Symptoms and consequences of a recurrent stroke, what to do for prevention

Hemorrhagic stroke is the most dangerous vascular disease. The consequences of this type of stroke are always serious, and the prognosis is often unfavorable.

Hemorrhagic stroke and its periods

A hemorrhagic stroke is a sudden bleeding into the cranial cavity. Hemorrhagic strokes account for about 10% of acute cerebrovascular accidents, the rest 90% are ischemic strokes. This disease is more common in people 45-70 years old, but can develop even in a child and often ends in death. How many people live after a hemorrhage and the prognosis are determined by the size of the affected area and the speed and quality of the treatment started.

Hemorrhage during a stroke can be both small-focal and extensive, depending on the caliber of the affected vessel. After a rupture of the vessel, a hematoma occurs or hemorrhagic impregnation of the brain tissue occurs. Pathology proceeds according to the following periods:

the most acute - the first day after the development of the disease;
acute - 2 days - 21 days;
subacute - from the beginning of the 4th week to 3 months;
early recovery - 3 months - six months;
late recovery - up to a year after a stroke;
the period of long-term consequences - more than a year from a completed stroke.

Causes and pathogenesis of the disease

In young people, the most common causes of stroke are ruptured or damaged vascular malformations- congenital anomalies in the structure of arteries and veins in the brain. With prolonged existence in aneurysms, dural fistulas and various types of vascular deformities, the tone of the walls decreases, they become thinner and can burst under the pressure of blood.

Another common cause of pathology is a chronic increase in blood pressure with hypertension, diseases of the kidneys, heart, and standing pheochromocytomas. Rarer causes of cerebral hemorrhage are::

deposition of amyloid protein inside the walls of blood vessels;
atherosclerotic lesion of the artery;
inflammation of the wall of the cerebral vessel;
thrombophilia and erythremia;
overdose of blood-thinning drugs.

Pathogenesis can develop in two directions. The altered vessel spontaneously ruptures with massive hemorrhage, or gradually becomes permeable with leakage of blood plasma into the brain tissue.

In the presence of predisposing diseases, stress, alcohol intake, overheating, hard physical work, smoking a large number of cigarettes can provoke a hemorrhagic stroke.

Clinical manifestations of a stroke

Harbingers can tell that a person will soon develop a stroke, but such signs do not always occur. These include impaired coordination of movements, slurred speech, pain in the eyes, numbness of the extremities, headache on the right and left sides. At 50% of patients with hemorrhagic stroke appears suddenly, without foreshadowing symptoms, in a number of patients the same signs turn into a transient ischemic attack, an ischemic stroke.

The pathology clinic is based on spontaneous hemorrhage and, as a rule, includes a feeling of a strong blow to the head or a sudden onset of severe pain. After such a blow, many lose consciousness, a number of patients fall into a coma or die (usually with a massive stroke). Those who are conscious experience the following symptoms of the disease:

throbbing headache;
nausea;
vomit;
strong heartbeat;
redness of the face;
increased sweating;
convulsions;
increasing drowsiness;
inability to answer a simple question;
speech disorder;
decreased tone of the limbs;
strabismus;
paralysis and paresis;
swallowing disorder.

Most symptoms on the left side of the body mean the development of a right-sided stroke, and vice versa.

Diagnosis of pathology

The main methods by which the diagnosis of stroke is made are CT, MRI of the brain, as well as radiography. They allow you to determine the location and type of hemorrhage, its size. Also, the patient can be urgently performed angiography, spinal puncture.

A differential diagnosis is made with various diseases accompanied by a similar clinic, according to the following signs:

Pathology	Differences from hemorrhagic stroke
Ischemic stroke	Gradual increase in symptoms, absence of meningeal signs, no blood in the cerebrospinal fluid during lumbar puncture.
Hemorrhage into a brain tumor	Less vivid manifestations, extremely rare development of coma, a person is more often conscious.
brain abscess	An increase in body temperature, often the disease is preceded by epileptiform seizures.
Epilepsy	The presence of seizures in history, the appearance of foam from the mouth, biting the tongue.
Traumatic brain injury	A history of trauma.
uremic coma	Slow increase in symptoms - weakness, insomnia, dyspepsia, edema, pain in the kidney area.
diabetic coma	The presence of diabetes mellitus, the development of a precoma with thirst, abdominal pain, vomiting, the smell of acetone in the mouth.

Complications of a right-sided stroke

If a hemorrhagic stroke occurs on the right side, the consequences, how long they live, are the first questions that interest the patient's relatives. With the right-sided type of pathology, the following signs are noted:

difficulty abducting the left eye;
sagging left cheek;
decreased pain sensitivity on the left;
dilation of the left pupil, etc.

Often, paralysis occurs immediately after the development of the pathology, while the impossibility of movement and flexion of the left leg is more often observed. The most common complications of damage to the right side in left-handed people are speech deviations, which are usually absent in right-handed people. Some of the most severe complications are cerebral edema and coma, which can last up to several weeks.

Other possible complications of right-sided hemorrhagic stroke are:

paralysis of the left side of the face, glossopharyngeal, ophthalmic nerve;
feeling of alienation of the body;
serious disorders of memory, hearing, perception of the world, orientation in space;
deterioration of brain activity, behavior;
depression, passivity;
psychical deviations.

Complications of a left-sided stroke

When did a hemorrhagic stroke develop on the left side, how long do they live, what are the consequences? The left hemisphere is usually affected more often ( 65% of cases). Since this part of the brain is responsible for speech and logical thinking, these functions suffer the most. Speech disorders include slurring, slurring of pronunciation, incomprehension of someone else's speech, explanation in fragments of phrases. Also, a person cannot think normally, read, his articulation is disturbed.

Paralysis of the right side of the face, right leg and arm is no less common. Characterized by synkinesis- when lifting a healthy arm, the patient involuntarily rises. Failures of acts of defecation, urination are registered.

Often, with this type of hemorrhage, epilepsy subsequently develops, regular severe headaches appear.

Post-stroke treatment and prognosis

First aid to a person should be early - only timely treatment and full recovery will help to recover. First aid includes ensuring the supine position, complete rest and an urgent call for an ambulance. It is strictly forbidden to reduce pressure sharply! The setting of antihypertensive drugs is started only by a doctor, more often in an ambulance, using a special algorithm.

