How to restore vision after a stroke: recommendations from doctors. Ocular stroke

One of the most dangerous diseases of the visual organs, which can lead to complete loss of visual function, is an ocular stroke; its symptoms can be different for each patient. This is due to the fact that this term refers to several disorders of the visual organs: occlusive pathologies of the retina, blockage or rupture of the vessels supplying the eyeball.

This vascular pathology of the retina and optic nerve is considered the most dangerous type of ischemic attacks and micro-strokes.

The disease is dangerous because it can occur unnoticed by a person. In this case, rapid vision loss occurs, which worsens as the pathology develops.

People over 60 years of age are at risk. This is due to the fact that elderly patients usually do not attach due importance to the first manifestations of the disease due to the small lesion.

Middle-aged people are also susceptible to eye strokes. The likelihood of pathology increases with mental or physical fatigue, unbalanced diet and abuse of bad habits.

Clinical picture of the disease

An ocular stroke can be determined by external hemorrhage or the formation of small hemorrhages. A characteristic sign is a strong expansion or contraction of blood vessels. In addition, the disease manifests itself as follows:

• temporary or progressive deterioration of visual function;
• significant weakening of peripheral vision;
• the appearance of glare and opacities, the location of which is constantly changing;
• unclear visual perception of objects;
• the formation of “blind spots” - individual areas of the visual field in which visibility disappears;
• disturbance of color perception.

If you have any symptom from this list, you should immediately contact an ophthalmologist or neurologist. Modern methods Diagnosis of ocular blood flow disorders allows us to determine the nature of the disease and prescribe effective treatment. Therefore, in most cases, after a treatment course, patients fully or partially restore their vision.

There are several pathologies that fit the definition of “ocular stroke”:

• artery occlusion and retinal detachment;
• separation of retinal veins;
• central artery occlusion.

Symptoms of these forms of ocular stroke allow a preliminary diagnosis to be made.

Artery occlusion and retinal detachment is a very dangerous disease that is extremely difficult. In this case, patients experience loss of peripheral vision without other symptoms. In some cases, when the retina is detached, spasms and narrowing of the carotid artery are observed.

The retinal vein section has the same clinical manifestations. But to their number are added white spots, reminiscent of glare of light. This form of ocular stroke very rarely affects both eyes. Unlike retinal detachment, vein separation is curable and has a positive prognosis in most cases.

Central artery occlusion appears suddenly and develops very rapidly. This type of ocular stroke is characterized by unilateral vision loss, as well as a deterioration in color perception.

As a rule, such an eye stroke is not accompanied by pain.

Previously, central occlusion was considered incurable, but with the advent of laser technology, the prognosis can be positive.

Don't underestimate the importance of diagnosing an ocular stroke. Deterioration in vision noticed in time and consultation with a doctor can completely change the further course of the disease.

Smirnova Olga Leonidovna

Neuropathologist, education: First Moscow State University medical University named after I.M. Sechenov. Work experience 20 years.

Articles written

Stroke is a very dangerous and insidious disease, which can lead to several pathological conditions and change the quality of life of the patient, possibly for the rest of his life. One such disease is vision loss.

This condition results from disruption of brain activity during. Restoring vision is an important stage for the patient.

How brain problems affect vision

The name of this disease scares many because as a result of its development, a person may lose the ability to perform vital functions. Most often the patient experiences:

• loss of sensation in the limbs;
• vision problems;
• speech problems;
• disorder of cognitive functions (thinking, memory, etc.).

The prognosis of the therapy depends on:

• which part of the brain is most damaged;
• to what extent pathological changes have occurred.

Loss of vision due to a stroke may not always be a final death sentence. This disease is caused by the fact that the blood vessels supplying the human brain with blood become clogged and their integrity is compromised.

Over time, the development of this process leads to irreversible consequences and a. In this case, long-term rehabilitation may be required to return the patient to health.

This vision problem occurs quite often in stroke patients: in about 30% of cases. If the volume of the affected area of ​​the brain is insignificant, then vision is usually restored, although not immediately.

As you know, the brain contains areas responsible for the functioning of all systems of the human body. Every person has 2 optic lobes in the brain. If a person is right-handed, then the image he sees is formed in the left lobe, and vice versa, for left-handed people - in the right.

The development of pathology in the area of ​​the optic nerves leads to the fact that a person begins to see poorly. If necrotic phenomena are sufficiently extensive, then there is a threat of complete loss of vision.

To get rid of this problem and at least partially (as far as possible) improve a person’s quality of life, a course of therapy should be carried out, combining several areas: taking medications and rehabilitation measures.

What does the disease lead to?

The symptoms with which a patient enters a medical facility can provide information about how far the disease has progressed. The consequences of a stroke in the eye area can be as follows:

• the appearance of a “blind spot” (loss of some field of vision);
• inability to see with peripheral vision;
• optic nerve palsy.

If the patient stops seeing any area and his eyes begin to hurt, this indicates that a small area of ​​the brain is damaged. In this case, it is possible to restore vision after a stroke without special effort on the part of the patient or doctors. It is enough to take a course for the eyes to restore their functions.

In the absence of so-called peripheral vision, it becomes clear to the doctor that serious pathological processes are occurring in the brain tissue.

The human brain is a unique thing and not fully understood. Those tissues that remain untouched by the disease can take on some of the functions of the dead areas. If the patient still undergoes a course of intensive therapy, then we can hope that vision will gradually be restored.

If paralysis of the oculomotor nerve occurs, it means that the muscles and fibers responsible for the movements of the eyeballs are involved in the disease. In this case, a person may experience:

• strabismus;
• hallucinations;
• inability to look straight ahead;
• turning the eyes in different directions;
• a veil before the eyes;
• protrusion of the eyeballs.

Such problems are characterized by their reversibility in most cases. But for this, some conditions must be met:

• timely and accurate diagnosis;
• intensive therapy.

Sometimes the eyes may not open at all. This means that a nerve that is very close to other parts of the brain is affected (for example, a nerve that is located between large arteries).

A stroke is a condition that creates tension in the eye area. As a result, the eyes of a sick person begin to constantly water due to the dryness of the cornea. If nothing is done to improve the condition of the organ of vision, a person may simply go blind. This process is irreversible, and the patient becomes disabled.

Some patients experience a phenomenon called presbyopia. This is the name for a condition when a person has difficulty perceiving objects or texts located close to the eyes.

How to restore eye health

How to restore vision after a stroke? Patients in this condition feel intense fear, afraid of never seeing anything again. In addition to an ophthalmologist, you should also consult a psychologist.

If the efforts of doctors applying drug therapy to a particular patient are unsuccessful, the patient is indicated for surgery.

Exercises

To return the oculomotor nerve to its usual healthy state, you need to act in 3 directions at once:

1. Take medications prescribed by your doctor to restore blood circulation in the brain.
2. Do exercises for the oculomotor nerve.
3. Surgical intervention.

Eye exercises should be performed for the first time under the supervision of an instructor, and then, having learned, you can restore vision after a stroke at home. These exercises are very simple, they are quite effective if, in addition to such daily eye exercises, you take vitamins. The regularity of exercise has a great influence on the speed of the process of restoring lost functions.

Various exercises are shown for the eyes, forcing the eye muscle to work in different directions, tense and relax. The complex includes exercises that include:

• pressing on the eyeballs with palms or fingers;
• squinting;
• frequent blinking;
• compression of the bridge of the nose;
• change focus.

If a person is paralyzed in one or both, then exercises that involve the arms can be done with the help of hospital staff or family members of the sick person.

Rotating the eyeballs in the directions up and down, left and right, clockwise and back is useful. You can do these exercises 2 times a day - morning and evening, they are very easy to do.

An exercise in which you can change focus is very useful: this is looking at a nearby object, and then moving your gaze to very distant objects.

The second version of this exercise: shifting your gaze from the fingers of your straightened hand to the tip of your nose and back. In this case, not only visual functions are restored, but also visual acuity increases, and the eye muscles become toned.

Patients can do exercises offered on the Internet. Such videos demonstrate execution technique, frequency and duration.

Compresses

Compresses, hot and cold, are good for the eyes. It performs several important functions:

1. Promotes have a good rest and relaxation.
2. Calms the nervous system.
3. Improves blood flow in the eyeball.

How to make a compress? You need to take 2 towels, wet one in cool water, the other in warm water and wring it out. Then you should lightly massage your eyelids, holding the towels on them for 5 minutes alternately.

