Mental state after hemorrhagic stroke. Hemorrhagic stroke consequences

Hemorrhagic stroke of the brain is a sudden violation of the cerebral circulation with the formation of a hematoma or blood soaking of the nervous tissue. Damage to the substance of the brain entails significant neurological disorders up to the complete loss of motor and sensory functions, as well as impaired swallowing, speech, and breathing. Stroke has a high probability of death, and most of the surviving patients remain permanently disabled.

Unfortunately, the word "stroke" is familiar, if not to everyone, then to most of us. Increasingly, such a diagnosis can be found among people of working age. Such a condition means a violation of blood circulation in the brain due to various reasons, as a result of which either necrosis occurs - then they talk about ischemic stroke (brain infarction), or outflow of blood into the brain tissue - then they talk about a hemorrhagic type of stroke, which will be discussed in this article.

According to statistics, mortality in the first month from the onset of the disease reaches 80% even in countries with a high level of medical development. Survival after hemorrhagic stroke is low and significantly lower than in cerebral infarction. During the first year, 60-80% of patients die, and more than half of the survivors remain permanently disabled.

Causes and risk factors for cerebral hemorrhage

The mechanisms of development and etiology of this insidious disease are well studied and described in textbooks on neurology, however, diagnostic difficulties, especially at the prehospital stage, still exist. So what are the main causes of hemorrhagic stroke? To date, the most common of these are:

• Vascular and.
• Among more rare causes can be called:
• Inflammatory and dystrophic changes in the vascular walls (, amyloid angiopathy);
• Diseases accompanied by a violation of blood clotting (,);
• Appointment, and fibrinolytic agents (aspirin, heparin, warfarin);
• Cirrhosis of the liver, in which there is a violation of the synthesis of blood coagulation factors in the liver, the number of platelets decreases, which inevitably leads to the development of bleeding and hemorrhage, including in the brain;
• Hemorrhages in a brain tumor.

It should be noted that the word stroke is more correctly used in cases where arterial hypertension acts as a causative factor or there are vascular anomalies, while the second group of causes causes secondary hemorrhages and the term "stroke" in such cases is not always used.

In addition to the above factors that create a morphological substrate for the disease (damage to the vascular wall), there are also predisposing, like so:

1. Smoking;
2. alcohol abuse;
3. Addiction;
4. Obesity and lipid spectrum disorders;
5. Age over 50;
6. Adverse family history (hereditary factor).

Speaking of hemorrhages in the brain, one cannot fail to mention the vascular wall. As a rule, the presence of lipid plaques leads to the closure of the lumen of the vessels with the development of necrosis - cerebral infarction, or ischemic stroke. At the same time, damage to the vascular wall with its thinning, atheromatosis, ulceration in conditions of high blood pressure creates all the conditions for subsequent rupture and hemorrhage.

Video: non-standard causes of stroke

Mechanisms of development of hemorrhagic stroke

As you know, most of the world's population suffers after 40-50 years. Many people simply do not pay attention to the alarming ones or do not even know that the disease already exists and is progressing without giving any manifestations. In the same time, are already taking place in the body irreversible changes, which primarily relate to arterial vessels. The brain in this case is the so-called "target organ" along with the kidneys, retina, heart, adrenal glands.

In the arteries and arterioles, under the influence of increased pressure, their muscle layer thickens, impregnation with plasma proteins, fibrinoid changes up to necrosis of sections of the vascular wall. Over time, these vessels become brittle, microaneurysms (local expansions) occur, which, with sudden rises in blood pressure (), are more likely to rupture with blood penetrating into the brain tissue. In addition, damage to the vascular walls is often accompanied by an increase in their permeability, as a result of which blood escapes through them (diapedetic bleeding) and, as it were, saturates the nervous tissue, penetrating diffusely between cells and fibers.

If arterial hypertension leads to acute hemorrhagic stroke, usually in the elderly, then changes such as aneurysms or vascular malformations are the lot of young people and even children and adolescents.

photo: ruptured saccular aneurysm in hemorrhagic stroke

is a local expansion of the lumen of the vessel, usually of a congenital nature, having an irregular wall structure.

- these are congenital malformations in the development of blood vessels with the formation of tangles, entanglements, pathological connections between the arterial and venous bed without the presence of a capillary network, in which blood is discharged directly from the arteries into the veins, which is accompanied by a disruption in the supply of oxygen and nutrients to the tissue.

Vascular aneurysms and malformations often do not give any clinical manifestations until they rupture and bleed. This is their "deceit", because patients or their relatives do not even suspect the presence of such a pathology.

a serious malformation of the vessels of the brain that can lead to a stroke at

This problem is especially acute in children and adolescents, when sudden brain damage can leave indelible consequences for the rest of their lives or even lead to death.

In the case of hypertension or vascular anomalies, compliance with healthy lifestyle life. Smoking, obesity, alcohol abuse can create that unfavorable background that will significantly accelerate the progression of the disease itself, as well as increase the likelihood of its severe course and death.

The main types of hemorrhagic strokes and their classification

Depending on the location and characteristics of structural changes in the brain, several types of strokes are distinguished according to the hemorrhagic type. Allocate:

• Subarachnoid hemorrhage;
• Parenchymal hemorrhage;
• Intraventricular hemorrhage;
• Sub- and epidural hemorrhage (non-traumatic).

is an accumulation of blood under the pia mater, consisting of vessels and covering the outside of the brain. As a rule, the cause of this type of stroke are aneurysms and vascular malformations. When a vessel ruptures, blood spreads over the surface of the brain, and sometimes involves its tissue in the pathological process - then they talk about subarachnoid-parenchymal hemorrhage.

Parenchymal hemorrhage- the most common type of stroke, in which blood enters directly into the substance of the brain. Depending on the nature of the damage, there are two types of parenchymal hemorrhages:

1. Hematoma;
2. Hemorrhagic impregnation.

Hematoma is a cavity filled with blood. With this type of stroke, the death of cellular elements in the affected area occurs, which causes a serious neurological deficit with severe clinical symptoms and a high risk of death. Nervous tissue is highly specialized and very complex in functional and structural terms, and neurons are not able to multiply by division, so such damage does not give a chance for a favorable outcome.

At hemorrhagic impregnation there is a penetration of blood between the elements of the nervous tissue, however, such a massive destruction and death of neurons, as with a hematoma, does not occur, therefore, the prognosis is much more favorable. As a rule, the main cause of this type of stroke is an increase in vascular permeability with erythrocyte diapedesis in arterial hypertension, thrombocytopenia, and anticoagulant treatment.

Intraventricular hemorrhages are possible with ruptures of the choroid plexuses located in them, but more often they are of a secondary nature. In other words, blood enters the ventricular system of the brain in the presence of large hemispheric hematomas. In this case, obstruction (closing) of the liquor pathways with blood occurs, hydrocephalus develops due to a violation of the outflow of cerebrospinal fluid from the cranial cavity, cerebral edema rapidly increases. The chances of surviving in such a situation minimal. As a rule, such patients die in the first 1-2 days after the penetration of blood into the ventricles of the brain.