With an intracerebral hematoma, surgical intervention is indicated with the evacuation of blood and stopping bleeding. If the operation is impossible, drug therapy is carried out. The following types of medicines are used:

diuretics, calcium channel blockers - to reduce pressure;
neuroprotectors - to protect brain cells;
antibiotics - to prevent infectious complications;
electrolyte solutions - to normalize the water-alkaline balance;
hemostatic agents or drugs for the prevention of thromboembolism (if indicated).

Rehabilitation includes a strict regimen of the day and sleep, proper nutrition (in case of swallowing disorders - through a tube). For recovery, you will need breathing exercises, classes with a speech therapist, a psychologist, massage, exercise therapy (including passive gymnastics), physiotherapy, hydrotherapy, treatment in sanatoriums.

The prognosis for a stroke will depend on the quality of the treatment and the size of the hemorrhage. Mortality reaches 40%, of the survivors, approximately 25% die from a second stroke within a year. 30% of those who survived after the disease become deeply disabled, the maximum survival threshold is considered to be 10-15 years, but with timely surgery and proper rehabilitation, it is possible to live a longer full life.

Given the annual increase in cases of stroke at a younger age, the problem is relevant. Doctors did not come to an unambiguous decision 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 at the same time (vascular surgeons, neurosurgeons, cardiologists, neuropathologists).

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

What is a stroke, types

A stroke is a sudden or acute disruption of the blood supply to the brain. The state cannot be called a complete cessation, because with some types of blood supply in a small amount, but remains.

The classification is based on the mechanism of problem formation:

Without the release of blood from the bloodstream into the tissue and cavity of the brain;
Rupture of the vessel wall and hemorrhage in the intrathecal region or in the brain tissue.

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

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

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

Transient disorders of cerebral circulation:
- transient ischemic attacks;
- cerebral hypertensive crises.
Acute hypertensive encephalopathy.
Shell hemorrhage:
- subarachnoid (subarachnoid);
- epi- and subdural
Hemorrhage in the brain:
- parenchymal;
- parenchymal-subarachnoid;
- parenchymal-ventricular;
Cerebral infarction (non-embolic):
- due to the pathology of the main arteries of the head;
- in case of pathology of intracerebral vessels;
- another genesis.
Embolic cerebral infarction:
- cardiogenic;
- another genesis.

According to the localization of the lesion:

Hemispheres of the brain.
The brain stem.
The ventricles of the brain.
Subarachnoid.
Multiple focus (several zones).

Causes of a stroke

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

The probable ones include:

Smoking and alcohol abuse;
Improper nutrition;
stress;
Obesity;
Sedentary work;
oral contraceptives;
metabolic disorder;
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 (2 and 3 degrees);
Cardiac ischemia;
Violations of the rhythm and conduction of the CCC (blockade and arrhythmias);
Elevated blood cholesterol;
Vasculitis (inflammation of the walls of blood vessels);
Aneurysms and anomalies of cerebral vessels;
Blood diseases;
Varicose veins;
Rheumatism.

Signs of a stroke

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

In the broad sense of the word, a stroke is a sharp violation of blood circulation in a certain part of the brain. The consequences of a hemorrhagic stroke of the left or right side lead to irreversible impairment of brain function. It is difficult to predict how long a person will live after, it depends on many factors. But in 70% of cases they cause death.

According to the ICD-10, stroke has the code I60 (subarachnoid hemorrhage) or I61 (intracerebral hemorrhage) and belongs to the category of cerebrovascular diseases - affecting the blood vessels.

It is customary to distinguish between two types of stroke: and hemorrhagic.

A hemorrhagic stroke is an outpouring of blood from a vessel into the medulla, ventricles, or under the lining of the brain with the formation of a hematoma. This is an acute condition that develops very quickly - literally in minutes. The immediate cause is a rupture of the blood vessel wall.

Due to the high rate of development of the process and injury to the brain tissue by a foreign body, which, in essence, is a hematoma, hemorrhagic stroke is much more severe than ischemic stroke. It has a higher probability of death, and its consequences are much more difficult to correct.

The manifestations of a stroke are directly related to which of the cerebral hemispheres the hemorrhage occurred:

with damage to the right hemisphere - violations in the left half of the body up to paralysis, memory and the ability to abstract thinking deteriorate, the perception of the body is disturbed (for example, there may be a feeling of multiple limbs - "extra" fingers, arms, legs, or alienation of one's own parts of the body);
with damage to the left hemisphere, the functions of the right half of the body are disturbed, paralysis and paresis are frequent; speech worsens, reading and writing skills are lost.

Classification

Hemorrhagic strokes are of two types:

when a hematoma (compact effusion of blood) is formed;
when the blood is evenly distributed over a large area of brain tissue (hemorrhagic impregnation). The consequences of a stroke of this type are much easier than the first.

Depending on the localization, there are:

parenchymal hemorrhages - in which blood enters the medulla. This is the most severe type of stroke, leading to irreversible brain damage;
subarachnoid - blood flows into the so-called subarachnoid membrane of the brain;
arachnoid - blood is also poured into the subarachnoid membrane when the previously existing cystic formations are ruptured. This type of stroke is extremely rare;
verticular - blood enters the ventricles of the brain;
mixed - in a situation where there are several foci of stroke.

Hematomas

Hematomas formed as a result of hemorrhage are also classified depending on the affected area:

subdural hematoma - occurs as a result of damage to the veins and is located between the hard and arachnoid membranes of the brain;
epidural - occurs when an artery located between the skull and the dura mater is damaged, it is localized there;
intracerebral - located in the very substance of the brain.

According to localization, the following types of hematomas are distinguished:

lobar - located in one of the lobes of the brain, does not affect the cortex;
medial - affects the thalamus;
lateral - affects the subcortical nuclei in the white matter of the brain.

stages

There are several stages in the development of hemorrhagic stroke.