Adaptations

For those who have visual impairment due to a stroke, there are various optical devices such as magnifying glasses and others, as well as electronic devices that help them see as well as healthy people. Such patients will benefit from technical “assistants” - tactile aids that will help a person read the desired text.

In the most doomed cases, the patient must agree to undergo surgery on the eye (or eyes). But before you decide to take such a serious step, you should weigh all the pros and cons, and for this you need to consult a surgeon.

Warning

If one of your relatives or friends suddenly begins to see poorly, has an unsteady, uncertain gait, and has also lost sensitivity in any limb, then you should immediately seek help from a doctor, since these signs characterize the development of a stroke .

The faster qualified medical care is provided to such a person, the greater the chance of recovery.

Statistics show that this pathology is most often characteristic of middle-aged and older men.

Navigation

For full human life huge role the visual system plays. The eye is a paired sensory organ that has a choroid responsible for its nutrition and metabolic processes. When one of the ocular arteries is blocked, the blood supply to the organ is disrupted, which leads to pathological processes in the retina and optic nerve. This disorder is conventionally called an ocular stroke.

The disease is the most dangerous among all pathologies of the organ of vision. This is due to the hidden nature of the course, so in almost 30% of cases there are no pronounced symptoms, so more often minor disturbances in visual function are mistaken for age-related changes and don't pay attention to them. Lack of treatment for early stages significantly reduces the chances of complete restoration of vision; moreover, the pathology begins to progress rapidly and over time can cause a complete loss of visual function.

As a rule, ocular stroke occurs in people of the older age category (over 60 years), less often in older at a young age(35-50 years old).

Main causes of eye stroke

The main cause of the pathology is blockage of the blood vessels of the eye. This condition is caused by the formation of emboli or blood clots, which break off and penetrate into the bloodstream. vascular system organ of vision, preventing normal blood supply. More often, blood clots occur in the coronary or carotid arteries, and under the influence of certain unfavorable factors, they break away from the walls and block the lumen of the central vessel of the visual system.

The main provoking factors are:

• arterial hypertension;
• frequent stressful situations;
• chronic fatigue syndrome;
• bleeding disorders;
• constant eye strain;
• deterioration of blood circulation;
• frequent use;
• eating disorder;
• long-term use of certain medications that negatively affect the eyes (corticosteroids, combined oral contraceptives, and others);
• damage to the arteries of the spinal column (more often occurs with a herniated disc, injury to the spinal column or osteochondrosis);
• intracranial surges.

Classification of ocular stroke

If characteristic symptoms are present, the type of pathology is determined during diagnostic measures. For this purpose, Doppler sonography of the vessels of the eye is performed.

Central retinal artery occlusion

Arterial occlusion and retinal detachment are a fairly serious condition, characterized by a painless course and decreased peripheral vision. Over time, in the absence of timely treatment, central vision is lost. In the majority of patients who have suffered a microstroke, the diagnosis reveals a narrowing of the lumen of the carotid artery, cardiovascular diseases and a persistent increase in blood pressure. With this type pathological process the highest chances of restoring visual function, however, consequences may develop, manifested in the form of distorted perception of the picture and the appearance of blind spots.

As the disease progresses, the patient ceases to distinguish colors and shades. Timely laser treatment allows you to prevent complications and eliminate any visual impairment that may occur.

Thrombosis of the central retinal vein

IN in this case signs of the disease appear in the form of white spots before the eyes and deterioration of peripheral vision. Patients at risk are those suffering from diabetes mellitus and arterial hypertension. Lack of timely medical care can cause consequences such as blindness.

Artery occlusion and retinal detachment

The development of the pathological process begins with a complete loss of peripheral vision, any painful sensations are missing. In fairly rare cases, cramping pain may occur. Most patients cannot distinguish the outlines of objects that are close to the affected eye and practically do not see bright light.

The first symptoms of an eye stroke

The first symptoms of an ocular stroke can be determined by visual examination of the eyeball: hemorrhage appears or minor hemorrhages form. The first signs of the disease include:

• narrowing of visual fields: in a healthy state, with the head still and the gaze concentrated, a person can see a certain part of space; with impaired fields of visual function, the picture narrows and the person cannot cover the previously viewed area with vision;
• Floaters, sparks or stars very often appear before your eyes;
• discomfort (sometimes painful) in the eye area; in severe cases, the full ability to see with the affected eye is lost;
• hemorrhage in the eye, minor hemorrhages;
• An eye stroke can develop with a sharp decrease in visual function along with the appearance of white, blind spots.

When examining the eye, hyperemia is noted.

Visual impairment develops after warning signs, which manifest themselves in the form of the following symptoms:

• fog, flickering or light glare appears before the eyes;
• in some cases, sensitivity in various areas of the skin decreases.

Precursors of this disease occur periodically, and with the necessary therapy they completely disappear. More often, such signs appear in people with a persistent increase in blood pressure, atherosclerosis and migraine.

Therapeutic measures

Only constant monitoring of vision will allow you to identify vision disorders and promptly contact an ophthalmologist and neurologist. The method of treating the pathological process depends on the type of stroke, the severity of the symptoms that occur, the severity of the course, causes and concomitant diseases. Timely medical care is also of great importance in successful treatment.

Laser correction is considered the most effective treatment for eye stroke.

The most commonly used and effective treatment for eye stroke is laser correction. During the procedure, laser radiation is applied to the clot that has formed and blocked the lumen of the vessel. As a result, the blood clot is destroyed and the blood supply to the organ of vision is restored.

In addition, laser treatment is performed for retinal detachment, as well as as a result of degenerative changes in the visual organ.

The use of laser therapy in conjunction with timely elimination of the main cause of pathology in short time allows you to achieve vision restoration without developing negative consequences.

Less commonly used treatment is hyperbaric oxygen therapy (HBO), which is unique technique oversaturation of blood with oxygen. The therapy is carried out in specialized hyperbaric pressure chambers, which use oxygen under high pressure.

To eliminate spasms, improve blood circulation, and lower blood pressure, drug therapy is prescribed. It is carried out under the supervision of an ophthalmologist at home or in an inpatient department.

Drug treatment consists of:

• drugs to prevent blood clots;
• antispasmodics;
• vascular drugs to improve blood circulation;
• angioprotective agents;
• in cases of the addition of an infectious pathogen, antibacterial drugs are prescribed;
• medications to normalize blood pressure and eye pressure.

To increase the effectiveness of treatment, patients are advised to adhere to certain rules:

• adjust your diet: give up fatty and fried foods, reduce salt intake, include a large amount of vegetables and fruits in your daily diet;
• perform eye exercises;
• spend enough time on fresh air, reduce television viewing;
• adhere to proper rest and sleep;
• exclude alcoholic drinks and smoking.

Possible complications of pathology

In the absence of timely medical care, serious consequences that cannot be corrected may occur:

• color vision disorders;
• narrowing of visual fields;
• periodic appearance of flies and glare of light before the eyes;
• partial or complete loss of visual function.

Human health and quality of life depend on the coordinated work of all organs and systems, in particular the visual. When full visual perception is impossible, psychological changes occur, and in some cases constant help from outsiders is required. Therefore, at the first symptoms of visual impairment, it is necessary to contact a medical institution for diagnosis and adequate treatment.

Drawing conclusions

Strokes are the cause of almost 70% of all deaths in the world. Seven out of ten people die due to blocked arteries in the brain. And the very first and main sign of vascular blockage is headache!

In fact, such a concept does not exist in medicine; it is used to describe the pathological condition described above (bleeding in the eye due to blockage of veins or arteries).

The danger of this disease is that in most cases it is completely asymptomatic. Vision does not undergo changes, and the injured retina does not cause painful manifestations. Absent symptoms do not allow timely detection of the disease and selection of the necessary treatment.

The main risk group includes people over 60 years of age, but sometimes younger patients (30-50 years of age) also become victims of eye strokes.

Reasons and typology

Main causes of the disease:

• hypertension;
• chronic fatigue, stress;
• blood clotting disorder;
• hereditary predisposition;
• constant strain on the eyes (for example, prolonged work with papers, prolonged exposure to a computer monitor);
• circulatory disorders;
• diabetes mellitus type II;
• unbalanced diet;
• alcohol abuse, smoking;
• long-term use of medications that may affect the eyes (corticosteroids, oral contraception).