Sub- and epidural hemorrhages, although they relate to strokes, as a rule, they are traumatic in nature and are the lot of neurosurgery.

In addition to the listed types of strokes, there are also their various options depending on the localization the focus of the lesion. So, they distinguish:

• Lobar hemorrhages, located within one lobe of the brain;
• Deep strokes affecting the subcortical nuclei, deep parts of the brain, the internal capsule;
• Hemorrhagic stroke of the cerebellum;
• Stem hemorrhagic stroke.

Speaking of extensive hemorrhagic stroke, they usually mean damage to several parts of the brain or several of its lobes at the same time. This condition is accompanied by damage to a significant part of the parenchyma, the rapid development of edema and, as a rule, is incompatible with life.

It is understood as small foci of damage to the brain tissue that occur against the background of vasospasm in arterial hypertension, diabetes mellitus. Clinical signs in the form of neurological symptoms most often resolve within 24 hours of their onset. It is important to start treatment as early as possible, preferably within the first 6 hours. A relatively mild course and the absence of irreversible changes should not disregard this condition, which indicates that changes in the vessels of the brain are already pronounced, and the development of a massive stroke may become the next stage.

In accordance with the international classification, acute disorders of cerebral circulation belong to the group of cerebrovascular diseases included in class IX (includes all diseases of the circulatory system), and are denoted by the letter I (lat.). According to ICD-10, hemorrhagic stroke is coded under heading I61, where an additional number after the dot indicates its localization, for example, I 61.3 - stem intracerebral hemorrhage.

Despite its wide prevalence, the word "stroke" cannot be used in the diagnosis. So, it is necessary to indicate its specific type: hematoma, hemorrhagic impregnation or heart attack, as well as the localization of the lesion.

Due to the high social significance associated with significant mortality and disability of most of the surviving patients, the diagnosis of cerebral hemorrhage is always heard under the heading of the underlying disease, although in fact it is a complication, in particular, of arterial hypertension.

Video: causes and types of strokes

Clinical manifestations of hemorrhages in the brain

The signs of a hemorrhagic stroke are so diverse and even complex that sometimes not every doctor can see them, but a neurologist can easily make this diagnosis. Such dangerous state can catch the patient anywhere: on the street, in public transport and even on vacation at sea. It is important that at this moment there are, if not specialists, then at least people who are ready to call a doctor or an ambulance, as well as provide first aid and participate in transporting the patient.

The clinic of hemorrhagic stroke is determined, first of all, by the localization of the lesion and its size. Depending on which brain structures are damaged, specific signs of a violation of one or another of its functions will appear. As a rule, the motor and sensitive spheres most often suffer, speech with damage to the hemispheres. With the localization of hemorrhage in the brain stem, damage to the vital respiratory and vasomotor centers is possible with a high risk of rapid death.

infographic: AiF

Depending on the time since the onset of the disease and clinical manifestations, the following periods of hemorrhagic stroke can be distinguished:

1. Acute period;
2. recovery period;
3. Residual period.

In the acute period cerebral symptoms associated with increased pressure in the cranial cavity due to hemorrhage predominate. It lasts up to a week and is accompanied by the accumulation of blood with damage to the nervous tissue up to necrosis. The most dangerous in the acute phase is the rapid development of cerebral edema with the dislocation of its structures and the wedging of the trunk, which will inevitably lead to death.

Recovery period begins from 2-4 weeks, when reparative processes are already beginning in the brain, aimed at removing blood and restoring the structure of the parenchyma due to the multiplication of neuroglial cells. This period can last several months.

Residual period continues for the rest of your life. With adequate and timely medical and rehabilitation measures, it is sometimes possible to restore quite well many functions of the body, speech and even working capacity, and patients live more than one year after a stroke.

The disease occurs more often suddenly, during the day, at the time of an increase in blood pressure (hypertensive crisis), with a strong physical activity or emotional stress. The person suddenly loses consciousness, falls, vegetative manifestations appear in the form of sweating, changes in body temperature, reddening of the face, or, less commonly, pallor. In some patients, breathing is disturbed, tachy-or appears, or the rapid development of coma is also possible.

Superficial epidural and subdural hematomas (pictured) may be accompanied mainly by the first group of symptoms

Symptoms of hemorrhagic stroke can be divided into two groups.

Cerebral symptoms

Cerebral symptoms due to increased intracranial pressure due to the accumulation of blood in the brain. The greater the volume of hemorrhage and the rate of its development, the more pronounced they will be. General cerebral manifestations of hemorrhagic strokes include:

1. severe headache;
2. vomiting;
3. Violation of consciousness;
4. Convulsive syndrome.

Focal neurological manifestations

Focal neurological symptoms associated with damage to a particular department nervous system. Yes, at hemispheric hemorrhages, the most common, the typical symptoms are:

1. Hemiparesis or hemiplegia on the opposite side of the lesion (complete or partial movement disorder in the arm and leg), decreased muscle tone and tendon reflexes;
2. Hemihypesthesia (impaired sensitivity on the opposite side);
3. Gaze paresis (eyeballs will be turned towards the hemorrhage), mydriasis (pupil dilation) on the side of the lesion, drooping of the corner of the mouth and smoothness of the nasolabial triangle;
4. Speech impairment with damage to the dominant hemisphere (left in right-handers);
5. The appearance of pathological reflexes.

• So, with a hemorrhagic stroke of the left side of the brain, the main symptoms will be expressed on the right, and in right-handed people there will also be speech impairment. With the defeat of the right side - on the contrary, but speech will be impaired in left-handed people, which is associated with the peculiar location of the speech center in the brain.
• When defeated cerebellum characteristic signs will be a headache in the back of the head, vomiting, severe dizziness, impaired walking, inability to stand, change in speech. With large cerebellar hemorrhages, edema quickly develops and wedging it into the large occipital foramen, which leads to death.
• With massive hemorrhages in the hemispheres often occurs breakthrough in blood ventricles of the brain. This condition is accompanied by a sharp disturbance of consciousness, the development of coma and poses an immediate threat to life.
• subarachnoid hemorrhage accompanied by severe headache and other cerebral symptoms, as well as the development of coma.
• brain stem stroke is a very dangerous condition, since vital nerve centers, as well as nuclei of cranial nerves, are located in this department. With hemorrhage in the trunk, in addition to the development of bilateral paralysis, impaired sensitivity and swallowing, a sharp loss of consciousness is possible with the rapid development of coma, dysfunction of the respiratory and cardiovascular systems due to damage to the respiratory and vasomotor centers. In such severe cases, the probability of death reaches 80-90%.

Unfortunately, the prognosis in the case of coma after a hemorrhagic stroke is disappointing. Especially often coma occurs with stem, massive hemispheric and cerebellar hemorrhage. Despite intensive therapy, such patients die, as a rule, in the acute period of the disease.