Stage name	Characteristic features	Duration
sharpest	Acute headache, confusion (up to coma), impaired perception and speech	First 24 hours after hemorrhage
Acute	For a short time, brain function can recover, but then there is a sharp deterioration. Violation of cognitive functions, memory impairment, clouding of consciousness (if it did not occur at the first stage)	24 hours to 3 weeks
subacute	Severe, non-progressive impairment of brain functions	3 weeks to 3 months
early recovery	The work of the cerebral vessels is restored, and brain functions are also partially restored	3 to 6 months
late recovery	The work of all areas of the brain is normalized, except for the affected	6 months to a year

Causes

A cerebral hemorrhage can be caused by various reasons - from a sharp increase in pressure to a head injury, so no one is immune from it. However, the main risk group is people aged 50 to 60 years.

Important! Another risk group is newborns and children under one year old. Contrary to popular belief, even a baby can have a stroke.

If a child has congenital problems with the cardiovascular system or blood diseases (leukemia, anemia, hemophilia, etc.), they can cause cerebral hemorrhage. However, in the process of growth, the risk of stroke gradually decreases.

There are two primary causes leading to a violation of the integrity of the walls of blood vessels:

- high pressure on the vascular walls leads to the formation of microcracks through which blood seeps into the brain or causes a simultaneous severe hemorrhage during a hypertensive crisis;
deformation of blood vessels - the wrong structure of blood vessels, the presence of expansions (aneurysms) and narrowings (stenoses). The presence of a defect of this kind creates strong stress in different parts of the vessel, which can lead to rupture of its wall.

There are certain diseases that can lead to these conditions:

atherosclerosis, often causing aneurysms;
amplodic angiopathy - a condition similar to atherosclerosis, in which protein deposits appear on the walls of blood vessels;
inflammation of various parts of the brain (encephalopathy);
brain tumors;
diabetes mellitus, in which thinning of the walls of blood vessels occurs.

These diseases can be triggered by factors such as:

traumatic brain injury;
spinal injury;
combining alcohol with anticoagulants - alcohol dilates blood vessels, anticoagulants thin the blood; The combination of these effects causes a strong load on the vessels;
smoking;
stress;
hard physical work.

Symptoms

Hemorrhagic stroke is characterized by an acute sudden onset, accompanied by severe headaches. Sometimes pain can begin hours or even days before the stroke itself.

This condition is characterized by the following general cerebral symptoms:

headache;
dizziness;
nausea, vomiting;
depression of consciousness up to coma.

Depending on which area of the brain is affected, focal symptoms can be observed, such as:

with the defeat of one of the hemispheres - paresis or paralysis of the opposite side of the body;
with medial hematoma - epileptimorphic seizures;
with damage to the cerebellum - impaired coordination of movements;
with damage to the areas responsible for vision and hearing - violations of the corresponding functions;
with damage to the right hemisphere - memory impairment;
with damage to the left hemisphere - violations of speech functions up to a complete loss of speech.

First aid

With a cerebral hemorrhage, it is extremely important to quickly provide first aid and send the victim to the hospital. The chances of recovery are highest in those patients whose treatment was started in the first 3 hours after the attack.

If a person is conscious, a simple test can detect a stroke.

Ask the person to smile. With a stroke, one corner of the mouth will remain down.
Ask the person to say their name. If the brain is damaged, his speech will be difficult and unintelligible, or he will not be able to understand the request.
Ask to raise both hands. With a stroke, one arm will drop down faster than the other, or remain motionless.

If you find any of the described abnormalities, call your doctor immediately.

Before the ambulance arrives, do the following:

lay the victim horizontally, with his head slightly raised;
free his neck from clothing and any accessories that may interfere with breathing;
remove dentures from the victim's mouth;
if the victim is unconscious, turn his head to the side to ensure an unimpeded outflow of saliva.

Do not try to bring the patient to consciousness on your own - there is a great risk of worsening his condition.

Coma with stroke

Hemorrhage in the brain is often accompanied by a state of coma - depression of brain activity, the severity of which depends on the size and location of the hematoma.

There are four degrees of severity of coma.

Degree	Symptoms
First	Stupefaction, inhibition of reactions, muscle tone increases, skin reflexes decrease. Often there is strabismus, disturbances in the movement of the eyes, but the reaction of the pupils to light remains normal. Swallowing reflexes are preserved, which allows the patient to eat independently. Pain reflexes are also preserved
Second	Sopor, depression of consciousness, uncoordinated chaotic movements, a sharp decrease in pain reflexes. The reaction of pupils to light is weakened. Skin reflexes are absent. Pathological types of breathing are often observed (rhythm and depth disturbances, such as Cheyne-Stokes breathing).
Third	Consciousness is completely absent, skin reflexes disappear. Blood pressure and body temperature are reduced, breathing is weakened.
Fourth	Reflexes and muscle tone are completely absent, body temperature is greatly reduced, blood pressure drops to a critical level. The fourth degree of coma often ends in death.

The heavier the coma, and the longer a person stays in this state, the less likely it is to get out of it. The minimum duration of a coma is an hour, the maximum can be more than a dozen years.

Diagnostics

Timely accurate diagnosis plays a crucial role in the treatment of stroke. For its implementation, the following methods are used:

Computed tomography is an X-ray examination of the brain. Helps to determine the location and size of the hematoma;
magnetic resonance imaging - a study of the brain using a magnetic field. Allows you to visualize the structures of the brain and get a more accurate and detailed picture than with an X-ray examination. This method, together with the previous one, is used for the differential diagnosis of hemorrhagic stroke with ischemic;
transcranial dopplerography - a study of brain vessels located under the skull. Helps to determine the presence of deformations and ruptures;
magnetic resonance angiography - visualization using a magnetic field of cerebral vessels;
electroencephalogram - a study of brain activity.

Also, for additional information, a coagulogram can be prescribed - a blood coagulation test and a biochemical blood test for glucose and lipid levels.

Treatment

With hemorrhagic stroke, medical and surgical treatment is possible. The principle of therapy depends on the location and volume of the hemorrhage. So, surgery is indicated:

with large hematomas;
with subarachnoid hemorrhage;
cerebellar hematoma.

In other cases, medications are used.

Medical

Drug treatment is primarily aimed at stimulating hemostasis and treating vasospasm. For this, the following drugs are used:

stimulation of hemostasis - Dicinon, Aminocaproic acid, Tranexamic acid;
spasm relief - Nimodipine, Magnesium sulfate.