All of the above factors provoke the formation of emboli or blood clots (blood clots interspersed with bacteria, calcium crystals, cholesterol). At one point, these structures break away from the arterial walls and, together with blood, enter the vascular network of the eye (disrupting the blood flow to the retina and cutting off the blood supply to the organ of vision).

If the embolus or thrombus resolves on its own, vision is restored (fully or partially), and other unpleasant symptoms pathologies gradually disappear.

Basically, blood clots (emboli), which pose a danger to the organ of vision, form in the carotid or coronary arteries. Under favorable conditions (CVS pathologies, infections, allergic reactions, eye injuries, blood clotting disorders), formations break away from the arterial walls and clog the central vessel of the visual organ.

Other reasons that provoke the symptoms of an ocular stroke include:

• rupture (blockage) of the vertebral arteries (this phenomenon occurs with disc hernias, injuries, osteochondrosis);
• a sharp change in intracranial pressure (the nutrition of the visual organ is disrupted).

Depending on what type of ischemic disorder occurred in the retina, several types of pathology are distinguished:

• Central artery occlusion. The disease progresses at lightning speed, causing unilateral visual impairment. The patient does not distinguish colors. Timely laser treatment helps eliminate the consequences of the problem (impaired visual function).
• Retinal vein division. White spots flash before the patient’s eyes (outwardly similar to glare of light). This form of stroke is unilateral. Timely diagnosis and treatment allow us to talk about a favorable prognosis.
• Arterial occlusion and retinal detachment. The most severe form of stroke. Peripheral vision is completely lost. The course of the disease is asymptomatic. In a number of clinical cases, retinal detachment is accompanied by spastic pain, and the carotid artery may narrow.

Clinical picture

The first “danger signals” indicating possible development disease, the following symptoms may occur:

The field of view is noticeably narrowed. Yes, eyes healthy person with a fixed position of the head and a fixed gaze, they cover a certain part of the space.

During a stroke, the “picture” transmitted to the brain becomes smaller, that is, the field of view decreases.

One of the main signs that the patient has suffered an ocular stroke is the simultaneous deterioration of vision (sharp) and the appearance of white spots in front of the eyes. Upon visual examination of the visual organ, local redness and minor hemorrhages are noticeable, and the patient’s blood pressure may rise.

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Due to the fact that an ocular stroke is caused by excessive expansion (constriction) of blood vessels, this leads to “cutting off” the optic nerve from access to oxygen.

This situation certainly entails a partial or complete disruption of the main function of the eye - vision is either greatly weakened or the patient becomes completely blind.

Symptoms of an eye stroke due to blockage of the central retinal artery:

• the emergence of “blind spots”;
• the perception of the picture (in particular, the outlines of objects) is distorted;
• peripheral vision partially or completely disappears.

The course of the disease is not accompanied by pain, but if not diagnosed in time, it can lead to blindness.

When the central retinal vein is separated, the following symptoms appear:

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• blindness or fulminant one-sided loss of vision;
• disturbance of the movement of the visual organ with loss of sensitivity of the limbs on the opposite side (the so-called cross syndrome);
• loss of visual fields, provided visual function and color discrimination are preserved;
• acute pain occurs in the eye, the pupil narrows;
• limited mobility or rocking movements of the organ of vision;
• doubling of objects;
• strabismus.

A typical harbinger of pathology is the symptom of flickering darkness, which manifests itself in the form of the following visual impairments:

• light glare, fog, flickering before the eyes;
• V different parts body skin may lose sensitivity;
• Such changes are paroxysmal in nature; after a short period of time, the symptoms disappear and vision is restored.

This symptom often accompanies severe hypertension, atherosclerosis, and migraine.

Features of therapy

Treatment of ocular stroke depends on the reasons that led to hemorrhage in the organ of vision. If you notice the first symptoms indicating a problem, you should seek help from an ophthalmologist or neurologist.

The specialist will prescribe an electronic scan of the blood vessels and, based on the diagnostic results, determine how to treat the disease.

Treatment and possible consequences of ocular stroke are determined by:

• degree of damage;
• duration of the illness;
• whether first aid was provided to the patient in a timely manner.

Given that early diagnosis Eye stroke patients manage to restore their vision. Some problems may remain: the outlines of objects are unclear or distorted; Some patients experience white spots flashing before their eyes from time to time.

The dangerous symptoms of a stroke cannot be ignored - if specialists fail to restore proper blood flow in the first few hours after the occlusion, the consequences for the patient can be tragic.

To eliminate the consequences of pathology (correction of visual acuity), laser treatment is used.

The use of this technology, in combination with successful and timely relief of transient ischemic attack, allows patients to completely restore visual function.

So, an ocular stroke is called serious pathology, developing as a result of blockage of the veins (arteries) feeding the organs of vision. If diagnosed untimely and without proper treatment, the disease can lead to complete blindness.

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Eye stroke

An eye stroke is one of the most dangerous diseases, which without timely treatment often provokes complete loss of vision. The clinical picture in patients is different, since this concept implies a combination of various disorders, for example, rupture or blockage of a vessel, occlusive pathologies of the retina, and others. The condition is classified as a type of ischemic attack and microstroke.

What it is

The disease is a condition accompanied by spasm, blockage (ischemic) or rupture (hemorrhagic) of a blood vessel in the eyeball. An attack can develop acutely or be sluggish. In the first case we are talking about the appearance severe pain, loss individual parts vision or complete blindness, numbness of the limbs. A sluggish stroke can cause alternations between deterioration and improvement of well-being, and minor visual disturbances. Whatever the symptoms, you should not let the disease take its course; you should consult a doctor as soon as possible.

Symptoms depending on the type

For timely diagnosis Any eye disease, every person should be careful about their vision. The concept of ocular stroke includes several conditions, among which are occlusion of an artery and detachment of blood vessels from the retina, blockage of the central artery, and detachment of the central retinal vein. Let's consider the signs characteristic of each pathology.

Artery occlusion and detachment of blood vessels from the retina

The retina is the nervous tissue that is responsible for image perception. Under influence various reasons detachment may occur. Signal for immediate medical examination are the following symptoms:

• narrowing of the field of view. In a normal state, a person should see clearly the world. Even if he looks forward, peripheral vision catches objects that are to the side. A decrease in the field of vision indicates the development of serious disorders;
• the appearance of flies, stars, sparks before the eyes. This symptom is especially pronounced when light enters the eyes;
• pain in the eyeball area;
• the formation of small or larger hemorrhages.

As already mentioned, the symptoms of an ocular stroke may vary depending on the characteristics of the disease. Often the development of pathology is indicated by sharp deterioration vision and the appearance of white or grayish spots before the eyes. In many cases, increased blood pressure.

The attack is accompanied by eye pain and blurred vision

During a visual examination, the ophthalmologist notes characteristic spider veins, areas of hemorrhage. The patient reacts painfully to light rays, discomfort appears when moving the eyes.

Blockage of the central artery

The eyes are nourished by numerous vessels. This has important physiological significance, since the blood carries oxygen and other essential substances that are required for the normal functioning of the visual organ. When the central retinal artery is blocked, signs may include the following:

• partial or complete loss of lateral vision;
• distortion of the outlines of objects, blurred visual images;
• the appearance of areas on the eye that are unable to perceive light impulses (blind spots);
• pain, dryness.

Division of the central retinal vein

The following clinical signs indicate separation of the central retinal vein:

• sharp deterioration of vision or its complete loss;
• the appearance of cross syndrome, characterized by impaired eye mobility and loss of sensitivity of the limbs on the opposite side;
• loss of individual fields of vision;
• severe pain accompanied by constriction of the pupil;
• decreased eye mobility;
• split picture;
• development of strabismus.

Particular attention is paid to the development of the symptom of flickering darkness. In this case, the patient experiences fog before the eyes, glare of light, and white spots. Skin sensitivity is impaired in various places. Often this clinical picture is typical for people suffering from persistent arterial hypertension, migraines, atherosclerosis and other pathologies. The symptom of flickering darkness is paroxysmal in nature, periodically the person experiences relief, after which the symptoms repeat.

Spots before the eyes or loss of visual fields are common signs diseases

Important! Any type of disorder without the necessary medical treatment leads to partial or complete loss of vision.

Main reasons

An ocular stroke can develop regardless of age and gender under the influence of various provoking factors.