Video: signs of a stroke

Diagnostic methods

If a cerebral hemorrhage is suspected, it is necessary to carefully question the patient's complaints if the ability to meaningful speech is preserved. If possible, even through relatives, to find out if the patient had previous arterial hypertension, the features of the development of the disease. As a rule, the main neurological defects are noticeable even to a non-professional. So, it is enough to talk to the patient, ask him to smile or show his tongue in order to suspect a brain lesion. The impossibility of walking, impaired consciousness, speech, as well as the sudden development of such symptoms indicate an acute circulatory disorder in the brain.

In stationary conditions, the diagnosis of hemorrhagic stroke is carried out with the help of a thorough neurological examination by a specialist doctor. The main instrumental method is currently considered to be an affordable and very informative diagnostic method. With CT, you can determine the localization, size of the lesion.

With small sizes of foci, the presence of vascular malformations, it is possible to use it, however, this method is expensive and not always available. In cases of subarachnoid hemorrhage, it may be informative to study the cerebrospinal fluid during lumbar puncture when the detection of erythrocytes in the CSF will be a reliable diagnostic criterion.

For the diagnosis of subarachnoid hemorrhages and, especially, vascular aneurysms and malformations, a highly informative diagnostic method can be angiography. With this research method, it is possible to determine the nature of blood flow in the affected sections of the vascular bed, the presence of anomalies in the development of blood vessels by introducing radiopaque substances. In addition, angiography data will be very useful for the subsequent surgical treatment of aneurysms.

Differential diagnosis for stroke

In the differential diagnosis of hemorrhagic stroke, it is necessary to distinguish it from brain tumors with secondary hemorrhage, abscesses, cerebral infarctions, epilepsy, traumatic injuries and even hysteria, especially in young women after suffering severe stress. In such cases, in addition to the data of the anamnesis, examination and neurological examination, CT and MRI, electroencephalography, and radiography of the skull come to the rescue.

Often the question arises as to whether an ischemic or hemorrhagic stroke developed in this case? For differential diagnosis, it is necessary to know the difference from hemorrhagic. So, hemorrhages in the brain are less common, but the mortality from them is much higher; they occur suddenly, during the day, more often in young people, while cerebral infarctions may be accompanied by a period of precursors and occur more often at night or in the morning, among complete rest. In addition, with hemorrhages in the brain, an accumulation of blood (hematoma) is formed, and with heart attacks, ischemia and necrosis will be observed, that is, bleeding and, as a result, cell death.

Complications and consequences of cerebral hemorrhages

Complications of hemorrhagic stroke can occur both in the acute period and for a long time after the onset of hemorrhage. Among the most dangerous are:

• Breakthrough of blood into the ventricular system;
• Increasing cerebral edema;
• Development of occlusive hydrocephalus;
• Violation of systemic hemodynamics and function of external respiration, especially with damage to the brain stem.

These complications appear more often in the acute period and lead to the death of patients.

Another group of complications is associated with dysfunction of the pelvic organs, heart, prolonged lying position and weakening of the body's defense reactions. Among them, the most characteristic are:

1. congestive pneumonia;
2. Urinary tract infections;
3. Sepsis;
4. bedsores;
5. in the veins of the leg with the risk of development;
6. Decompensation of cardiac activity,.

Currently, the most common causes of death in patients with cerebral hemorrhages are its edema, dislocation of structures (displacement relative to each other) and wedging of the brain stem into the foramen magnum. In a later period, infectious and inflammatory complications, in particular, pneumonia, are most common.

Approaches to the treatment of hemorrhagic stroke

If you suspect a cerebral hemorrhage, you should call a doctor or an ambulance as soon as possible. In no case should the patient get up, walk, or move with the help of relatives. Treatment of hemorrhagic stroke should be started as soon as possible. early dates. When carrying out the necessary activities in the first 6 hours after the onset of the attack significantly increases the likelihood of a favorable outcome.

infographic: AiF

Treatment of cerebral hemorrhages should be carried out only in specialized clinics, and in the first week it is desirable to place the patient in the intensive care unit under constant medical supervision. Subsequently, with a favorable course, the patient is transferred to a specialized neurological or department for patients with vascular pathology of the brain. It is important that the hospital has the possibility of round-the-clock diagnostic measures such as CT and MRI, as well as the possibility of emergency neurosurgical intervention.

First aid for hemorrhagic stroke will be provided by an ambulance team at the pre-hospital stage and on the way to the hospital. It includes:

• Transportation of the patient in a prone position with a raised head end;
• Normalization of blood pressure by administering antihypertensive drugs (clophelin, dibazol, enalapril);
• The fight against cerebral edema with the help of osmotic diuretics (mannitol);
• The use of drugs aimed at stopping bleeding (etamsylate);
• The introduction of anticonvulsants if indicated, sedative therapy (Relanium);
• Maintaining, if necessary, the function of external respiration and cardiac activity.

Further treatment of hemorrhagic stroke, in a hospital setting, can be conservative and operative.

Surgery for a stroke

Surgical treatment is carried out in the Department of Neurosurgery, as a rule, in the first three days from the onset of the disease. Indications for surgery for hemorrhagic stroke are:

1. Large hemispheric hematomas;
2. Breakthrough of blood into the ventricles of the brain;
3. Rupture of the aneurysm during growth.

Removal of blood from a hematoma is aimed at decompression, that is, reducing pressure in the cranial cavity and on the surrounding brain tissue, which significantly improves the prognosis and also helps to save the patient's life.

Non-surgical treatment

Conservative treatment cerebral hemorrhage involves basic and specific neuroprotective and reparative therapy with the prescription of drugs from various pharmacological groups.

Basic stroke therapy includes:

• Maintain adequate lung function, if necessary - tracheal intubation and artificial ventilation;
• Normalization of blood pressure (labetalol, enalapril for hypertensive patients, infusion therapy, dopamine for hypotension), correction of the heart in arrhythmias;
• Normalization of water-salt and biochemical balance (infusion therapy, the appointment of diuretics - lasix);
• Appointment of antipyretic drugs for hyperthermia (paracetamol, magnesium sulfate);
• Reduction and prevention of cerebral edema (mannitol, albumin solution, sedatives, drainage of cerebrospinal fluid);
• Symptomatic therapy - for convulsive syndrome (diazepam, thiopental), cerucal for vomiting, fentanyl, haloperidol - for psychomotor agitation;
• Prevention of infectious and inflammatory complications (antibiotic therapy, uroseptics).

Specific drugs for the treatment of hemorrhagic stroke should have a neuroprotective, antioxidant effect, improve repair in the nervous tissue. The most frequently prescribed ones are:

1. Piracetam, actovegin, cerebrolysin - improve the trophism of the nervous tissue;
2. Vitamin E, mildronate, emoxipin - have an antioxidant effect.