Surgical

The main indication for surgical intervention is an extensive hemorrhage (40 or more ml of blood) in the cerebellum. Surgical reconstruction of blood vessels is also used to avoid recurrence. Today, the following types of surgical intervention are used:

removal of a hematoma by craniotomy - this method is effective, but often leads to associated injuries and is considered obsolete;
removal of a hematoma with an endoscope;
clipping of the aneurysm - isolation of the aneurysm from the general blood flow, which prevents its rupture;
removal of an arteriovenous malformation (a site of vessel deformity) is an effective way to prevent hemorrhages, but it is used only with a small size of the malformation.

Rehabilitation

During rehabilitation after a stroke, special drugs are used that improve cerebral blood supply, and procedures that help restore brain function and restore muscle tone.

In post-stroke rehabilitation, the following medications are used:

Piracetam, Phenotropil, Noopept - to improve the blood supply to the brain;
Encephabol - to normalize metabolism in brain tissues;
Choline, Actovegin, Cytoflavin - to stimulate metabolic processes.

The following procedures apply:

Orthosis therapy is the restoration of the function of the musculoskeletal system with the help of orthoses - devices that change its structural characteristics, as a rule, immobilize any muscle group or joint. These include tires, collars, etc.;
kinesitherapy - physiotherapy exercises aimed at restoring motor functions;
mechanotherapy - performing restorative exercises with the help of special tools (devices, simulators);
physiotherapy is a method of restoring body functions with the help of physical factors such as heat, electric current, magnetic field, etc.

Diet plays an important role in rehabilitation after a stroke. Its main principles are as follows:

moderate calorie content - no more than 2500 kcal per day;
fragmentation - you need to eat often, but in small portions;
a large amount of fiber in the diet, which is found in vegetables and fruits;
the use of complex carbohydrates that can be obtained from cereals.

Forecast

It should be remembered that in most cases the prognosis is unfavorable. Mortality due to stroke is high at 70%. After an attack, only 35% survive for more than a year, and the main reason for this is the complications that develop after an attack, such as cerebral edema and heart failure. The risk of relapse is also high - especially in the first year after the attack. According to statistics, almost 30% of registered cases of hemorrhagic stroke are repeated.

The most serious consequences of a stroke are:

swelling of the brain;
paralysis of the limbs;
impaired memory and cognitive functions;
violation of sensory sensitivity;
speech disorder.

Prevention

Preventive measures to prevent stroke are aimed primarily at lowering blood pressure and strengthening blood vessels. For this, various medicines are used:

to normalize pressure - Enalapril, Liprazide, Furosemide, Metoprolol;
to strengthen the vascular walls - Askorutin, Atorvastatin;
to reduce nervous excitability - Valerian, Fitosed, Gidazepam.

Also, with high blood pressure, it is recommended to follow a diet with a minimum content of animal fats, avoid excessive physical activity (in no case abandoning such in principle), monitor cholesterol levels, in case of glucose metabolism disorders and diabetes, control blood sugar levels.

Hemorrhagic stroke is an acute violation of cerebral circulation, in which blood from bursting 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 in the first day. The prognosis depends on the age and general health of the patient, as well as on which hemisphere of the brain was damaged.

Causes of a stroke

The officially proven causes contributing to the development of the disease are considered to be the following factors: 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.

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

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

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

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

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

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

An unhealthy diet, excessive body weight, smoking and alcohol and drug abuse can increase the likelihood of developing a hemorrhagic stroke. The age of the patient, the nature of the work is of great importance.

Constant stress, prolonged exposure to direct sunlight also do their job. If you accurately determine the causes of hemorrhagic stroke, then a person can be provided with more effective assistance.

Distinctive features

With a right-sided stroke, it forms the loss of functional manifestations by the organs of the left side of the body: there may be a lack of response to external stimuli in the left arm or leg, 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 anoagosia occurs (lack of reaction to what is happening around).

The lesion of the right part of the brain has features in the elderly: against the background of atherosclerotic encephalopathy, violations of cognitive processes appear - thinking slows down, memory and attention decrease, volitional apathy, a decrease in intellectual and emotional manifestations are observed.

An elderly person needs time to feel the impending disaster and call for help. The destruction of the volitional sphere is especially dangerous, since the recovery period requires willpower efforts in exercise therapy classes.

Varieties of hemorrhagic stroke

A characteristic complication of a stroke is paralysis - complete or partial. Paralysis of the right side is observed with damage to the left hemisphere, while a noticeable loss of strength and a decrease in muscle tone are clearly expressed.

Distinctive external signs of a stroke - on the face, the right corner of the lips is lowered than usual, the hand is pressed to the body, the fist is strongly clenched, the foot is turned inward.

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

Loss of control over one's own body, hence - complete helplessness, a sense of dependence, deepening stress.
Hardening of muscle mass, aggravation of immobility of the joints;
Prolonged immobility. The result is the formation of bedsores, the formation of blood clots, the development of pneumonia. Preventive measures - you need to turn the patient over after 3-4 hours, monitor the condition of the skin, ventilate the room more often. Restriction of motor activity after a stroke with complete paralysis of only the right side has serious consequences for the patient and requires a long-term persistent recovery. Here, the help of others will be required so that rehabilitation measures are 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.

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

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

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

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

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

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

Methods for recognizing a right-sided stroke

Hemorrhage into the intracranial cavity almost always occurs unexpectedly and suddenly. Very often, the patient cannot even determine the reason for the sharp deterioration in his condition.

First signs:

nausea and vomiting (while vomiting does not bring visible relief and occurs involuntarily);
severe headaches and dizziness;
weakness in the whole body;
weak intermittent pulse, which is very difficult to feel on the arm of the victim;
pallor of the skin and numbness of the upper and lower extremities.

Very dangerous and insidious is a cerebral hemorrhage that occurs without visible signs. The patient may not feel anything, except for a slight dizziness and weak throbbing headaches. In this case, there is a high probability that medical assistance will not arrive on time and the victim will significantly aggravate his clinical picture.

Diagnosis of right-sided cerebral catastrophe does not cause any particular difficulties. In order to suspect a right-sided stroke, it is necessary to contact the affected person with a request to simultaneously raise both hands up. In addition, you can ask the victim to stick out his tongue or smile.

If such actions cause difficulty in a person, then the probability of a right-sided cerebral infarction is at least 80%.