• hypertonic disease. Patients suffering from a persistent increase in blood pressure are at risk for the disease, since their vessels are constantly exposed to high stress;
• stressful situations and chronic fatigue. It has been proven that excessive production of the hormone adrenaline does not have the best effect on veins and capillaries. Overfatigue is also considered a cause of deterioration in the condition of vascular walls;
• low blood clotting. This condition promotes hemorrhages;
• hereditary predisposition and congenital vascular weakness;
• prolonged eye strain. The risk group includes people who are forced to spend a long time behind a computer screen or work with papers;
• diseases accompanied by impaired blood flow;
• diabetes mellitus type II;
• bad habits (drug use, alcohol use, smoking);
• lack of vitamins and minerals.

A common cause of ocular stroke is the use of certain groups of medications. This includes hormonal agents, oral contraceptives and some other medications.

All these factors contribute to the formation of blood clots (thrombi, emboli). They are formed on the walls of blood vessels from cholesterol, bacteria, and particles of calcium crystals. When a blood clot breaks away from the wall, it enters the bloodstream and can cause a blockage in any part of the body, including the eyes. In turn, this provokes acute disorder blood circulation and decreased visual function. If the blood clot resolves on its own or with timely treatment with drug therapy, vision is partially or completely restored. In severe cases, blindness occurs.

Hypertension and other vascular diseases are a common cause of stroke

For the organs of vision, the greatest threat is posed by emboli formed in the area of ​​the coronary or carotid artery. For diseases of cardio-vascular system, infectious pathologies, allergies, poor coagulation and other conditions, a blood clot breaks away from the vessel wall and closes the lumen of the central vessel of the organ of vision.

In addition, the causes of stroke include the following provoking factors:

• blockage with subsequent rupture of the vertebral artery. This often happens with diseases such as osteochondrosis, back injuries, intervertebral hernias;
• severe increase in intracranial pressure. This is another reason that leads to impaired nutrition of the eye.

Diagnostics

Diagnosis of pathology is carried out in a hospital setting. If a patient is suspected of developing a stroke, he urgently needs to undergo examination by a neurologist. The doctor evaluates a person’s reflexes, his speech, orientation in space, and vision. If a stroke is confirmed, consultation with an ophthalmologist is also required.

Among the instrumental diagnostic techniques use:

• computed tomography;
• CT angiography (vascular visualization);
• Magnetic resonance imaging.

These methods help to find out the location and degree of occlusion, select necessary measures treatment. X-rays of the person are often performed to identify the presence of malformations, vascular aneurysms, and other abnormalities. To identify pathologies that caused the development of ocular stroke, ultrasonography and electrocardiography. Blood and urine tests show glucose concentrations, electrolytes and kidney metabolites.

To diagnose an attack, a comprehensive examination is used

In addition to confirming an ocular stroke, these techniques make it possible to identify at an early stage such dangerous conditions as renal failure, hypertensive crises, heart attacks and others.

Treatment tactics

Treatment for stroke always depends on several aspects. This includes the type of pathology, features of its course, causes, symptoms in the patient and some other factors. The most effective and safe method Laser coagulation is considered. The use of a laser allows you to effectively get rid of a blood clot, which helps restore blood flow in the affected area and prevent dangerous complications. The same technique is used for retinal detachment.

Another type of therapy is hyperbaric oxygen therapy. Its essence is the use of oxygen under pressure. In this case, the patient is in a hermetic pressure chamber.

Drug therapy includes groups of drugs designed to eliminate a blood clot, normalize blood circulation, relieve spasms, and normalize blood pressure. Treatment includes:

• antihypertensive drugs. To normalize blood pressure, the patient is prescribed diuretics, beta blockers, calcium antagonists, and ACE inhibitors. The decision on the type of drug in a particular case is made by the attending physician, depending on the characteristics of the course of the disease;
• anticoagulants. The main goal of therapy for ocular stroke is to restore normal blood flow. Since the cause of circulatory disorders is most often a blockage with a blood clot, to eliminate it, agents are prescribed that help dissolve blood clots;
• antispasmodics. These medications relieve spasm and pain that develop during an attack.

Treatment tactics depend on the characteristics of the pathology

Depending on the patient’s concomitant pathologies, other medications may be prescribed, for example, non-steroidal anti-inflammatory drugs, corticosteroids, narcotic analgesics, etc.

Prevention

Like many other diseases, ocular stroke can be prevented by following simple preventive measures. First of all, it is worthwhile to promptly treat various diseases of the cardiovascular system and respiratory organs. This is explained by the fact that it is pathologies of the heart, arteries and veins that often cause ruptures or spasms of blood vessels. Under no circumstances should you self-medicate. Medications must be selected by a doctor.

In addition, it is recommended to comply balanced diet and correct drinking regime. Saturating the body with beneficial vitamins and minerals will ensure the health of blood vessels and all internal organs. To do this, you should give up a large amount of animal fats, limit the consumption of salt, sugar, fatty, smoked, and sour foods. It is better to give preference to plant products, vegetables, fruits, preferably raw or baked.

Another important aspect– refusal bad habits and sufficient physical activity. These and other activities will help maintain not only the health of your eyes, but also your entire body for many years.

Stroke of the eye organs and its types

Among all the types of micro-strokes and ischemic attacks, an ocular stroke is considered one of the most unpleasant and dangerous. The reason for the danger lies in the hidden nature of the disease: about 30% of people do not even notice that it has occurred. At the same time, the loss of visual functions is noticeable, and the consequences are progressive.

Manifestation of ocular stroke

According to statistics, ocular stroke most often occurs in people over 60 years of age, since the lesion is small. And age makes itself felt, patients simply do not pay attention and do not take any measures.

However, an eye stroke can occur at an earlier age. As usual, there are several causes of the disease:

• Excessive strain on the visual organs - due to heavy work at the computer or with papers.
• Mental fatigue, fatigue, stress.
• Violation of circulatory functions and blood pressure indicators.
• Heredity and blood type (II positive is most susceptible to stroke diseases).
• Non-compliance with diet and daily routine, etc.

How to distinguish a dangerous illness from ordinary pain due to overwork? One of the first signs that a microstroke has occurred in the eye is a deterioration in vision with the simultaneous appearance of white “fireflies” in the field of vision. And on the other hand, unlike the closed brain, the vessels of the eyeball are almost 60% visible. A visual examination of the eyes will determine the preconditions or presence of TIA: from minor hemorrhages and hemorrhages to high blood pressure.

The occurrence of a stroke in the eye is caused by vasoconstriction or excessive dilatation. If the retina or optic nerve is cut off from the supply of oxygen, their functions are lost, vision is distorted, or even completely lost.

Types of ocular strokes

Diagnostics of the eyeball and nerve, retina allows you to identify the blockage channel and determine the type of microstroke. In this case, it is necessary to perform an electronic scan of the vessels. Depending on the results, the most likely cases of stroke in the eye organ are distinguished:

1. Arterial occlusion and retinal detachment. One of the most dangerous manifestations, because often occurs painlessly. The main symptom is loss of peripheral vision, which often develops into loss of central vision. Many patients with this type of mini-stroke are diagnosed with narrowing of the carotid artery, heart disease and problems with high blood pressure. The chances of restoring vision are quite good - 80% of patients have the right to regain at least 0.2-0.4 diopters of difference. However, subsequently there will be problems with distorted perception of the picture, such as blind spots or distorted outlines.

Any of the symptoms of sudden deterioration in vision requires immediate medical attention and diagnosis. Cherish your health!

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Life story

How to recover after a stroke? You just need to drink it every day.

Bakhyt, 6 days ago

Weakness and dizziness do not go away after a cold. It's been a month now, what should I do?

Alexandra, 1 week ago

I've been feeling dizzy, nauseous and tired for more than 2 days now! My blood pressure is always low! Pills don't help! It feels like the ground is disappearing from under your feet! I eat well! What could it be?

Irina, 1 month ago

My mother had a benign tumor. They had an operation and everything was going well until the doctors started doing punctures every day, they forbade me to get up and it was possible that the broths resulted in me becoming ill, vomiting, and sent home.

Elena, 1 month ago

Katya, my husband has now been in a deep coma for 6 days, the doctors are giving no hope at all, his body has stopped fighting, I still hope,

Tatyana, 1 month ago

Katya, thank you. It is these words of hope that are so lacking, my mother has been in the ICU ward since Friday evening, yesterday they said that she was in a coma and that they rarely get out, after your words hope appeared!

The information presented on the site is for informational purposes only, does not replace qualified medical care and is not intended for self-diagnosis and self-medication. Selection and purpose medicines, treatment methods, as well as control over their use can only be carried out by the attending physician. Be sure to consult a specialist.