Consequences and prognosis

Life after a hemorrhagic stroke can create many difficulties not only for the patient himself, but also for his relatives. Long-term rehabilitation, the irretrievable loss of many vital functions require patience and perseverance. As a rule, the majority of patients lose their ability to work. In such a situation, it is important to maintain at least the ability to self-service and independent living.

It implies carrying out:

• Therapeutic physical education;
• massage;
• Physiotherapy procedures.

If necessary, a psychotherapist works with the patient, and occupational therapy is also useful, aimed at restoring working capacity and self-service.

The consequences of a hemorrhagic stroke, as a rule, remain for the rest of your life. Violations of motor and sensory function, speech, swallowing require constant attention from relatives caring for the patient. In case of impossibility of movement and walking, it is necessary to ensure the prevention of bedsores (adequate hygiene, especially in violation of the function of the pelvic organs, treatment of the skin). It is also necessary to take into account the possibility of impaired cognitive functions - attention, thinking, memory, which can significantly complicate contact with the patient at home.

First of all, consists of a healthy lifestyle, exclusion bad habits normalization of blood pressure levels. In the presence of adverse hereditary factors, it is important to explain that timely prevention will help to avoid the development of the disease and its dangerous complications.

Video: hemorrhagic stroke, cerebral hemorrhage

Red circles before the eyes

Violation of the rhythm of breathing

Violation of cardiac activity

Slurring of speech

Pulsating sensation in the head

Paralysis

Low blood pressure

Loss of orientation in time

Different pupil diameter

Hemorrhagic stroke is a dangerous condition that is characterized by bleeding in the brain due to rupture of blood vessels under the influence of critically elevated blood pressure. According to ICD-10, the pathology is coded under I61. This type of stroke is the most severe and has the worst prognosis. It most often develops in people aged 35–50 years who have a history of hypertension or atherosclerosis.

Violation of cerebral circulation is accompanied by the formation of a hematoma or impregnation of nerve tissues with blood. When the brain substance is damaged, neurological disorders develop, up to the point that a person can completely lose motor functions. Also, speech, swallowing and even breathing can be disturbed. Hemorrhagic stroke has a fairly high probability of death. Most of the people who still survive after it remain permanently disabled.

In medicine, there are two types of strokes - hemorrhagic and. With the first indicated ailment, an acute violation of blood flow in the brain is noted due to narrowing of the lumen of the vessels or a violation of their integrity. The concept of "hemorrhagic stroke" combines subarachnoid and intracerebral hemorrhage. Unlike the ischemic form, this disease is very difficult and has a high mortality rate. The prognosis in most clinical situations is unfavorable.

Hemorrhagic and ischemic stroke can be either primary or secondary. Primary acute cerebrovascular accident is the result of thinning of the wall of blood vessels or a hypertensive crisis. The secondary form of the pathology progresses due to rupture of the aneurysm or due to hemangioma.

Etiology

There are many reasons for the progression of hemorrhagic stroke. Among the main etiological factors are the following:

• formation and rupture of an aneurysm;
• frequent hypertensive crises;
• formed hemangioma;
• vessels;
• vascular malformation - both congenital and acquired;
• disseminated intravascular coagulation;
• angiopathy;
• various pathologies of the cardiovascular system;
• uncontrolled intake of antiplatelet agents and thrombolytic drugs;
• the use of narcotic drugs;
• inflammatory vascular pathologies;
• benign and malignant brain tumors;
• drinking alcohol and smoking.

Many people confuse hemorrhagic and ischemic stroke. In a hemorrhagic stroke, a hemorrhage occurs in the brain, provoked by a violation of the integrity of the blood vessel. With ischemic stroke, necrosis of a certain part of the brain is observed. Blood circulation is disturbed due to blockage of a blood vessel by a thrombus, an atherosclerotic plaque.

The vessel is torn, as a rule, spontaneously. But the starting factors are the following:

• overheating;
• severe stress;
• hypertensive crisis.

Kinds

Based on the location and changes in the structures of the brain tissue, there are several types of hemorrhagic strokes:

• intraventricular hemorrhage;
• subarachnoid;
• subepidural and epidural;
• parenchymal.

In the case of a subarachnoid hemorrhage, blood accumulates under the pia mater of the brain. The main causes of this condition are vascular malformations and aneurysms. Most often, there is a parenchymal hemorrhage, as a result of which blood seeps directly into the substance of the brain. Clinicians distinguish two types of such hemorrhages:

• hemorrhagic impregnation;
• hematoma.

Intraventricular hemorrhage is possible when the integrity of the plexuses of the vessels that are located in them is violated. But usually this condition does not develop initially. Most often, blood enters the ventricles if there are already large, extensive hematomas in the brain. If this particular type of hemorrhagic stroke of the brain develops, then the blood will block the CSF pathways and hydrocephalus will begin to progress, since the CSF will not be able to flow out of the cranial cavity. This will result in swelling of the brain. In such a situation, the forecast is not optimistic - the chances of survival are almost zero. Patients die within 1-2 days.

Symptoms

A hemorrhagic stroke usually begins to progress during the daytime after a person has experienced stress or a hypertensive crisis has begun. Symptoms of pathology occur abruptly:

• Strong headache;
• the inability to look at the light, as this increases pain;
• nausea;
• vomit;
• dizziness;
• feeling of pulsation in the head;
• red circles begin to flash before the eyes of a person - this is a characteristic symptom of the development of a hemorrhagic stroke.

All these symptoms gradually increase. A person has depression of consciousness. He may even fall into a stupor or coma. But immediately before this, the patient himself loses orientation in time, he exhibits hallucinations of various kinds.

Simultaneously with the above signs, symptoms also develop, which are called focal. They directly depend on which area of ​​the brain the hemorrhage occurred:

• facial asymmetry;
• paralysis of the limbs;
• speech is slurred;
• nasal voice;
• impaired speech reproduction.

Against the background of these symptoms, body temperature often rises, and convulsions may occur. This indicates the development of cerebral edema. The following symptoms also appear:

• strabismus;
• critical decrease in blood pressure;
• pupil diameter becomes different;
• the depth and rhythm of breathing are disturbed;
• cardiac activity is also disturbed.

How to recognize a stroke?

If symptoms appear that may indicate the development of a stroke, then it is necessary to conduct a small diagnosis that will show whether a cerebral hemorrhage has really occurred:

• you should ask the person to raise both hands up and hold them in this position for several seconds. In the event of a stroke, he will not be able to do this. Either he will not raise his hand, or she will immediately fall;
• please smile. In a person who develops a hemorrhagic stroke, instead of a smile, either a wry smile or a grin will turn out;
• you just need to ask him to say something. The phrase will not sound clear.

If the victim is unable to complete these simple tasks, an ambulance should be called immediately.

Consequences

The consequences of a hemorrhagic stroke depend on where the lesion is located in the brain, how much hematoma is, and what is the age of the person who has symptoms of the disease:

• lack of coordination;
• partial lack of movement in the limbs;
• inability to correctly reproduce speech;
• aggressive behavior;
• swallowing disorder;
• suspiciousness and shyness;
• facial asymmetry;
• epileptic seizures;
• memory loss;
• disruption of work Bladder or intestines;
• severe headaches.

