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Ischemic stroke
مقاله تخصصی

Ischemic stroke

3 months ago
538 بازدید
Dr. Majid Kihani Fard

Dr. Majid Kihani Fard

Tehran

Neurologist

There are two types of stroke: ischemic stroke and hemorrhagic stroke. Ischemic stroke is characterized by a sudden loss of blood flow to a part of the brain, leading to neurological dysfunction. Acute ischemic stroke is caused by cerebral artery embolism. Ischemic attack or TIA?. According to the definition of transient ischemic attack, there are no permanent neurological signs of damage to the brain as a result of damage to blood flow.. In the past, neurologists believed that TIA symptoms lasted less than 24 hours, but with the advent of MRI, they realized that many patients whose symptoms lasted less than 24 hours still had evidence of stroke changed from 12 hours to MRI.. Less... Some patients after TIA have evidence of stroke on MRI Although it has not caused permanent neurological symptoms.. The difference between TIA or transient ischemic attack and stroke is not very important because both of these conditions indicate problems with blood supply to the brain and therefore both of these conditions require immediate and special attention. It is less than men.. ### Risks of transient ischemic attack The prevalence of TIA or transient ischemic attack before stroke is estimated to be approximately 10%. The relatively low prevalence of TIA in stroke is likely due to several factors, including underlying pathology such as carotid artery disease or the cardiac origin of the stroke. Vascular after TIA and ischemic stroke has shown that the risk of stroke after TIA will be about 5.9% within 90 days and 5.14% within one year.. So the combined risk of stroke in the brain 21 to heart attack or death is calculated to be about 21%.. TIA or transient ischemic attack is a serious condition that should be carefully investigated... Also TIA is an important warning sign of vascular disease... from one of the heart attacks in Patients are considered.... Symptoms similar to transient ischemia can occur in other diseases such as tumors, cerebral hemorrhage, and inflammatory conditions of the brain. Therefore, if you observe any of the symptoms of TIA, it is necessary to carefully investigate these symptoms. Cerebral ischemic stroke. A stroke is diagnosed in all patients with an acute neurological decline or any change in a person's level of consciousness. The common signs and symptoms of a stroke include the following: - Sudden onset of motor weakness on one side of the body, incomplete paralysis of one limb or (rarely) quadriparesis (incomplete paralysis of four arms and legs)... - Loss of vision in one or both eyes... - Decreased field of vision - double vision (double vision) - Inability to control and coordinate the muscles needed to speak - Facial paralysis - Ataxia (irregularity and incoordination of movements) - Dizziness - Dudok; Sudden, involuntary and rhythmic eye movement - Impaired expression or understanding of language - Sudden decrease in level of consciousness Although these symptoms can occur alone, they are more likely to occur together... There are no features or symptoms to distinguish ischemic stroke from hemorrhagic stroke, although nausea, vomiting, headache, and sudden changes in the level of consciousness are more common in hemorrhagic strokes. Migraines or the use of oral contraceptives can be triggers. Perform a brief but accurate neurological examination for patients with suspected stroke syndrome... The goals of such tests include the following: - Confirming the presence of stroke symptoms (neurological disorders) - Diagnosing a stroke from the symptoms of a false stroke - Creating a nervous base and observing the improvement or deterioration of the patient's condition - Determining the condition and severity of a stroke by using a neurological test and score (stroke scale of the National Institute of Health \ [NIHSS\]) to check the symptoms before a stroke and predict the patient's condition and choose the type of treatment... ### Examining cerebral ischemic stroke patients The main and necessary components of the neurological examination include the following examinations: - Cranial nerves - Movement function - Brain function - walking - Deep tendon reflexes - Language and speech (ability to express and understand content) - Mental state and level of consciousness The skull and spine should also be tested and the signs of meningism should be checked.. ### Diagnosis of cerebral ischemic stroke Emergency brain imaging is an essential procedure to investigate acute stroke. Computed tomography scan is the most common type of neuroimaging in the acute phase of the disease... The following neuroimaging techniques may also be used in emergency situations: - CT angiography or CT perfusion - Magnetic resonance imaging (MRI) - Carotid duplex scan - Digital subtraction angiography #### \# Waist slit Lumbar cavity is used to remove cerebrospinal fluid or subarachnoid fluid when the result of CT scan is negative but doctors still doubt the presence of disease. #### \# Laboratory test Laboratory tests are used to diagnose and investigate ischemic stroke in the brain, including the following: ##### 1) Comparing the number of blood cells (CBC) An initial test and procedure that may determine the cause of stroke (eg, polycythemia, thrombocytopenia, leukemia) and provide evidence of possible complications and confirm the absence of thrombocytopenia during fibrinolytic therapy. ##### 2) Initial metabolic testing A baseline study that shows stroke-like symptoms (eg, hypoglycemia, hyponatremia) or provides evidence of a preexisting condition (eg, diabetes, renal failure)... ##### 3) Blood coagulation studies These tests can determine possible coagulation syndrome and are used when blood clotting drugs or anticoagulants are used. ##### 4) Cardiac biomarkers The importance of this test is the examination of cerebrovascular diseases and coronary artery diseases... ##### 5) Toxicology examination This test can be useful in identifying the possibility of toxicity in the body of patients with stroke-like symptoms or the use of sympathomimetics (adrenergic receptor agonists) that cause ischemic and hemorrhagic cerebral strokes. ###### 6) Pregnancy test Urinalysis for pregnancy should be performed in all women of childbearing age with symptoms of stroke. Recombinant tissue plasminogen activator protein (rt-PA) is considered a class C pregnancy factor.. ### Emergency management of stroke Emergency management of stroke requires the following actions to be taken in 60 minutes or less to keep the patient alive: - Examining the airway, breathing and blood flow and stabilizing the patient's condition (including bleeding control, warming the patient's body, etc.) if necessary... - The need to examine and open the airway - Optimal control of blood pressure - Detection of potential reperfusion therapies (such as intravenous fibrinolysis by rt-PA (alteplase, which is a thrombolytic drug) or intra-arterial procedures and drugs) The doctor's knowledge and participation with stroke training is considered an ideal and suitable situation.... When the care unit for patients who have suffered stroke injuries includes trained nurses and doctors, it can clearly create a high efficiency in saving the lives of patients.... ### Ischemic cerebral stroke treatment Treatment of ischemic stroke includes the following: - Fibrinolytic treatment - Anticoagulants - Mechanical thrombectomy Treatment in conditions where other diseases are also seen in the person include: - Reduce fever - Correction of high or low blood pressure - Correction of hypoxia - Correction of hypoglycemia - Management of cardiac arrhythmias - Management of myocardial ischemia ### The newest treatment methods for ischemic stroke in the world In the past, the field of treatment for ischemic stroke was open surgery and removing the blood clot from the blood artery, which was associated with many complications and a long recovery period, but fortunately, the current methods that are performed through angiography, have been able to save the lives of patients well and with much less complications, and the complications caused by it can be opened in the angiography machine. See cerebral.. ### Prevention of cerebral ischemia Primary stroke prevention refers to the treatment of people who have not had a previous history of stroke. Criteria may include: - Anticoagulants and drugs - Statins (cholesterol-lowering drugs) - Sports - Factors involved in a person's lifestyle (such as smoking, alcohol consumption) Secondary prevention refers to the treatment of people who have had a previous stroke.. Criteria may include the use of: - Anticoagulants and drugs - Antihypertensive drugs - Statins - Factors involved in lifestyle ### A word with the patient's companions I suggest you read the article on emergency resuscitation (what is CPR) to save the patient's life if necessary..
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