Microstroke: symptoms, signs, treatment

A microstroke is a transient disruption of the blood supply to the brain caused by thrombosis or a sharp spasm of a small vessel. The consequences of a microstroke in the form of restrictions on life support functions are insignificant, since the damage to brain tissue is of a targeted nature. This fact does not always make it possible to diagnose an attack in a timely manner, as a result of which a person may develop a major stroke.

Microstroke and stroke: what are their differences?

The main differences between a micro-stroke and a full-fledged stroke are as follows:

• a microstroke affects small vessels of the brain, resulting in a smaller volume of nerve tissue being affected;
• the symptoms of a micro-stroke are blurred and erased, so they are easily confused with signs of a mild illness;
• the duration of an attack of transient ischemic attack in most cases does not exceed 1 hour - after this time the victim’s condition improves;
• the consequences of a micro-stroke are not as serious as with a major stroke; after an attack, the victim can recover almost completely and not experience restrictions in self-care and society.

Due to minor damage to brain tissue and mild symptoms, diagnosing a microstroke based on visual signs can be quite difficult. This leads to the fact that the victim does not receive timely medical assistance, and the chances of developing a major attack increase significantly.

Who is at risk

Regardless of age, people most susceptible to microstroke are those who:

• suffer from arterial hypertension chronic form, angina pectoris, atherosclerosis, arteritis and other vascular diseases;
• have increased blood clotting and a tendency to thrombosis;
• suffer from overweight and obesity;
• have a history of circulatory disorders and manifestations of ischemic attacks;
• suffer from diabetes and are susceptible to sudden changes glucose level in the blood structure;
• have a hereditary predisposition to developing a stroke or myocardial infarction;
• abuse alcohol, smoke or take drugs;
• suffer from compression of blood vessels by intervertebral hernias or deformed discs;
• suffered intracranial injuries;
• have congenital vascular diseases;
• suffer from oncology, and not only the tumor localized in the brain structures, but also metastases growing in their tissue can affect the vessels;
• are subject to regular nervous strain and stress;
• live in unfavorable environmental conditions.

Also at risk for developing a microstroke are women with unstable hormonal levels caused by taking oral contraceptives, pregnancy, ovarian dysfunction and menopause.

Symptoms and first signs of a microstroke

Many people attribute the deterioration in well-being caused by an attack of a micro-stroke to fatigue or bad weather conditions. The reason for this is the similarity of many of its symptoms with the symptoms of neurological and vegetative-vascular disorders. Common signs indicating an approaching transient ischemic attack include:

• headache that occurs suddenly;
• a sharp increase in blood pressure;
• dizziness;
• weakness;
• “dark spots” and “spots” in the eyes;
• nausea.

• numbness of the limbs, face;
• loss of skin sensitivity;
• short-term disturbance of consciousness;
• difficulty speaking (incoherence of words and phrases) and its perception;
• loss of orientation;
• crooked smile;
• short-term amnesia;
• loss of coordination.

The described symptoms are mild and short-term in nature. After an hour, the victim of a transient ischemic attack may feel well and because of this do not perceive the seriousness of the situation.

First aid for microstroke

A feature of the symptoms of a microstroke is the moderate severity of signs of brain failure and their rapid disappearance. Despite the improvement in health, the person next to the victim should immediately call an ambulance and provide him with emergency assistance:

• sit down or lay down a person who has become ill in a comfortable position;
• unfasten clothing items that may impede breathing and normal blood flow (tie, belt, buttons on a shirt);
• turn the victim’s head to the side if he feels sick and may experience an attack of vomiting;
• constantly measure blood pressure in order to track the dynamics of changes in indicators and then report this information to the paramedic;
• reassure the victim in a calm voice, if he is nervous or in panic, talk to him constantly;
• If the victim assures that he feels well, it is important not to allow him to make sudden movements and assure him that medical help is necessary.

If you suspect an attack of a micro-stroke, you cannot provide primary care with untested methods - give the victim the medicines on hand, apply cold to the head, feed. The paramedic needs to provide details of the onset of the attack and its duration, the severity of symptoms, as well as blood pressure readings.

Diagnostics

A person who has suffered an attack of transient ischemic attack should undergo examination, even if the unpleasant symptoms have passed and health has improved. To study the condition of cerebral vessels and diagnose a microstroke, the following methods are used:

• consultation with a neurologist, ophthalmologist and cardiologist to assess the visual signs of a microstroke;
• undergoing MRI and CT - to study the condition of brain tissues and vessels, identify the location of lesions, assess their severity and the dynamics of their resorption, if any;
• dynamic measurement of blood pressure to assess the criticality of changes in its indicators;
• blood test for cholesterol levels, the amount of glucose in the composition and the degree of coagulation;
• performing an electrocardiogram to assess the functioning of the heart and the frequency of its muscle contractions;
• angiography - performed to determine the exact location of the ischemic focus or microcrack in the vessel, as well as assess the degree of its damage.

During the diagnostic process, it is also important to identify diseases and pathological conditions that could provoke an attack of a mini-stroke. This will allow them to begin treatment and thereby reduce the risk of developing not only a repeated transient ischemic attack, but also a full-fledged major stroke.

Treatment and recovery

To restore cerebral circulation after a stroke, the victim is placed in a hospital, where, depending on the degree of damage to the vessel and the presence of diseases that aggravate the condition, he is prescribed the following drugs:

• angioprotectors – agents that improve blood microcirculation and metabolic processes in brain tissue;
• vasodilators;
• antiplatelet agents – agents that reduce blood viscosity and prevent the development of thrombosis;
• vitamins that help improve brain function and strengthen the immune system;
• nootropics – medicines, improving brain activity;
• drugs to support the metabolic system.

After eliminating the risk of developing a full-fledged stroke, the patient is prescribed supportive and restorative therapy:

• physiotherapy;
• massages;
• physical therapy;
• health treatment in a sanatorium;
• diet;
• unconventional methods – manual therapy, acupuncture, herbal medicine, yoga, leech treatment.

Treatment of a microstroke should consist not only of relieving the attack and restoring brain activity. Attention should be paid to diseases that can become a catalyst for a transient ischemic attack and provoke a full-blown stroke.

Consequences of a mini-stroke

A single transient disruption of the blood supply to the brain caused by an attack of a micro-stroke, quite often, provided primary care and subsequent treatment are provided, does not leave consequences. In some cases, a person who has had an attack may experience the following brain dysfunctions:

• memory loss;
• absent-mindedness and inattention;
• deterioration in concentration;
• depressed mood;
• outbreaks of irritability and aggression or, conversely, tearfulness.

Usually after passing drug treatment these disorders pass, and the patient ceases to experience discomfort.

A dangerous consequence of microstroke attacks following one after another is the development of a full-fledged ischemic attack. In such cases, acute cerebral circulatory disorders lead to serious consequences:

• paralysis of body parts - arms, legs, parts of the face;
• mental disorders;
• speech impairment or lack thereof;
• decreased vision due to stroke;
• epileptic seizures;
• inability to eat independently due to impaired swallowing reflex;
• partial amnesia, when the patient forgets certain events or loses previously acquired knowledge;
• decreased intelligence and thinking;
• coma;
• of death.

Prevention of micro-stroke

The best way to combat the consequences of a microstroke is to prevent its development. For this purpose in Everyday life People at risk must adhere to the following rules:

• prevent the transition of chronic diseases to an advanced or aggravated stage, for which purpose regularly undergo examination and preventive treatment;
• give up smoking, alcohol and other bad habits;
• eat right - stick to a diet that promotes healthy blood vessels and prevents the formation of cholesterol plaques on their walls;
• control blood pressure and prevent its sharp increase;
• prevent or adequately respond to situations that can cause nervous tension and stress;
• normalize wakefulness, rest and sleep patterns;
• monitor your own weight and prevent the development of obesity;
• regularly spend time in the fresh air, walk;
• develop physically - perform daily gymnastics, swim in the pool, play sports games;
• eliminate mental fatigue.

A healthy lifestyle and periodic examinations will help to significantly reduce the risk of micro-stroke, regardless of age.

Choosing a doctor or clinic

©18 The information on the site is for informational purposes only and does not replace consultation with a qualified physician.

Temporary loss of vision As a rule, it occurs suddenly in one eye, is painless and is described by patients as a sudden shadow. This condition may last for several minutes, then vision returns. Sometimes this condition repeats again and again. May occur V belt vision loss and in the second eye.