Forecast

The prognosis for this disease is quite serious. In 50-90% of cases, a fatal outcome is observed. Even in the case of a timely response to the symptoms of pathology, competent diagnosis and proper treatment, there is no guarantee that the patient will survive and the hemorrhage will not recur. Also, the prognosis is unfavorable for later life. Almost all patients who were able to cope with the disease remain disabled.

Treatment

When the first symptoms of the disease appear, it is important to immediately contact a medical institution for diagnosis and treatment of the disease. Delay can cost the patient his life. Treatment of hemorrhagic stroke should be started within the first three hours after the first symptoms appear. Otherwise, his prognosis will be unfavorable. The main goal of therapy is to reduce blood pressure, support the functioning of vital organs and systems, and eliminate unpleasant symptoms. To prevent the development of sepsis in the brain, broad-spectrum antibiotics are prescribed. Drugs containing active substances are also introduced to help stop bleeding from a ruptured vessel. Sometimes it is required to carry out surgical removal of the formed hematoma.

As soon as the acute period of hemorrhagic stroke ends, the patient is prescribed various rehabilitation measures that will normalize his condition and improve the prognosis of the disease:

• breathing exercises;
• massage;
• hydrotherapy;
• the patient is assigned to study with a speech therapist;
• electrical neurostimulation;
• color therapy.

Treatment of hemorrhagic stroke is a very long and difficult process. It should be carried out only in stationary conditions under the constant supervision of doctors. This is also necessary in order to prevent the recurrence of pathology.

A stroke is an acute circulatory disorder in the brain. There are two types of stroke: ischemic and hemorrhagic. Hemorrhagic stroke is less common than ischemic stroke. However, its mortality rate is higher. Symptoms of hemorrhagic stroke occur suddenly, more often in young people. Well, perhaps the most important difference between these two types of stroke is the mechanism of damage to the brain tissue.

With a hemorrhagic stroke, a hematoma forms in the brain due to hemorrhage, while with an ischemic stroke, the brain tissue suffers from a lack of blood circulation, which leads to necrosis of a part of the brain. The prognosis for both forms of stroke depends on the extent of the lesion, the presence of concomitant pathology and timeliness of seeking help.

In addition to intracerebral hemorrhage, it is customary to attribute hemorrhagic stroke to hemorrhage in the subarachnoid (interstitial) space.

Reasons for the development of the disease

Since a hemorrhagic stroke develops as a result of an outpouring of blood from a vessel, the cause of its occurrence should be sought in processes and conditions that can disrupt the integrity of blood vessels. The most common cause (in 85% of cases) leading to rupture of cerebral vessels is hypertension, as well as hypertensive crises that occur against its background.

The vascular wall in patients with hypertension becomes thinner, and against the background of a sharp increase in blood pressure, the vessel ruptures. Blood, pouring into the brain tissue, forms a cavity, which it fills itself. This forms an intracerebral hematoma. Small hematomas, merging with each other, can form large blood tumors, which subsequently either leave a scar in the brain tissues or degenerate into cysts.

Bleeding can occur without compromising the integrity of the blood vessel. This happens as a result of impregnation of the constituent parts of the blood through the wall of the vessel thinned under high pressure. This process is called diapedetic bleeding.

Atherosclerotic disease, congenital malformations of blood vessels, and aneurysm also contribute to the thinning of the walls of cerebral vessels. In addition, the development of a stroke may be associated with a violation of the blood clotting process due to concomitant diseases (for example, hemophilia) or uncontrolled intake medicines that thin the blood. Chronic intoxication of the body arising from the use of alcohol, drugs, tobacco, as well as the state of chronic vitamin deficiency are also predisposing factors in the development of hemorrhagic stroke.

The main signs of a stroke

Hemorrhage in the brain is manifested by cerebral and local neurological symptoms. Cerebral signs in hemorrhagic stroke are as follows:

• disturbance or short-term loss of consciousness;
• coma;
• a state of stupor;
• drowsiness or agitation;
• dizziness;
• loss of orientation in space and time;
• nausea and vomiting;
• increased breathing and heart rate.

The focal symptomatology of a stroke is determined by the part of the brain in which the hemorrhage occurred. If the part of the brain that provides the motor function is damaged, paresis or paralysis of the corresponding side of the body with the limbs develops. When the damage affects the areas of the brain responsible for the coordination of movement and body position in space, unsteadiness of gait, dizziness, vomiting, impaired vision, swallowing, speech and sensitivity are noted.

Methods for rapid recognition of the disease

The sooner a hemorrhagic stroke is recognized, the higher the likelihood of avoiding complications and achieving full recovery of the patient. Therefore, it is important to know the techniques for recognizing the symptoms of a stroke. One of these methods is the USP method.

A crooked smile is one of the signs of the disease

U - smile. With a brain hemorrhage, the smile is usually twisted due to the fact that the corner of the lips on one side is directed not up, but down;

Z - speak. Ask the person with a suspected stroke to say a simple sentence. Often with a stroke, the pronunciation of sounds is disturbed.

P - raise your hands. If both limbs rise unevenly, then this may be a sign of a stroke.

There is also a method for emergency diagnosis of a stroke “IMPACT”, in which Y is a smile (with a stroke it is asymmetrical), D is movement (one of the paired limbs rises lower or more slowly), A is articulation (there may be speech retardation, impaired diction ), Р is the solution. If at least one of the above items matches your observation, you need to call emergency help.

Before the arrival of the ambulance team, you need to lay the patient down, provide fresh air, put a pillow under his head and shoulders, remove dentures from his mouth, if there was vomiting, turn the patient’s head on its side so that he does not suffocate with vomit.

Diagnosis of the disease

Treatment of hemorrhagic stroke cannot be started without a definitive diagnosis. Therefore, in addition to examining the patient, it is necessary to conduct basic and additional laboratory, as well as instrumental research methods. All patients with suspected hemorrhagic stroke undergo general analysis blood, coagulogram, lipidogram, blood test for sugar and urea, ECG, computed and magnetic resonance imaging. It is also necessary to consult an ophthalmologist, since with a hemorrhage in the brain, a hemorrhage in the retina of the eye may be detected.

Computed tomography is one of the main methods for diagnosing hemorrhagic stroke, as it allows differentiating cerebral hemorrhage from other types of stroke. If CT is not possible, echoencephalography and lumbar puncture are used.

Features of the treatment of patients with stroke

Treatment of hemorrhagic stroke consists of a set of measures for emergency care and the subsequent long recovery period (rehabilitation), carried out in stages. Treatment of the patient should be started within the first 2-4 hours after the onset of symptoms in the neurological or neurosurgical department of the hospital. If the stroke is extensive, the patient may fall into a coma, which requires hospitalization in the intensive care unit. Patients are prescribed strict bed rest.