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

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

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

Also, a sick person is unable to walk straight, complains of an intense manifestation of symptoms of pathology (especially severe headache, dizziness). Naturally, such a patient requires immediate qualified assistance from doctors.

That is, the first action is to call a team of doctors with clarification of the proposed diagnosis. Emergency care for hemorrhagic stroke includes the following actions:

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

Symptoms

Right-sided hemorrhagic stroke can be manifested by the following symptoms:

paralysis and decreased sensitivity of the left side of the face, limbs;
violations of the perception of one's own body: it may seem to a person 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: often it is difficult for patients to orient themselves in the room, assess the distance or put on clothes and shoes correctly;
depression, psychological passivity, inadequacy of behavioral responses;
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-handed people, in whom the left hemisphere of the brain is responsible for speech skills).

A stroke often develops suddenly. Among the first acute symptoms of a stroke:

sudden severe headache;
An abrupt increase in blood pressure;
Feeling of numbness all over the body;
Sudden deterioration of vision;
Partial or complete loss of sensation on the left side of the body;
Slow breathing;
Speech disorder;
Nausea, possible vomiting;
Loss of consciousness;
Convulsions.

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

Ask to smile or stick out your tongue. With a stroke, the smile will be asymmetrical, the tongue is skewed.
Talk to the victim, ask any question. If a person has a stroke, he or she will not be able to answer, or the speech will be slurred.
Ask to raise your arms, if possible - and legs. If problems with lifting one of the limbs are noticeable, this indicates a high likelihood of a stroke.
Ask for 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 found, you must immediately call an ambulance, informing the operator of a suspected stroke. The sooner the doctors arrive, the more chances to save the patient's life.

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! Signs of an impending stroke can be noticed before it occurs. If you apply medication during this period, you can avoid its onset.

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

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

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

The symptoms that appear depend on the location and size of the lesion. They are divided into cerebral, vegetative and focal. With cerebral ischemia, cerebral disorders are less pronounced than with hemorrhagic stroke, in some cases they may be absent. The most common:

sudden onset of severe headache;
dizziness;
loss of consciousness, with extensive lesions - coma of varying severity;
nausea and vomiting;
convulsions.

Any form of stroke is accompanied by the manifestation of focal symptoms, and their combination and severity are determined by the functional characteristics of the affected area. Left-sided stroke is characterized by:

paralysis of the right side of the body of varying severity;
sensory disturbances on the right side of the body;
impaired vision, hearing, smell, up to a complete loss of the ability to perceive the corresponding stimuli. In severe lesions, the disorder may involve both sides;
violation of the sense of balance and coordination of movements;
speech disorders.

Diagnostics

The main diagnostic methods for determining hemorrhagic stroke on 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, the area of edema. These indicators are the most informative in dynamics, so CT studies will need to be repeated after a while.

In addition, it is very important to conduct 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, meningeal symptoms and a slow increase in cerebral disorders can be distinguished. In addition, in ischemic stroke, the CSF taken for analysis usually has a normal composition, and in the hemorrhagic form of the disease, blood impurities are observed in it.

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

Confirmation of the diagnosis of hemorrhagic or ischemic stroke of the right hemisphere of the brain is carried out on the basis of magnetic resonance imaging of the brain.

This diagnostic technique allows to identify ischemic stroke on the right side, a reliable location of the pathological focus, its size and prevalence.

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

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

Treatment of hemorrhagic stroke is carried out in a hospital, in which there is an intensive care and neurosurgical department. The fight against pathology is primarily carried out with the help of surgical intervention, since it is necessary to eliminate the hematoma.

The patient also requires strict bed rest. He is prescribed glucocorticoids, calcium antagonists.

You will also need antiseptics and antibiotics (in the presence of a traumatic brain injury).

Undifferentiated treatment includes:

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

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

Treatment

The tactics of treating hemorrhagic stroke depends 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, surgical treatment, physiotherapy, folk remedies are used.

Medical treatment

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

In the absence of a positive effect, the patient may be prescribed Novocain and Aminazine.

In order to increase blood clotting and reduce the permeability of the 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.

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

Under the basic treatment means:

Support for 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 convulsions, heart rhythm disturbances and other symptoms;
Prevention of thrombotic and other possible complications.

Specific therapy includes the following activities:

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 it is possible to reduce the affected area, which increases the patient's chances of survival and recovery after a stroke.
Improvement of blood flow, necessary for the prevention of recurrent thrombosis. For this purpose, antiplatelet agents and anticoagulants are administered.
Neuroprotection. Protection of viable nerve cells.

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

For ischemic stroke, treatment is chosen that involves the elimination of the causes of blockage of blood vessels. Ischemic stroke is treated with neuroprotective therapy drugs, thrombolytic agents, as well as drugs that can counteract the formation of blood clots in the bloodstream. All foci of ischemia formation are exposed to therapeutic effects.

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

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

Conservative treatments

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

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

At the first sign of a stroke, you should:

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

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

Surgical treatment

Operative treatment includes surgical intervention. It is necessary in the presence of extensive hematomas in the brain tissues.

In most cases, a hematoma is punctured through a small burr hole - it makes up about 70 percent of operations. Open brain surgery is performed with superficial hematomas or in case of extensive hemorrhages in deep areas of the brain, accompanied by the patient's most difficult condition - up to 30 percent of the number of surgical interventions.

Also, in the course of surgical treatment, in case of violation of the respiratory reflex, oxygen inhalations and artificial ventilation of the lungs are used.

Treatment in the acute phase and after it

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

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

Revitalizing treatment

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

Therapy

Treatment of ischemic stroke begins directly on the spot. Emergency measures depend on the severity of the patient's condition and are primarily aimed at stabilizing the condition for transportation to a specialized department.

Immediately after hospitalization, studies are carried out to determine the general physical condition of the patient, the location and size of the lesion. Basic treatment for ischemic strokes is aimed at restoring blood circulation in the affected area, maintaining and restoring vital body functions, and preventing possible complications.

Within a few hours after the onset of the attack, the patient is given a thrombolytic drug to dissolve the clot. After this period, thrombosis can only be eliminated surgically. The patient is prescribed drugs that improve blood microcirculation, vasoconstrictor drugs to normalize blood circulation.

Neurotrophics are prescribed to restore and normalize metabolic processes in brain tissues.