Typically, temporary vision loss occurs in elderly patients suffering from atherosclerosis and various diseases vessels. The cause may be small thrombi (blood clots) that break off from the arterial wall and enter the vessels of the eye, blocking the blood supply to the retina. When the blood clot is destroyed, it is destroyed and vision returns. Thrombosis or embolism usually occurs in the carotid or coronary (heart) arteries. An embolus may be cholesterol or calcium crystals.

This issue falls under the category " transient ischemic attacks", as a result of which even heart attack or stroke .

In this case, vascular studies are indicated and anticoagulants may be prescribed.

Also acute vision loss may be caused by other problems such as:

• Blockage of the vertebral arteries involved in the blood supply to the optic lobe of the brain.
• Increased intracranial pressure (the pressure of the fluid surrounding the brain). An increase in intracranial pressure can cause immediate loss of vision, especially when the person's position changes (for example, from sitting position to a standing position).
• Spasm of the orbital artery, which supplies the retina with blood. It can also, although extremely rarely) cause temporary loss of vision in the eye.

Occlusion (blockage) of the central retinal artery

If a blood clot or embolus enters a retinal artery, it may become blocked, stopping blood flow and causing loss of vision. In some cases, the blood clot can quickly dissolve, and vision can be restored.

However, if the blood clot is large enough, vision is not restored. As a rule, the patient does not experience pain. There is usually no pain in this case. If blood supply to the retina is interrupted for more than 1.5 hours (approximately), vision may not be restored, even if the blood clot resolves and blood circulation resumes.

(In Fig. The white arrow shows an arterial thrombus.) This condition indicates a risk of heart attack or stroke.

If the patient immediately contacts an ophthalmologist, the prescribed treatment will help prevent irreversible vision loss.

Central retinal vein occlusion

Venous outflow from vessels retina carried out by one single vessel - central retinal vein. If this vein becomes blocked, there may be various problems, proportional to the degree of obstruction. In the case of such a pathology, the patient notices:

* vision impairment,

* blurred image,

* appearance of floaters

* loss of visual fields.

These changes occur unexpectedly and progress over a period of time (from several hours to several days). As a rule, these changes occur in one eye, rarely in both eyes.

This pathology is usually based on vascular changes, blood clots(as well as with blocked arteries).

The most effective treatment for this disease is treatment of concomitant diseases (diabetes, hypertension, atherosclerosis) in the hope that blood flow will be restored.

In about a third of all cases, vision is almost completely restored, in a third it remains at the same level, and in a third there is further deterioration and significant loss of vision.

In the most difficult situations one has to resort to laser treatment to prevent dangerous forms glaucoma. however, laser treatment will not restore vision.

Stroke. Loss of vision due to strokes

Stroke- a violation of blood circulation in the brain as a result of blockage of a vessel. If the blockage occurs in the blood vessels supplying the optic lobes of the brain, vision loss may occur. When the affected area is small, a small portion of the visual field is lost (the so-called blind spot).

There are two visual lobes of the brain - right and left. In the left, a visual image is formed from the right halves of the retinas of both eyes, in the right - from the left halves. Therefore, when one half of the brain is damaged, the corresponding parts of the visual fields are lost in both eyes.

Treatment of strokes. occurring in the vascular system supplying blood to the occipital lobes of the brain, is carried out in the same way as the treatment of any stroke, with the participation of a therapist and a neurologist.

Ophthalmology Clinic

Causes of vision loss

Loss of vision (amaurosis) can be a consequence of retinal detachment or ischemia and other eye diseases (for example, glaucoma or uveitis), damage to the optic nerves, or bilateral damage to the visual cortex. Patients with acutely developed visual impairment should be urgently hospitalized. At the same time, the information that the emergency doctor is able to collect about the development of vision loss is important and helps to quickly establish a diagnosis at the hospital stage. In this article we will look at what sudden loss of vision is and the causes of this disease.

Causes of vision loss and blindness

Sudden loss of vision in one eye usually results from damage to the retina and other structures of the eye or the optic nerve. One of its common causes is a transient circulatory disorder in the retina. Typically, patients complain of a veil that suddenly falls in front of the eye and sometimes covers only part of the field of vision. Sometimes sensory disturbances and transient weakness in opposite limbs are simultaneously observed. The duration of the episode ranges from several minutes to several hours.

In 90% of cases, the cause is retinal artery embolism from an ulcerated atherosclerotic plaque in the internal carotid artery, aortic arch, or from the heart (often with valvular disease or atrial fibrillation). Less commonly, the cause of vision loss is a drop in blood pressure in a patient with severe stenosis of the internal carotid artery. Sudden loss of vision in one eye is a harbinger of a stroke and should be a reason for active examination of the patient. The likelihood of developing a stroke can be reduced by constant intake of aspirin (100–300 mg per day) or indirect anticoagulants (for cardiogenic embolism).

Migraine as a cause of vision loss

In young people, retinal migraine may cause transient blindness in one eye. The loss of vision in this case is a migraine aura that precedes an attack of headache or occurs shortly after its onset. However, even with a typical history, it is advisable to exclude pathology of the carotid arteries and heart using a special study. The differential diagnosis is also made with a visual aura in the form of a migrating scintillating scotoma during an attack of classical migraine, but the visual aura usually involves the right and/or left visual fields in both eyes, and not one eye, in addition, it remains visible in the dark and when closing the eyes .

Vision loss due to ischemic neuropathy

Anterior ischemic optic neuropathy is caused by insufficient blood flow through the posterior ciliary artery, which supplies the optic disc. Clinically, it manifests itself as a sudden loss of vision in one eye, not accompanied by pain in the eyeball. The diagnosis of vision loss can be easily confirmed by fundus examination, which reveals swelling and hemorrhages in the area of ​​the optic nerve head.

Most often it develops in patients with long-term arterial hypertension and diabetes mellitus, often in patients with vasculitis or polycythemia. In 5% of cases (especially often in patients over 65 years of age), neuropathy is associated with temporal arteritis and requires immediate corticosteroid therapy to prevent loss of vision in the second eye. The diagnosis of temporal arteritis is facilitated by identifying painful thickening and absence of pulsation of the temporal artery and signs of polymyalgia rheumatica.

Posterior ischemic optic neuropathy is less common. It is usually caused by a combination of severe anemia and hypotension and may cause retrobulbar nerve infarction. Sometimes posterior ischemic neuropathy occurs against the background of massive blood loss during surgery, gastrointestinal bleeding, or trauma. There are no changes in the fundus. In hypertensive crisis, a sudden drop in vision may be a consequence of spasm of the retinal arterioles or ischemic edema of the optic nerve head. An excessively rapid decrease in blood pressure can lead to optic disc infarction.

Causes of vision loss: optic neuritis

Optic neuritis, an inflammatory demyelinating disease, often involves the retrobulbar part of the nerve (retrobulbar neuritis), so pathology cannot be detected during the initial examination of the fundus. Most patients, in addition to acute loss of vision, experience pain in the eyeball, which intensifies with its movement. Vision loss often develops at a young age, can recur, and is often the first manifestation of multiple sclerosis. Intravenous administration of large doses of methylprednisolone (1 g per day for 3 days) accelerates recovery.

Loss of vision due to toxic neuropathy

Sudden blindness in both eyes may be a manifestation of toxic optic neuropathy. Toxic neuropathy may be associated with methyl alcohol, ethylene glycol (antifreeze), or carbon monoxide poisoning. A more gradual development of optic neuropathy with increasing atrophy without a disc swelling phase can be caused by a number of drugs - chloramphenicol (chloramphenicol), amiodarone, streptomycin, isoniazid, penicillamine, digoxin, ciprofloxacin, as well as lead, arsenic or thallium poisoning.

Loss of vision due to increased intracranial pressure

Blindness can also be a consequence of intracranial hypertension and the development of congestive optic discs (with benign intracranial hypertension or brain tumors). It is often preceded by short-term episodes of blurred vision in one or both eyes, occurring when changing body position and lasting several seconds or minutes. In case of persistent loss of vision, administration of methylprednisolone (250–500 mg intravenously) and urgent consultation with an ophthalmologist and neurosurgeon are necessary.