Treatment consists of the main therapy, which involves the restoration and maintenance of the activity of all vital systems of the body - respiratory, cardiovascular, hematopoietic. Drugs are prescribed to prevent cerebral edema and other post-stroke complications. In addition, specific therapy is carried out aimed at strengthening the vascular walls and preventing the dissolution of the formed thrombus. For this purpose, they use medicines like trasylol, caprical, dicynone, aminocaproic acid, etc.

Surgical treatment is carried out only according to special indications, which include the young age of the patient, aggravation of cerebral and local symptoms, deterioration after relative stabilization. It consists in removing the hematoma with the help of trepanation of the skull.

Rehabilitation of patients

Due to such a property of the nervous system as neuroplasticity, the human brain has the ability to self-heal due to the formation of new relationships between healthy and damaged nerve cells.

The following consequences of a hemorrhagic stroke are possible:

1. Violation of motor functions, paresis and paralysis.
2. Speech impairment, difficulty in writing, reading and counting.
3. Perceptual changes.
4. Violations in the field of thinking, memory impairment, loss of learning ability.
5. Behavioral change, manifested in the form of aggression, delayed reactions, fearfulness, etc.
6. Changes in the emotional and sensual spheres (depression, mood swings, anxiety, low self-esteem).
7. Violation of the processes of urination and defecation.
8. Pain that is not relieved by analgesics.
9. epileptic disorders.

The sooner the patient begins to carry out rehabilitation measures, the more chances he has for a full recovery. In the process of rehabilitation of post-stroke patients, specialists from various fields should take part. In addition to the constant supervision of a neurologist, patients who have had a stroke should work with:

• physiotherapist and trainer physiotherapy exercises correcting and controlling the restoration of sensitivity and motor ability;
• speech therapist-defectologist involved in the restoration of speech, reading, etc.
• ergotherapist, restoring the functions of the hand;
• a psychologist who provides emotional support to the patient, helps to strengthen the volitional sphere, works to restore lost or changed mental functions, and also helps the patient adapt to social life.

It is also important to have a representative from the closest environment next to the patient, whom the patient could fully trust.

Any disease is easier to prevent than to treat. Hemorrhagic stroke is no exception. Therefore, with any signs of a health disorder, it is recommended to seek help from specialists who can diagnose the disease in a timely manner and prescribe a full-fledged treatment.

Among all types of acute cerebrovascular accident, hemorrhagic stroke is the most severe. It is accompanied by a hemorrhage in the brain, the cause of which is a burst vessel. Bleeding is accompanied by the development of a hematoma of various sizes and a violation of the blood supply to neighboring areas of the brain. As a rule, there is a pronounced swelling of the brain.

Acute violation of cerebral circulation with a rupture of the vessel and hemorrhage in the brain

Hematoma, edema and lack of blood supply lead to a rapid increase in symptoms of neurological deficit. The severity of the patient's condition is due to cerebral edema and disruption of the vital centers, especially with untimely medical care. The same fact causes frequent subsequent disability, as well as high mortality - according to this indicator, stroke is second only to coronary heart disease.

At the slightest suspicion of a hemorrhagic stroke, for example, impaired consciousness or convulsions, doctors should be called immediately - if time is lost, the chances that the brain will fully recover drop sharply.

Until the thunder came

The consequences of a hemorrhagic stroke are very serious, and there is very little chance of returning to a normal lifestyle, so it is important to know the causes of such a stroke and its first symptoms - this will help prevent a stroke, or provide timely assistance, which significantly improves the prognosis for the patient.

How to recognize a stroke

Main reasons

Hypertension is practically main reason hemorrhagic stroke. In the absence of therapy, hypertension leads to microangiopathies, which subsequently cannot withstand high pressure and rupture in the brain tissues. Other causes include congenital vascular pathologies, as well as blood diseases that occur with a violation of its coagulability.

Symptoms

Sudden and severe headache, psychomotor agitation, sweating, vomiting, possible loss or depression of consciousness, epileptiform seizures, impaired movement in the limbs - the right side suffers more often, the left side is affected less often. Speech becomes difficult or impossible. When observing such symptoms, you should immediately call an ambulance - any independent action is meaningless and dangerous.

Consequences of the disease

All the consequences of hemorrhagic stroke are associated with several factors at once. Cerebral edema and blood decay processes provoke nonspecific inflammation and secondary ischemia of the adjacent brain tissue. All damaged areas of the brain cease to perform their functions, and the consequences of a hemorrhagic stroke will depend on which area was affected.

Movement disorders

Post-stroke movement disorders lead to unsteadiness when walking

They can manifest themselves not only in complete paralysis, when, for example, the entire right side of the body suffers. The consequences caused by hemorrhage can be expressed in permanent muscle weakness or tremor, partial paralysis (paresis, hemiplegia), impaired coordination, difficulty walking independently. Performing work that requires concentration and precise movements becomes impossible.

Swallowing disorder

Cerebral edema during a stroke also provokes such a problem as a violation of the normal swallowing process. It is difficult to swallow even liquid food, which leads to food particles entering the bronchi and lungs. This, in turn, is the cause of pneumonia, which is rather severe and difficult to treat. Difficulties with swallowing food provoke other consequences - constipation, dehydration, rapid weight loss.

Difficulties in perception and speech disorders

Edema and hematoma in the left hemisphere of the brain lead to difficulties in understanding and reproducing speech. At the same time, there are consequences not only in the form of speech impairment, it is difficult for the patient to count, read and write. Along with this, problems with the perception of reality also develop - while normally seeing a picture of what is happening, a person does not understand what is happening. For example, it becomes impossible to drink water because the patient does not understand that it needs to be poured into standing next to cup.

Most speech disorders after a stroke proceed as aphasias.

Cognitive impairment and behavior problems

Patients whose brain has suffered as a result of a hemorrhagic stroke often behave inappropriately, showing complete emotional instability - aggression can be replaced by sudden fearfulness, slowing down the reaction to what is happening. A person becomes unable to concentrate on performing even simple, familiar work. At the same time, there are also difficulties with mental perception.

The ability to think logically is rapidly declining, memory is rapidly deteriorating, it becomes simply impossible to learn something new. The consequences of a stroke, in which the brain is seriously affected, also affect decision-making - the patient is no longer able to do this on his own, as well as plan anything for the near future (even a few hours).

Urination disorders

Brain damage often results in the patient's inability to consciously control urination or defecation. In addition to incontinence, constipation or urinary retention often occurs - in the latter case, only bladder catheterization performed by medical worker.

Mental disorders

Severe mood swings that change many times a day, irritability, crying or laughing for no apparent reason. Developing depression is quite dangerous, accompanied by loss of appetite, insomnia, and a constant feeling of anxiety. Self-esteem of patients who have had a hemorrhagic stroke is sharply underestimated. Cerebral edema and hemorrhage often cause the development of epilepsy (up to 20% of cases).

