Cerebrovascular accident - causes and signs of cerebrovascular accident

Clinical forms of CVA:

Acute cerebrovascular accidents (CVA).

1. Transient (temporary) cerebrovascular accidents:

• Transient ischemic attacks (TIA).
• Cerebral crises.

Acute hypertensive encephalopathy. Intrathecal hemorrhages:

• subarachnoid hemorrhage;
• epidural hemorrhage;
• subdural hemorrhage.

Hemorrhages into the substance of the brain:

• parenchymatous lesion;
• parenchymatous-subarachnoid lesion;
• ventricular.

Cerebral infarction of cardiogenic or other origin.

The beginning manifestations of cerebral circulatory failure in the vessels of the brain - cerebrovascular insufficiency (CVI).

By the localization of the lesion, due to CVI:

• the lesion is in the cerebral hemispheres;
• the lesion is in the brain stem;
• the lesion is in the ventricles of the brain;
• a combination of multiple foci.

Causes

The main factors influencing the development of CVI:

• Arterial hypertension (loss of control over blood pressure).
• Cardiac and vascular lesions (ischemic heart disease, various cardiac arrhythmias, atherosclerotic lesions vessels).

Minor factors influencing the development of CMC:

• Abuse of alcoholic beverages, nicotine intoxication from smoking tobacco.
• Excessive body weight.
• A sedentary lifestyle (hypodynamia).
• Gender, age characteristics, hereditary factor.
• Change in blood fluidity with increased platelet adhesion; change in hematocrit level; increased fibrinogen levels in blood plasma.
• Metabolic diseases, diabetes mellitus.
• Acute or chronic infections.

Symptoms

There are many types of cerebrovascular accidents, but let's look at the most common cerebral vascular lesions.

As a result of a sharp jump in blood pressure (vascular rupture) or blockage of a vessel by a thrombus coming from the affected vessels of the lower extremities, from the heart cavities, acute circulatory disorder in the cerebral vessels occurs. Such a circulatory disorder will be called a hemorrhagic or ischemic stroke, depending on the mechanism of development of the cerebral vascular lesion.

Manifestations of a hemorrhagic stroke occur acutely, most often during the day and begin with a headache, nausea or repeated vomiting. Loss of consciousness or manifestation of other types of impaired consciousness in the form of stupor, and in severe cases up to a comatose state is possible. The patient becomes covered in sweat, the skin is moist, sticky. The skin of the face turns red, and the mucous membranes become cyanotic. An increase in body temperature and an increase in blood pressure are possible. Breathing is heavy, shallow.

Immediately after the general cerebral symptoms, focal manifestations of a hemorrhagic stroke appear. On the side of the lesion, mydriasis (pupil dilation) appears, which does not react to a light stimulus, the eyeballs diverge outward or look at the lesion, the nasolabial fold on the face is smoothed out, the corner of the mouth drops, the limbs on the opposite side are immobilized and pathological reflexes are detected. Depending on the area of the brain lesion (hemispheres, midbrain, pons), the symptoms of a stroke will vary from the disruption of the anatomical structures, pathways and nuclei located in this area.

Ischemic stroke is caused by a thrombus or embolus that has blocked the lumen of a cerebral vessel. Depending on the affected vessel in a particular basin, clinical manifestations will depend on the functions performed by these areas.

CVD occurs when control over blood pressure is lost, after stress or heavy physical exertion.

Diagnostics

Diagnostics of impaired blood circulation in the brain is carried out by a neurologist, assessing the clinical picture of the stroke. Then the doctor prescribes additional research methods to clarify the location, type and size of the lesion.

• Echoencephaloscopy - shows the displacement of midline structures with a large hemorrhage.
• CT (computer tomography) of the brain, MRI (magnetic resonance imaging) of the brain - a more sensitive diagnostic method for identifying details and characteristics of the stroke.
• Transcranial Doppler sonography - a non-invasive diagnostic method for visualizing ischemic stroke.
• Cerebral angiography.

A CT or MRI study is performed and a description is given by a functional diagnostics doctor. For more detailed information on the diagnosis and treatment of impaired cerebral circulation, you need to make an appointment with a neurologist.

Treatment

In case of hemorrhagic stroke, it is necessary to put the patient to bed with the head slightly elevated. Apply cooling objects (ice pack) to the head, and heating pads to the feet. Prescribe drugs that increase blood clotting in combination with heparin, as well as ascorbic acid.

At the first signs of ischemic stroke, in the first hours it is necessary to immediately administer fibrinolytics, anticoagulants and nootropic drugs.

Treatment tactics for hemorrhagic stroke will differ significantly in hemorrhagic and ischemic stroke, due to the different mechanism of its formation. In one case, it is a ruptured vessel and hemorrhage, in another - a blockage of the vessel and ischemia of the brain tissue.

Prevention

• Regularly measure blood pressure and take antihypertensive drugs on a regular basis.
• Avoid psycho-emotional and excessive physical overload.
• Healthy, deep and long sleep.
• Timely treatment of coronary heart disease, arrhythmia, atherosclerosis, diabetes.
• Do not abuse alcohol, tobacco.
• Weight control, diet.