As part of the prevention of thrombotic complications, antiplatelet agents, anticoagulants and drugs that improve blood flow are prescribed.

At the same time, the background disease is treated and symptomatic treatment of possible complications from the vital organs is carried out.

The most dangerous early consequences of a stroke are cerebral edema, coma and recurrent stroke, which are the most common cause of death in patients in the acute period.

The severity of residual neurological lesions varies greatly, ranging from minor speech and motor impairments to complete loss of the ability to move, the ability to perform minimal self-care. After a stroke, mental disorders, memory disorders, and speech disorders are observed.

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

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

raise the patient's head by 30%, placing a blanket or clothes 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 end of the attack, help him clear his mouth of vomit;
measure blood pressure and record indicators.

Consequences

Even under ideal circumstances, a stroke does not go unnoticed. After an ischemic stroke are possible:

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

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

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

Domestic figures and statistics on hemorrhagic stroke are very disappointing - up to 50 percent of patients die. Of the survivors, about eighty percent of the people become disabled of 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 one in five will be able to fully restore all the basic functions of the body.

Possible and very likely 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 take care of himself.

The external consequences of a hemorrhagic stroke are manifested by several visible signs that the patient may not feel, but they will be noticeable to others:

immediately after the lesion, the patient will not be able to smile (with a hemorrhage in the right hemisphere, the left side of the face becomes immobilized, and with a hemorrhage in the left hemisphere, the right side);
the patient cannot stick out his tongue or he immediately spontaneously falls in one direction;
an indirect symptom is a violation of speech and diction (however, this symptom does not appear if the hemorrhage has not affected the speech brain receptors);
the victim cannot raise both hands at the same time, in addition, he can be asked to close his eyes, stretch his arms forward with palms down and stand like that for several seconds. If one arm spontaneously begins to move down and to the side, then with a high probability it can be determined that a stroke has occurred.

If a person complains of one or more of the above symptoms on their own, or you yourself have identified something suspicious, then you should urgently seek medical help. After all, his life depends on how quickly measures are taken.

With a hemorrhagic stroke of the left side of the brain, partial or complete immobilization of the right side of the body occurs.

According to medical statistics, a stroke in the left hemisphere occurs more often than in the right. Since it is the left side that is responsible for speech and logic, if its blood supply is disturbed, not only the right side of the body is immobilized, but acute speech symptoms also appear.

The victim may have severe speech impairment. The words that he utters become incomprehensible, often it is almost impossible for others to make out them at all.

In addition, the patient does not understand what they are saying to him and what exactly they want from him. The only thing he can do is express himself in parts of words or single sounds.

Often, with a hemorrhagic stroke, the victims look like dumb people. However, it should be noted that these symptoms are observed exclusively in right-handers.

If a person is left-handed, then some disorders may either be completely absent, or be the same as with a right-sided stroke.

In addition to serious speech disorders, left-sided hemorrhagic stroke contributes to severe disorientation in space, exacerbates problems with logic and introduces the patient into a powerful depression. The victim, in addition to being unable to express himself normally, closes up and withdraws into himself. Thus, his communication and interaction with others becomes severely limited.

With this stroke, partial or complete immobilization of the left side of the body occurs.

Often it is accompanied by pronounced sensory disturbances and decreases in muscle mobility, which are characterized by a spastic type. These symptoms tend to increase rapidly during a crisis period. In addition, contractures are actively formed in the process and a serious violation of the sensitivity of all types occurs.

In victims, there is a decrease in pain threshold, tactile, articular, muscle and temperature sensitivity is significantly reduced. In addition, there is a violation of eye movement. Very often, when the right hemisphere is affected, the pupils and the head of the patient remain turned to the left.

With a stroke of the brain on the right side, the consequences that develop in patients are closely related to the type of brain catastrophe.

Hemorrhagic form

The most dangerous form of cerebral catastrophe is the right-sided hemorrhagic stroke of the medulla. For right-sided hemorrhagic lesions of the brain tissue is characterized by severe and aggressive symptoms.

On the eve of the catastrophe itself, a person may be disturbed by symptoms such as dizziness, hypertension, shortness of breath, pain in the heart area. After the onset of the acute phase of the disease, the symptoms of a right-sided stroke include paralysis of the left side of the body, loss of sensation, loss of consciousness, and numbness of the upper and lower extremities on the left side.

With a hemorrhagic stroke on the right side, the consequences are severe. They are expressed in partial or complete disability, cerebral edema, up to cerebral coma.

Hemorrhage in the structures of the brain is 15-30% of all strokes, there is no exact data on the damage to the right or left side.

30% of patients die within the first week after bleeding, another 30% during the first month (more often against the background of repeated hemorrhage). The remaining 40% live longer, 5-10% of these people can live for many more years.

The remaining statistics are of a general nature and are not divided into ischemic and hemorrhagic types of circulatory disorders.

About 70% of strokes are diagnosed in the older age group, but cerebrovascular accidents also occur in children, including infants.

During the first year after a violation of cerebral blood supply, 40–45% of patients die, one in five from a recurrent stroke. The maximum risk of death in the recovery period is with extensive lesions in the basin of the carotid arteries.

Mortality after a second stroke is twice as high, the risk of recurrence of circulatory disorders in the first year is 10% and each subsequent year increases by 5–8%.

A stroke of any type and volume is the cause of permanent disability, while after the recovery period:

15–20% of patients return to lighter work activities;
60% are self-supporting at home;
19-35% of people remain completely dependent on others.

With good care and medical supervision, 5-10% of patients can live for many years, but half of them require constant help from those around them.

Men recover from hemorrhages much better than women. The most good effect of rehabilitation measures (64%) was noted in the group under 50 years old; in elderly patients, significant positive dynamics can only be achieved in 27%.

The severity of the consequences of circulatory disorders in the right part of the brain depends on the extent of damage to its substance and arterial pool.

Neurological disorders are divided according to severity, the degree of loss of abilities. They can be combined with each other.