Stroke patients may develop depression

Pain syndrome

In some cases, the consequences of a stroke are expressed in the occurrence of a persistent pain syndrome - the damaged brain perceives pain as pulsating, shooting. The attack can last long enough, standard analgesics do not have a pronounced analgesic effect.

After a stroke, when the brain has not yet recovered, the patient should not be left alone - perhaps inappropriate behavior up to suicide attempts against the background of severe depression.

Is there a chance for a full recovery?

Despite the extremely serious consequences of a hemorrhagic stroke, the human brain has certain resources for recovery. Thus, the number of neurons that the brain contains significantly exceeds the number that is involved in Everyday life. Edema and inflammatory process in the brain tissues lead to the death of some of its cells, but the "spare" ones are able to take on the functions of the dead - this is the task of rehabilitation after a stroke.

Of great importance for a patient who has had a stroke is the constant maintenance of normal blood pressure. If it is raised again, the chances of a new stroke will increase dramatically, and the consequences of a repeated violation will not only be more pronounced - it will no longer be possible to get rid of them. It should be noted the importance of avoiding excessive stress after illness, as this can provoke a hypertensive crisis, which will negatively affect the recovery process.

Early rehabilitation - a chance to return to normal life

To minimize Negative consequences swelling and hemorrhage, the patient must observe the regime of work and rest, normalize nutrition, completely abandon bad habits. After a stroke and the loss of certain functions, the brain is able to "learn" to perform daily duties again.

In order to make the brain work again, doctors use various methods - both with medication and without the use of drugs. So, motor disorders become frequent consequences of a stroke - massage and exercise therapy have a good effect here. The work of psychologists helps the patient in the fight against depression and helps to return to society.

The International Classification of Diseases classifies two types of strokes: ischemic and hemorrhagic. With each pathology, an acute violation of cerebral circulation occurs.

Ischemia or cerebral infarction occurs due to blockage of blood vessels and partial or complete cessation of blood circulation.

A hemorrhagic stroke is a brain injury in which there is internal bleeding.

What is a cerebral hemorrhage

According to the international classification of diseases, hemorrhagic stroke is described as an acute circulatory disorder, accompanied by internal hemorrhage. The lesion is assigned an ICD 10 code.

The patient's brain is supplied with nutrients by several large arteries. The cause of hemorrhage may be a concomitant disease or pathological changes in the structure of blood vessels or capillaries.

Types of cerebral hemorrhages, what are

The consequences of extensive cerebral hemorrhage depend on the causes that caused the violation. It is customary to classify strokes according to the etiology or nature of the occurrence, as well as the clinical picture of the atrophic and necrotic phenomena caused by it.

Hemorrhagic strokes are divided into subarachnoid, subcortical, arachnoid and parenchymal hemorrhages.

The type of intracranial hemorrhage determines and directs the course of drug therapy. The disease has similar symptoms, regardless of the type of bleeding. Differential diagnosis of hemorrhagic stroke helps to establish how appropriate surgical intervention is and to prescribe effective drugs to help the patient.

Why and what causes hemorrhage

The prognosis of recovery after a hemorrhagic stroke of the brain depends on the amount of hemorrhage and whether the causes of the lesion have been eliminated. In addition to their localization, types of hemorrhagic stroke are classified depending on the etiology or causes of development:

Repeated hemorrhagic stroke often occurs in the first few days after the first attack. A high probability of recurrence remains after the first year after the bleeding. To prevent a recurrence, lifelong drug therapy will be required.

How does a hemorrhage occur, what does a person feel

The main symptoms of a cerebral hemorrhage are directly related to how a hemorrhagic stroke develops.

The etiology and pathogenesis of disorders has the following development:

• The thinned vessels do not withstand the increased blood pressure, tissue rupture occurs. The opened bleeding fills the existing cavities of the cerebral ventricles. At this stage, the patient feels a sharp attack of headache.
• There is a rapid swelling of the brain tissue. With a hemorrhagic stroke of the brain stem, swelling develops that affects the function of nerve tissues.
• An extensive cerebral stroke with hemorrhage leads to the development of occlusive hydrocephalus or dropsy. The normal circulation of the cerebrospinal fluid is prevented by the emerging and growing hematoma. As a result of dropsy, pressure on the brain tissue increases. Often there is an indentation of the brain into the intercerebral lumen. In an unfavorable combination of circumstances, a coma occurs with a hemorrhage in the brain.
• Tissue atrophy and necrosis - a small hemorrhage usually causes minor neurological damage. If the patient is given emergency care at this stage, lost brain function can be gradually restored.
  Disability after a cerebral hemorrhage occurs due to the development of a large hematoma. With damage to the brain stem, speech and respiratory dysfunction is observed.
• Fatal outcome - a hemorrhage in the brain threatens that the affected person has irreversible necrotic phenomena. Brain tissues stop working. If the areas of the brain responsible for breathing and the functioning of the cardiovascular system are damaged, death occurs.
  Extensive hemorrhage cannot be stopped without surgery. Craniotomy is the only way to save the patient's life.

During intracranial bleeding, pathological changes occur that affect the patient's well-being. The periods of hemorrhagic stroke are manifested in the manifestations characteristic of each stage, which makes it possible to establish the approximate severity of the lesion, even before instrumental diagnostics.

Early recognition of symptoms allows you to provide the necessary assistance and reduce the intensity of complications. Signs of developing bleeding are:

1. Rapidly increasing pain, burning sensation in the head - accompanied by vomiting and nausea.
2. Light sensitivity - eyes are irritated by bright light. A neurological attack develops when the eyes are rotated from side to side.
3. Violation of the patient's consciousness - depending on the degree of damage, the patient may briefly lose consciousness or fall into a coma, especially with serious brain injuries.
4. Neurological manifestations - partial or complete paralysis of the limbs, stupor, epileptic seizures indicate the onset of a stroke.

If a hemorrhagic stroke occurs after a mental overstrain, then the first manifestation may be a rapidly developing epileptic seizure. In this case, the remaining symptoms of a stroke will be absent.

What is the danger of a hemorrhagic stroke

The consequences after hemorrhagic stroke in elderly patients are manifested in serious pathological changes that affect the performance of the body. The prognosis of the disease is unfavorable. In 50-75% of cases, a hemorrhagic attack ends in the death of the patient. Prognosis after stroke at a young age is more optimistic.

The result of therapy is affected by the presence of serious complications resulting from a hemorrhagic attack.