Infarction of the occipital lobes of the brain as a cause of vision loss

Acute blindness in both eyes can also be a consequence of bilateral infarction of the occipital lobes (cortical blindness) and occur as a result of blockage of the basilar artery (usually as a result of embolism) or prolonged systemic arterial hypotension. The source of embolism is usually atherosclerotic plaques in the vertebral arteries. Vision loss is often preceded by episodes of vertebrobasilar insufficiency with unilateral or bilateral paresthesias or paresis, ataxia, dysarthria, hemianopia, dizziness, double vision. Unlike bilateral blindness caused by damage to the optic nerves, with cortical blindness, pupillary reactions remain intact. Some patients with cortical blindness develop anosognosia: such a patient denies the presence of blindness, claiming that the room is dark or he simply forgot his glasses.

Acute loss of vision as a symptom of hysteria

Acute loss of vision may be psychogenic in nature and be one of the manifestations of hysteria. Typically, such patients (usually young women) claim that everything around them is immersed in darkness (patients with organic cortical blindness often find it difficult to describe their visual sensations). The history often reveals other hysterical symptoms (lump in the throat, pseudoparesis, hysterical seizures, mutism, hysterical gait disturbances). Pupillary reactions are normal, there are no stem symptoms. Unlike those around them, whose obligatory presence and extreme concern can serve as an additional diagnostic criterion, patients are often not alarmed, but rather calm, and sometimes even smile mysteriously (“beautiful indifference”).

Stroke

Stroke, stroke treatment, stroke prevention, hemorrhagic stroke, ischemic stroke, International Center for Neurosurgery.

Definition

A stroke occurs when blood flow to part of the brain is stopped or significantly reduced. As a result, the brain does not receive enough oxygen and the nutrients it needs. Within minutes, brain cells begin to die.

Stroke is a medical emergency because prompt medical attention can minimize brain damage and possible complications.

The good news is that stroke can be treated and prevented. The key to preventing stroke is strict control of the main risk factors for stroke. These include: high blood pressure, smoking and high level cholesterol.

Symptoms of a stroke

Look for the following symptoms if you think you or someone you know may be having a stroke. Also remember when these symptoms started, as how long they last may have an impact on treatment options.

Main symptoms:

• Walking disorder.
• Impaired speech and understanding of words.
• Paralysis or numbness on one side of the face or entire body. You may feel sudden numbness, weakness, or paralysis on one side of your body. Try raising both arms above your head. If one arm begins to fall, you may have a stroke. Likewise, one side of the mouth may fall down when trying to smile.
• Visual impairment on one or both sides.
• Headache. A sudden, severe, “out of the blue” headache that may be accompanied by vomiting, dizziness, or confusion.

When should you see a doctor immediately?

If you notice any of the above signs, even if they change or disappear, call immediately ambulance. In the event of a stroke, every minute counts. Don't wait, even if your stroke symptoms begin to subside. The later treatment for a stroke is started, the greater the likelihood of brain damage and disability. To ensure maximum effectiveness of stroke treatment, it is necessary to transport the patient to the hospital within 60 minutes of the first symptoms.

What can you do while waiting for an ambulance?

Causes of stroke

When a stroke occurs, blood flow through the brain is disrupted and brain tissue is damaged. There are two main types of stroke. The most common type is ischemic stroke, which results from blockage of blood flow through an artery. Another type, hemorrhagic stroke, occurs as a result of bleeding from a blood vessel in the brain. A transient ischemic attack (TIA)—sometimes called a mini-stroke—occurs when blood flow through the brain is temporarily interrupted.

Ischemic stroke

Almost 90 percent of strokes are ischemic strokes. They occur when the arteries in your brain become narrowed or blocked, resulting in a sharp reduction in blood flow to the brain (ischemia). The lack of blood flow deprives brain cells of oxygen and nutrients, and the cells can begin to die within minutes. The most common types ischemic stroke are:

• Thrombotic stroke. This type of stroke occurs when a blood clot (thrombus) forms in one of the arteries supplying blood to the brain. The clot usually forms in areas affected by atherosclerosis, a disease in which the arteries are clogged with fatty deposits (plaques). The process can occur in one of the two carotid arteries that run through the neck and carry blood to the brain, as well as in other arteries in the neck or brain.
• Embolic stroke. An embolic stroke occurs when a blood clot forms in blood vessels outside the brain—usually in your heart—and travels through the bloodstream into narrower arteries in the brain. This type of blood clot is called an embolus. The cause is an irregular heartbeat (atrial fibrillation). This abnormal heart rhythm can cause blood clots to form in the chambers of the heart, from where they travel to other parts of the body.

Hemorrhagic stroke

Hemorrhage is the medical term for bleeding. A hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures. Brain hemorrhages can result from a number of causes affecting the blood vessels, including uncontrolled high blood pressure (hypertension) and weak spots in the walls of blood vessels (aneurysms). A less common cause of hemorrhage is the rupture of an arteriovenous malformation (AVM), which is a tangle of thin-walled blood vessels and is a congenital pathology. There are two types hemorrhagic stroke:

• Intracerebral hemorrhage, with In this type of stroke, blood leaks from a blood vessel in the brain into surrounding tissue, damaging cells. Brain cells are also damaged due to impaired blood supply. High blood pressure is common cause this type of hemorrhagic stroke. With long-term hypertension, high blood pressure can cause small arteries inside the brain to crack and collapse, leading to hemorrhage.
• Subarachnoid hemorrhage, with In this type of stroke, bleeding develops in the arteries near the surface of the brain, and hemorrhage occurs in the space between the surface of the brain and the skull. Bleeding is often signaled by a sudden, severe headache. This type of stroke is usually associated with a ruptured aneurysm, which may be congenital or develop with age. After a hemorrhage, the brain's blood vessels may widen or narrow randomly (vasospasm), causing damage to brain cells, further restricting blood flow to parts of the brain.

Transient ischemic attack (TIA)

A transient ischemic attack (TIA)—sometimes called a mini-stroke—is a brief episode of symptoms similar to those of a stroke. A transient ischemic attack is caused by a temporary decrease in blood flow to part of the brain. Most TIAs last less than five minutes.

As with an ischemic stroke, in a TIA, a clot disrupts blood flow to part of the brain. But unlike a stroke, which is characterized by a longer-term lack of blood supply and often permanent tissue damage, a TIA does not cause significant damage because the blockage of the vessel is temporary.

Seek emergency medical help even if your symptoms begin to subside. If you have had an episode of TIA, this means that the blood vessels leading to the brain are partially blocked or narrowed and you have big risk development of stroke with significant damage. It is difficult to differentiate between a stroke and a TIA based solely on the presence of symptoms of the disease. Some symptoms go away even in the presence of a stroke with brain damage.

Risk factors

Many factors can increase your risk of stroke. Some of these factors also increase your risk of developing heart disease. Risk factors for stroke include:

• Have a personal or family history of stroke, heart attack, or TIA.
• Age 55 years and older.
• High blood pressure. The risk of stroke begins to increase as blood pressure rises above 115/75 mmHg.
• High cholesterol - total cholesterol levels above 5.2 mmol/L.
• Smoking cigarettes or passive smoking.
• Diabetes.
• Overweight(body mass index from 25 to 29) or obesity (body mass index from 30 and above).
• Lack of physical activity.
• Cardiovascular disease, including heart failure, heart disease, heart infection, or abnormal heart rhythm.
• Usage birth control pills or hormone therapy that includes estrogen.
• Alcohol consumption.
• Drug use.

Because the risk of stroke increases with age and women tend to live longer than men, women are more likely to suffer and die from stroke.

Complications

A stroke can cause temporary or permanent disability, depending on how long the brain suffers from lack of blood flow and what part of the brain is affected. Complications may include:

• Paralysis or loss of muscle movement. Sometimes a lack of blood flow to the brain can cause paralysis on one side of the body or loss of control of certain muscles, such as on one side of a person's face. Physical therapy may lead to improved muscle movement or decreased paralysis.
• Speech or swallowing problems. A stroke can cause loss of muscle control in the throat and mouth, making it difficult to speak, swallow, and eat in general. For a person, having aphasia can be a severe condition in which they experience difficulty expressing thoughts through language. Sessions with a speech therapist and psychotherapist can improve this condition.
• Memory loss or difficulty understanding. Typically, people who have had a stroke have some memory impairment. Others may have difficulty making decisions, reasoning, and understanding concepts. Improvement may be due to rehabilitation therapy.
• Pain. Some people who have had a stroke may complain of pain, numbness, or other strange sensations in parts of the body affected by the stroke. For example, if a stroke caused loss of sensation in your left arm, you may feel a tingling sensation in that arm. You may also become sensitive to temperature changes. This is called central stroke pain or central pain syndrome. The complication usually develops several weeks after the stroke and may subside over time. Sometimes requires treatment.
• Changes in behavior and self-care. People who have had a stroke may become more withdrawn and less socially active. They may lose the ability to care for themselves and often need outside care and daily care.

