What kind of disease is a stroke

Sergey Vasin, Atlas

Stroke is an acute violation of cerebral circulation. In Russia, it overtakes half a million people every year, 70% of patients become disabled. Atlas told us what a stroke is, what causes it and how to detect it.

Ischemic stroke

70% of all strokes are ischemic. This circulatory disorder, due to which a part of the brain dies, occurs most often after 60 years.

Possible risk factors for ischemic stroke include arterial hypertension, atherosclerosis of the carotid and vertebral arteries and pathology of the heart valves.

Most often, cerebral ischemia occurs when fats are deposited in the blood vessel and an atherosclerotic plaque appears. Due to the increase in size, it can rupture, and then a blood clot forms, which clogs the vessel. If atherosclerosis develops slowly, collaterals open – additional blood flow pathways bypassing the blockage.

As a rule, an ischemic stroke progresses gradually, and therefore the symptoms occur in ascending order. For example, the patient feels increasing weakness in the right leg, then weakness in the right arm appears, and after a few days this side of the body is taken away.

Hemorrhagic stroke

Brain hemorrhage accounts for 25-30% of all strokes. It usually occurs in 30-60 years, they die from it in half of the cases.

Arterial hypertension, atherosclerosis and inflammation of the vascular wall are considered risk factors.

Basically, hemorrhage occurs for two reasons: it is either a rupture or a spasm of a vessel in the brain. With spastic contractions, the vessel becomes permeable, and blood enters the medulla. Spasms occur due to a sharp expansion of blood vessels and an increase in blood flow under high pressure.

In some cases, an aneurysm rupture in the brain also leads to hemorrhage. Aneurysm is a pathological dilation of an artery. Due to the expansion, it bulges out, and a pouch is formed. Under the flow of blood, the sac is torn, and there is a hemorrhage in the brain, which is also called subarachnoid.

All symptoms appear suddenly in 30-90 minutes. In a seemingly healthy person, the muscles partially paralyze, the face is distorted or the eyes look in different directions. Pupils are dilated and do not react to light in any way. All this can be accompanied by disorders of consciousness such as sopor, convulsions and repeated vomiting.

How to recognize and help

Regardless of the type of stroke, symptoms can be detected on the spot. To do this, ask the person to smile, speak and raise their hands.

In case of stroke:

• the smile is crooked – one of the corners of the lips is directed down, not up;
• diction is often broken – a person can 't connect pairs of phrases and speaks sluggishly;
• one hand rises slower and lower than the other.

If any of the items match, call an ambulance and tell us what exactly is wrong. An intensive care team will be sent to you.

Before the arrival of doctors, take care of the patient's breathing. Unbutton his clothes, put him on the bed so that his head and neck form a straight line at an angle of 30 °, and do not let him eat. When vomiting, turn the patient on his side. If he has lost consciousness, immediately start artificial respiration and heart massage.

Illustration by Rita Cherepanova from the website "Such things"

The most important thing is to see doctors in time. If an ischemic stroke is diagnosed in the first hour, they will be able to remove a blood clot or restore blood supply to the brain with medication. If a hemorrhage is found in time, and the remaining indicators are normal, the accumulation of blood will be immediately removed. And the chance to return to normal life will increase.

Preventive examination can be performed at the Atlas Medical Center.

Sources: WHO.
 10 leading causes of death in the world, 2017
Mayo Clinic. Stroke, 2017
Merk Manual. Ishemic Stroke, 2016
The Lancet. Subarachnoid Haemorrhage, 2007

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