Hemorrhages in the right hemisphere of the brain

Hemorrhage in the occipital lobes, cerebellum, brain stem

Complete loss of spontaneous movements in all limbs (tetraplegia), or “locked-in” syndrome, is the most severe consequence of a stroke in the brain stem. Consciousness does not suffer, but the patient cannot move and speak, the blinking function is preserved.
Disturbances of sensitivity and movements as part of "cross" or alternating syndromes, combining motor lesions on the one hand and dysfunction of the cranial nuclei on the other. They can affect half of the body or separate parts of it, lead to significant disorders in the form of the inability to take a sip or swallow food, to utter any sound.
Violations of sensitivity from complete loss to perversion.
Disturbances in balance, coordination during movements as part of cerebellar ataxia. Small- or large-wave trembling may be noted. Significantly affect the quality of life, but lend themselves well to recovery against the background of rehabilitation measures.
Visual disturbances: double vision, the disappearance of half of the field of vision, complete blindness.
Eye mobility disorders: from strabismus to complete immobility (gaze paralysis).
Loss or significant hearing loss on the side of the hemorrhage in the brain tissue.

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

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

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

Many are interested in the question of how long patients live after a hemorrhagic stroke of the brain. Most of the victims die during the first 1-2 days after the hemorrhage and 1 year after the elimination of the pathology.

If a person managed to pass a critical moment, then he manages to survive. Although the quality of his life will be significantly worsened.

We can distinguish the following consequences of hemorrhagic stroke:

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

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

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

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

Risk factors

The following have an increased risk of formation:

Rheumatism of the heart;
Atherosclerotic lesion of cerebral vessels;
High blood pressure;
Vascular tumors;
Depressed psycho-emotional state;
Aneurysm of cerebral vessels;
Taking narcotic drugs;
Alcoholism;
tobacco smoking;
Postponed myocardial infarction.

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

Forecast and prevention

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

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

Forecasts and life

In addition to the consequences for the relatives of the patient, it is important 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 are not excluded.

According to statistics, after an ischemic stroke, about 5% of patients die within a month, the same number of deaths is recorded within 2 weeks after a hemorrhagic form of pathology. The development of a 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 about 20% of survivors cross the seven-year milestone and only 10% of stroke survivors live 10 years or more.

80% of patients of any age lose their ability to work and about 20% need constant care.

Having completed a full-fledged rehabilitation course after suffering a right-sided cerebral stroke, each person will have to face new living conditions. In order to prevent an extensive stroke of the right hemisphere, each affected person is recommended to follow a protective regimen, which provides for the absence of a stress factor, excessive emotional and physical overload.

When all recovery measures are performed, indicators of the functional state of the body can reach a level where a person is able to serve himself independently at home and adapt to the environment as much as possible. The prognosis for life in ischemic cerebral infarction is much more favorable.

Speaking about the severity of a stroke on the right side, the consequences, and how long such people live, it is impossible to give an unambiguous answer. After a person has suffered a right-sided cerebral stroke, his life expectancy is reduced by an average of 6 years. This is especially true for females over 55 years of age.

It is most difficult to predict the nature of the consequences in patients after 80 years. In old age, recovering from a stroke is very difficult.

Each person who has undergone such a condition must be prepared for the appearance of functional disorders of the urinary and circulatory system.

A timely appeal to a medical specialist will prevent this condition and figure out how to treat the consequences of a cerebral infarction that has already occurred.

The prognosis for a stroke is generally rather unfavorable, it is extremely difficult to predict the possible consequences of each specific case, even after a complete examination of the patient. The prognosis worsens for the elderly, as well as in the presence of certain chronic diseases.

According to statistics, early complications of ischemic stroke are the cause of death in approximately 25% of patients within a month after a stroke.

Approximately 60% have disabling neurological disorders.

Survival within a year approaches 70%, within five years - about 50%, a ten-year threshold is overcome by about 25% of surviving patients. Recurrent strokes within five years of the first episode occur in approximately 30% of patients.

There are specially developed methods for assessing the risk of re-strike.

Stroke is a common neurological disease. About 5 million people around the world suffer from it every day. The consequences are of particular severity, because people who have had this disease become disabled. The prognosis in these cases is disappointing. The whole body and neurology suffer. A stroke is a sudden damage to an area of the brain due to blockage of blood vessels or hemorrhage. How long can a person diagnosed with a stroke live? No matter how long life lasts, even if it is 10 years, it will not be possible to completely restore the body.

Two types of stroke (apoplexy) are defined: ischemic, as a result of which a nerve is pinched or a vessel is blocked; hemorrhagic (accompanied by bleeding in the brain due to rupture of the vessel). As a result, this leads to partial (left or right side of the body) or complete paralysis.

The main causes of apoplexy:

cerebral thrombosis - neurology, clogging of a blood vessel supplying the brain by a blood clot. It develops as a result of chronic diseases of the arteries of the muscular-elastic type, provoked by a violation of lipid-protein metabolism;
internal bleeding into the brain occurs due to the fact that the artery of the brain, being under the influence of the disease, can break and stop the supply of blood and oxygen to the vital elements of the brain.

In simple terms, the causes of stroke are neurology, damage to nerve cells located in the brain. Violation of this kind is caused by a violation of blood circulation in one of the head sections, due to the fact that the cells no longer receive proper nutrition. The prognosis in this case is disappointing. Often this type of hemorrhage affects people who take drugs with a high content of anticoagulants, as well as abuse drugs, cocaine or amphetamines.

ICD-10 classification

The classification of the disease and its symptoms are clearly visible in the International Classification of Diseases (ICD-10). Hemorrhagic stroke code according to ICD-10:

I60 subarachnoid hemorrhage;
I61 intracerebral hemorrhage;
I62 other non-traumatic intracranial hemorrhage;
I63 cerebral infarction;
I64 stroke, unspecified as hemorrhage or infarction;
I65 blockage and stenosis of the precerebral arteries, not leading to cerebral infarction;
I66 blockage and stenosis of the cerebral arteries, not leading to cerebral infarction;
I67 other cerebrovascular diseases;
I68 damage to cerebral vessels in diseases;
I69 consequences of cerebrovascular diseases.

Each code in the ICD-10 system has its own severity, disability, stages of treatment and prevention. This code is needed solely for the understanding of medical personnel, in order to minimize and save time for writing a diagnosis. Since medical terminology and diagnostics are often quite cumbersome, it is generally accepted to classify the disease, putting the code according to the ICD-10 system. So is the ICD-10 system, and each disease code ensures uniformity and similarity of medical approaches and materials to certain diseases.