Possible consequences of internal bleeding are:

• Congestive pneumonia - the development of the disease is affected by the patient's long lying position and impaired respiratory function, due to atrophic phenomena and the death of nerve tissues.
• Sepsis - in severe cases, the hematoma resolves for a long time, bleeding is extensive. According to individual indications, surgical intervention is required. The entry of infection into the bloodstream leads to general sepsis of the body.
• Bedsores - a stroke is accompanied by disturbances in the blood supply and nervous trophism. Any irritation of the skin quickly develops into severe ulcers.
• Thrombosis - pathology develops due to a decrease in heart rate. The formation of decompensation leads to the entry of blood clots into the bloodstream.
• Impaired consciousness - the consequences of coma after a cerebral hemorrhage are irreversible changes in brain activity. The unconscious state of the patient lasts several days, weeks, months, rarely years.
  After a patient comes out of a coma, who has been unconscious for a long time, it is impossible to predict the further development of complications. Full recovery of all brain functions: speech, movements, is rare.

The prognosis after a stroke depends on several factors: timely medical care, the presence of complications and the efforts of the patient and his relatives. Some complications depend on the location of the hematoma.

The consequences of a right-sided hemorrhage are manifested in the paralysis of the limbs and a violation of the autonomic functions of the body, the left-sided - in the loss of perception of reality, the deterioration of speech and visual capabilities.

Can a hemorrhagic stroke recur?

The probability of repeated hemorrhagic lesions exists. The consequences of a second stroke are more serious than the first attack. In almost every case, relapse ends in death.

Stroke is not a separate disease and develops as a result of related pathologies: atherosclerosis, thrombosis, pathologies of the cardiovascular system. Differential diagnosis helps to accurately determine the cause of a stroke.

Therapy after elimination of the hemorrhage itself is aimed at combating the catalyst factor. If the causes that led to the stroke are not eliminated and the normal blood supply to the brain is not restored, a relapse can be expected already a few days or years after the primary lesion.

First aid for hemorrhage

If there is a suspicion of the development of a stroke, it is necessary to follow several recommendations that directly affect the rate of further recovery of the patient. Before the arrival of an ambulance, it is necessary to provide appropriate conditions to prevent the development of a severe hemorrhage.

The following guidelines must be followed:

A patient with a hemorrhagic stroke is indicated for urgent consultation, even if the symptoms of the lesion were temporary. A second attack is the cause of death in 80-90% of cases.

Treatment of the consequences of a hemorrhagic stroke

Conservative treatment of patients with hemorrhagic stroke is mainly aimed at combating the consequences and preventing the development of a secondary attack. The effectiveness of therapy is influenced by accurate diagnosis of the causes of hemorrhage, as well as the use of traditional and non-traditional methods of treatment.

Diagnosis of hemorrhage

It is quite difficult to determine the presence of a stroke solely by visual examination. The neurological history of the disease has similar manifestations with epileptic seizures, the development of tumor and cystic formations. For this reason, immediately after admission, the patient is prescribed an instrumental examination:

• Computed tomography - although CT is inferior to MRI in terms of information content, the speed of obtaining results makes CT examination indispensable in determining a stroke at an early stage of development.
• MRI examination - helps to determine both the existing internal bleeding and to predict the possibility of developing hemorrhagic abnormalities. The method is used for early diagnosis and subsequent monitoring of the effectiveness of prescribed therapy, during the prevention of recurrent hemorrhagic stroke.

Drugs for the treatment of stroke with hemorrhage

The first priority in the treatment of stroke is to maximize fast recovery normal blood supply to the brain. In the absence of oxygen and nutrients carried by the blood, irreversible changes and necrotic phenomena develop within a few minutes.

It will not be possible to solve the issue simply by increasing the volume of blood, as this will lead to even greater complications associated with increased bleeding.

Actovegin in the acute period helps to solve the issue of oxygen saturation of tissues. The active substances of the drug contribute to increased metabolism and saturation of cells with oxygen, which localizes necrotic phenomena.

The principles of treatment of hemorrhagic stroke in the recovery period are the fastest possible rehabilitation of the patient. Prolonged recovery has a depressing effect on the emotional and mental level.

Drug therapy uses neoprotectors, as well as macropreparations. In case of heart disease and thrombosis, antiplatelet agents are prescribed to prevent blood clotting. Relatively recently, a new drug has appeared that prevents the formation of blood clots - Etamzilat. It is used for prevention and treatment in the acute and post-acute phase of stroke.

Surgery

With extensive bleeding, surgery is performed to save the patient's life. The decision on the appropriateness of a surgical decision is made taking into account several important factors:

1. Hematoma volume.
2. Threat to the patient's life from continued bleeding.
3. Consequences of removal of a hematoma and rupture of tissues of an artery or vessels.

The operation requires opening the skull and is potentially dangerous to the life and health of the patient. Surgical intervention is prescribed, only in cases where the condition of the victim without trepanation is rapidly deteriorating and death is likely.

The duration of resorption of a hematoma after a stroke can also create prerequisites for endoscopic surgery with minimal risk to the patient's health.

Treatment with folk remedies

Recovery after a hemorrhagic stroke at home is possible only after undergoing mandatory drug therapy. ethnoscience offers many ways to prevent a relapse and restore lost brain functions.

Decoctions and tinctures are widely used on cones, bee pomor, horse chestnuts, etc. When choosing the optimal therapy option, it is necessary to choose a treatment aimed at a catalyst for the development of disorders.

Rehabilitation after a brain hemorrhage at home requires self-discipline and perseverance. With sufficient effort on the part of the patient, the main lost brain functions will gradually recover.

How to recover from a brain hemorrhage

Brain hemorrhage doesn't just happen. Usually it is preceded by years of ignoring the recommendations of a doctor, a nutritionist, a disease at an advanced stage.

It will take a long time to recover. The rehabilitation program is developed individually. Don't expect instant results. It will take years to recover.

Fast recovery is facilitated by a combined recovery program that includes the simultaneous use of physiotherapy, acupuncture, gymnastics and massage after a stroke.

Exercise therapy during rehabilitation

The catalyst for internal hemorrhage is a sedentary lifestyle and stress. Exercising after a stroke can help reduce the chance of a recurrence. The attending physician will select the classes most suitable for the patient. As exercise therapy, it is recommended to use: Pilates, yoga, breathing exercises.

What to eat after a stroke, what should be the diet

Secondary prevention necessarily includes making adjustments to eating habits, daily routines, and other changes.

After a stroke, the following types of foods should be excluded from the diet:

1. Fatty meats.
2. Smoked products.
3. Confectionery and bakery products.
4. Some types of vegetables and fruits (for diabetes).

Diet is the best prevention of stroke. It is recommended to adhere general rules regarding the diet. The table or therapeutic diet No. 10 is optimal for nutrition.

Prevention and prevention of hemorrhage

The best prevention of stroke is maintaining a healthy lifestyle, giving up bad habits, and reducing stress. Patients with chronic vascular and cardiac diseases should be constantly monitored by a specialist.

To prevent relapse, the use of strengthening and stimulating drugs, as well as a complex of vitamins, is indicated. Often, cardiomagnyl is used for this purpose.

Women during pregnancy are shown folic acid preparations, as well as constant monitoring by the attending physician. Good nutrition, the absence of bad habits and stress, are the key to the full development of the fetus, and prevent the development of congenital hemorrhagic brain damage.