, and this type of stroke is more common on the right side (in approximately 60% of all cases).

Accordingly, the right side of the body is paralyzed, and the paralysis affects not only the limbs, but all parts, including even the right side of the tongue and larynx, so many patients pay attention to unnatural sensations when swallowing.

In addition, when walking a person trails behind him right leg, and the hand is bent at the elbow with the palm extended forward, the fingers are closed in the form of a “boat”, from the outside it seems that he is asking for alms.

In many medical schools, for better memorization by students, they use the so-called rule: “the leg squints, the hand asks.” When walking, a person deviates to the side, although he is sure that he is moving in a straight line.

Serious consequences also include violations of speech function, when a person cannot logically express his thoughts (build cause-and-effect sentences), forgets important dates for himself, speech itself becomes slurred (sometimes you can recognize fragments of words or individual sounds); writing disorder - handwriting changes, a person forgets how to write numbers and letters correctly.

Thanks to all of the above, the patient often begins to develop complexes, so he tries to avoid society, withdraws into himself, and limits his circle of contacts.

Forecast

It is difficult to say unambiguously about the patient’s prognosis and possibility of recovery, since it depends on the following factors:

• Degree manifestations of neurological symptoms.
• Violation Strength mental consciousness and the occurrence of pelvic disorders.
• How much pressure below normal.
• Violations that occurred muscles and joints.
• Serious related diseases.
• The degree of increased muscle tone, which hinders movement, gait and speech.

The presence and severity of the above deviations significantly worsen the prognosis for further quality of life and full recovery for the patient.

According to statistics, the recovery period with a left-sided hemorrhagic stroke lasts less, while at the same time, cell death is slower than with a right-sided hemorrhage. The reasons for this have not yet been fully elucidated.

After suffering a severe stroke, about 30% of patients die within the first 30 days, approximately 50% within a year. Most often, people of advanced age and with concomitant heart disease die.

After a hemorrhagic stroke of the left side, 70% become disabled; the patient’s life expectancy also depends on the above factors and further lifestyle. To increase it, you need to constantly monitor your blood pressure and minimize stress. The same measures are used to prevent strokes.