As with any traumatic brain injury, the success of treating these complications will vary from person to person.

Examination and diagnosis

To determine the most suitable method treatment, the ambulance team must find out what type of stroke the patient has and what parts of the brain are affected. Others must be excluded possible reasons symptoms such as a brain tumor or reaction to drugs. The doctor may use the following tests:

• Physical examination. Doctor asks you or a family member about your symptoms, when they started, the medications you are taking, any head injuries, your personal and family history diseases. He will check your blood pressure, listen to your heart and sounds (murmurs) over your carotid arteries, which may indicate atherosclerosis. The doctor may also use an ophthalmoscope to check for signs of tiny cholesterol crystals or blood clots in the blood vessels at the back of the eye.
• Blood tests. Blood tests provide important information about how quickly your blood clots, what your blood sugar levels are, whether you have an infection, and what your blood chemistry levels are, which is important for deciding how to treat your stroke.
• Computed tomography (CT). Image of a brain that plays key role in determining the presence of stroke and its type. A CT angiography scan is a specialized test in which dye is injected into a vein and X-rays create a 3-D image of the blood vessels in the neck and brain. Doctors use this test for aneurysms and arteriovenous malformations to assess the degree of narrowing of the arteries. CT without angiography can provide an image of the brain and show hemorrhage, but provides less information about the blood vessels.
• Magnetic resonance imaging (MRI). In this type of examination, a strong magnetic field and radio waves create a 3-D image of the brain. MRI can reveal damage to brain tissue during an ischemic stroke. Magnetic resonance angiography (MRA) uses magnetic fields, radio waves and a dye injected into a vein to evaluate the arteries of the neck and brain.
• Ultrasound examination of the carotid arteries. This procedure may show narrowing of the arteries or the presence of blood clots in the carotid artery.
• Arteriography.
• Echocardiography. Ultrasound technology creates an image of the heart and allows the doctor to identify blood clots in the cavities of the heart.

Stroke treatment

Emergency treatment for stroke depends on its type - ischemic or hemorrhagic stroke.

Ischemic stroke

To treat an ischemic stroke, doctors must quickly restore blood flow to the brain.

Treatment with drugs. Treatment with blood thinners should begin within 4.5 hours - the sooner the better. This improves the chances of survival and reduces stroke complications. For this use:

• Aspirin. Aspirin is the most proven effective drug for the immediate treatment of ischemic stroke, reducing the likelihood of a recurrent stroke. The dose of the drug may vary.

Other blood thinners such as warfarin, heparin and clopidogrel may also be used, but not for emergency treatment.

• Administration of tissue plasminogen activator (tPA). Some patients with ischemic stroke will benefit from early administration (within 4.5 hours of onset) of tissue plasminogen activator (tPA), which dissolves the clot and restores blood flow in the blocked artery. The administration of this drug is contraindicated for hemorrhagic stroke.

During treatment ischemic strokes often require procedures that must be performed as quickly as possible. These are the following procedures:

• Using tissue plasminogen activator (tPA) delivered directly to the brain. Doctors may use catheters to inject this drug into the brain.
• Mechanical clot removal. Doctors also use a catheter to maneuver into the brain to mechanically remove the clot.

Other procedures. To reduce the risk of another stroke or TIA, your doctor may recommend procedures to open arteries narrowed by plaque. These may include:

• Carotid endarterectomy. In this procedure, the surgeon removes plaque blocking the carotid arteries in the neck. The blocked artery is opened and the plaque is removed. The procedure may reduce the risk of ischemic stroke. However, carotid endarterectomy itself can also cause a stroke or heart attack by promoting blood clot formation. To reduce the risk of stroke, special filters are used at strategic points in the blood flow.
• Angioplasty and stenting. Angioplasty is another method of widening the arteries leading to the brain, usually the carotid arteries. This procedure uses a catheter balloon that inflates to compress the plaque and dilate the arteries. More often, stenting is used with the placement of special metal tubes (stents) in the narrowed areas of the arteries, which remain in the artery, preventing its narrowing. Placing a stent in an artery in the brain (intracranial stenting) is similar to stenting in the carotid arteries.

Hemorrhagic stroke

Acute treatment of hemorrhagic stroke focuses on controlling bleeding and reducing pressure in the brain.

Emergency measures. If you are taking warfarin or antiplatelet drugs to prevent clots, such as clopidogrel (Plavix), you may receive blood transfusions or medications to counteract the effects of warfarin or clopidogrel. You may need medications to lower your blood pressure. The use of aspirin and tissue plasminogen activator is prohibited because it may worsen bleeding.

Treatment for hemorrhage usually involves bed rest. If the bleeding area is large, surgery may be needed to remove the blood and relieve pressure on the brain.

Surgical reconstruction of blood vessels. Surgery may be used to repair certain blood vessel abnormalities associated with hemorrhagic stroke. Your doctor may recommend one of these procedures after a stroke or when high risk spontaneous rupture of aneurysms or arteriovenous malformation (AVM):

• Aneurysm clipping. Tiny clamps are placed at the base of the aneurysm, sealing it off from blood flow in the artery. This may keep the aneurysm from rupturing or prevent the aneurysm from bleeding again. The clip remains in place permanently.
• Embolization of aneurysm. This procedure is an alternative to aneurysm clipping. Surgeons use a catheter to maneuver inside the aneurysm.
• Surgical removal AVM. Surgical removal of small AVMs in accessible parts of the brain can eliminate the risk of rupture and reduce the overall risk of hemorrhagic stroke. This does not apply to AVMs that are too large or deep inside the brain.

Recovery and rehabilitation

After initial measures, stroke treatment focuses on helping the patient regain strength, function, and return to independent living. The effect depends on the area of ​​the brain damaged and the extent of the damage. Damage to the right side of the brain can affect movement and sensation in the left side of the body. Damage to the left side of the brain can affect movement in right side, may cause speech disorders. In addition, stroke patients may have problems breathing, swallowing, balance, and hearing. Possible loss of vision, impaired bowel and bladder function.

People who have had a stroke need treatment using rehabilitation programs. Your doctor will help you choose a program based on your age, general health, and degree of disability. Lifestyle, interests and priorities, and the presence of other family members are also taken into account.

A rehabilitation program may begin before hospital discharge. It can continue in specialized rehabilitation departments, sanatoriums, and at home. The degree of recovery after stroke in different people different.

Stroke Prevention

The key to preventing stroke is identifying risk factors, following your doctor's recommendations, and maintaining a healthy lifestyle. If you've had a stroke or TIA, these steps will also help prevent another. A healthy lifestyle includes:

• Controlling high blood pressure (hypertension). If you have had a stroke, lowering your blood pressure will help prevent another transient ischemic attack or stroke. Stress management, maintenance normal weight, limiting salt and alcohol intake will help keep blood pressure under control. Adding more potassium to your diet may also help. In addition to recommendations for lifestyle changes, your doctor may prescribe medications to treat high blood pressure, such as diuretics, calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers.
• Reduce cholesterol and saturated fat in your diet. Diet adjustments and statin use are necessary to lower cholesterol levels.
• To give up smoking. Smoking increases the risk of stroke for smokers and nonsmokers exposed to secondhand smoke. Quitting smoking reduces risk several years after quitting.
• Diabetes control. Diabetes can be managed through diet, exercise, weight control and treatment.
• Healthy weight support. Excess weight contributes to other risk factors for stroke, such as high blood pressure, heart disease and diabetes. Losing weight can lower blood pressure and reduce blood cholesterol levels.
• Maintain a diet rich in fruits and vegetables. A diet containing five or more servings of fruits or vegetables may reduce the risk of stroke.
• Physical activity. Aerobic exercise reduces the risk of stroke in different ways. Exercise can lower blood pressure, increase high-density lipoprotein (“good” cholesterol) levels, and improve overall blood vessel and heart health. It also helps you lose weight, control diabetes and reduce stress levels. 30 minutes of activity - walking, running, swimming or cycling - gives good results.

Preventative treatment

Your doctor may also consider prescribing Agrenox, a drug that combines low doses of aspirin and dipyridamole to reduce blood clotting. Clopidogrel (Plavix) or ticlopidine (Ticlid) may be prescribed.