Coma and neurology in the development of apoplexy

To cure a patient with hemorrhagic apoplexy is much more difficult than to cure after an ischemic stroke. The consequences of an ischemic stroke are less complex than with a hemorrhagic stroke, especially on the left side. If you do not pay attention to the symptoms for a long time, the prognosis can be disappointing. One of the unpleasant consequences of neurology is a prolonged coma of a protracted nature. Coma occurs due to the necrosis of the affected brain cells, and can last for several months or even years. The coma can last from 10 days to 6 months, the percentage of improvement in the condition while in a coma decreases sharply. Coma is the case when time decides a lot, because the longer the body stays in this state, the more difficult it is to recover from it. A special risk zone for a patient is considered to be coma after a second stroke.

Coma is an extremely unfavorable prognosis for the central nervous system. The reasons for the patient to be in this state are a violation of the central nervous system and neurology in general. Neurology is the branch of medicine that deals with damage to the central nervous system. Neurology should be checked regularly at the slightest suspicion of the possibility of a stroke.

Classification of types of stroke

It should be noted that the symptoms of hemorrhagic stroke develop much less frequently than ischemic stroke, the percentage is from 10 to 20%. But damage to the brain stem carries a very sad prognosis, practically does not give hope for at least a partial recovery of the body, and in most cases ends in death.

The main classification of types of hemorrhagic apoplexy according to the mechanism:

intracerebral hemorrhage due to arterial hypertension or amyloid angiopathy. Hemorrhage occurring with impaired consciousness, affecting the region of the leading hemisphere. Consciousness may be active and undisturbed, but compression of the brainstem may result in instant death;
subarachnoid hemorrhage resulting from a ruptured saccular aneurysm. Often associated with rupture of the saccular aneurysm - damage to the inner elastic membrane of the arterial wall. Such a gap, in many cases, affects people over the age of 35 years. The appearance of severe, sudden pain in the head should cause suspicion and the need for urgent computed tomography. Severe attacks of headache can lead to loss of consciousness, in some cases coma occurs.

It is necessary to pay special attention to the symptoms, and in case of sharp pain or visual disturbances, contact the clinic for a check.

Classification of ischemic stroke can be divided into:

atherothrombotic;
embolic;
lukarny.

By the place of localization, it is possible to determine the impact: extensive, acute, early, late. At the initial stage of both hemorrhagic stroke and ischemic stroke, although the disease is difficult to diagnose, it is easier to treat than after its onset.

Harbingers of hemorrhagic stroke

It is known that hemorrhagic apoplexy occurs only in 10-15% of cases, in contrast to ischemic stroke, the frequency of which ranges from 30% to 40%. Hemorrhagic stroke is much more difficult with its consequences, it is difficult to tolerate, the likelihood of death increases. Therefore, it is necessary to diagnose diseases in a timely manner.

Symptoms that may indicate the development of a hemorrhagic stroke:

rapid loud breathing with hoarseness;
intense pulsation of blood vessels in the neck;
the eyeball can mow in the direction of the focus of inflammation, or in exceptional cases in the opposite direction;
paralysis of the opposite side;
the appearance of nausea, vomiting;
sharp, severe headache of a long nature;
with extensive hemorrhage, spontaneous movement of intact limbs occurs.

Symptoms of ischemic stroke:

loss of consciousness or sudden agitation;
disorientation;
headache;
nausea, vomiting;
fever, sweating.

If you find signs of a hemorrhagic stroke, you should immediately contact a medical institution. The initial period of development of apoplexy lasts for 21 days. Medical workers have the concept of a therapeutic window, which is 6 hours from the moment a stroke is detected. During this period, the therapeutic course is most effective. Symptoms play an important role in the diagnosis and detection of neurological diseases. Since from the first minutes it is possible to block the focus of inflammation, it is required to stop bleeding at the cellular level and provide the necessary prevention in order to avoid cerebral edema.

Diagnosis of hemorrhagic stroke, differential in relation to, can be made without special equipment. The patient is invited to simultaneously speak, raise his hands and smile. In one of the cases, the patient has a smile distortion, in the other, a violation of pronunciation.

Consequences and first aid

As you know, by nature, the human body is arranged in such a way that the right hemisphere of the brain is responsible for the performance of the left side, while the left hemisphere of the brain is responsible for the right side. There are a number of differences between right and left stroke. For example, a stroke on the left side in medical practice is much more common. Since the left hemisphere is responsible for such functions in the body as logical thinking, remembering names and dates, time sequence, written and oral speech, if this hemisphere is disturbed, there is a problem with speech and writing recognition. In some cases, the patient cannot build a logical chain, reproduce this or that date from the past.

A stroke of the left hemisphere leads to partial or complete paralysis of the right side, up to paralysis of the right side of the tongue and larynx. People with this diagnosis often experience inconvenience in swallowing water and food.

The consequences and treatment of a left-sided stroke depend solely on its severity and the timing of diagnosis. In the case of treatment in the early stages, it is possible to begin the restoration of movements within the first two weeks. The consequences of a left-sided stroke are more severe than apoplexy of the right side. Complete recovery of the body, speech and movement in most cases does not occur.

Since the disease is quite widespread, each person should be able to correctly and timely provide first aid for a stroke. The first step is to call an ambulance. After that, gently place the patient on his back, and in case of vomiting, slightly turn his head, and stay close to the patient until the arrival of medical personnel. If the symptoms of apoplexy were fleeting, the patient needs emergency medical care, inpatient observation and treatment, in order to avoid a recurrence of an attack.

Treatment of a stroke is a lengthy and lengthy process. The quality of treatment and recovery after a stroke on the left side depends on the intensity of diagnosis. Prevention of hemorrhagic stroke is one of the important components of recovery. It is timely necessary to pay attention to the symptoms of hemorrhagic stroke, and how extensive they are, this will help to start the examination on time and improve the prognosis. As medicines, vasodilating and strengthening agents are prescribed, as well as a complex of physiotherapy.

The pathogenesis of hemorrhagic stroke is a serious disease that requires immediate action. Reviews of people who have experienced the symptoms of the disease say that life after suffering apoplexy is possible. It's hard to say how long it will take to fully recover. Tests show that many people take the rest of their lives to relearn lost functions.