Stroke

Cerebrovascular diseases, the most significant stroke being the third most important cause of mortality and mortality and the leading cause of disability in the world and in our country. It is estimated that as many as 46% of cases of stroke occur in the productive age of the general population between 45 and 59 years of age. The time needed to rehabilitate after a stroke depends on its weight. Two thirds of survivors of stroke recover to less or greater autonomy, and a third of them are permanently disabled for independent living and depend on someone else's help. If the patient is recovering enough to be able to work, without the need for preventive measures, the risk of stroke may increase, which may be fatal.

To function properly, brain cells need constant and adequate supply of oxygen to oxygen and other nutrients. If the blood supply to the brain cells is completely interrupted, even for a short time, they die.

The brain supplies four major vessels out of the upper part of the aorta, the largest blood vessel that draws blood from the heart: the right and left joint carotid artery, located at the front of the neck, and the right and left vertebral arteries located at the back of the neck and passing through bone spinal cord. The first two vessels are stretched to outer carotid arteria that supplies blood to the face and head and the inner carotid artery that supplies the blood to the front two thirds of the brain and on the base of the brain form a ring into which the inlet and back veins, vertebral arteries, and are interconnected by small communicational arteries which ensures constant blood supply to the brain. The arteries are bent on the smaller thin shear vessels we call capillaries. Capillary nutrients from the blood come to millions of tiny brain cells

Blood supply disorders are caused by blood for several reasons, which can result in various types of damage that are the most severe stroke.

One of the most common causes is clotting blood clotting blood called by thromb - thrombosis of the cerebral artery - it arises in the arteries damaged by atherosclerosis. The result is ischemic stroke. The collision can also occur on the wall of the artery itself, most commonly on the scrotum or in the heart cavities. An embryo that is removed from the blood vessel walls or caused by various irregularities in cardiac work is called embolus. The blood stream carries it to the extreme veins where it comes to their complete blockage, which is another way of producing a stroke called cerebral embolism. Stroke can also occur when the diseased artery of the wall dies and the blood is shed in the brain tissue, and this kind of stroke is called cerebral hemorrhage. Following the onset of blood vessel enlargement due to the inherited changes in the development of the blood vessel wall (aneurysm), a stroke caused by cerebral haemorrhage is called a subarachnoid haemorrhage. If there are only transient brain circulation disorders that have not resulted in permanent neurologic deficiency and which is retracted within 24 hours, and most often for a few minutes, we talk about transitional ischemic attacks.

The most common symptoms of stroke are:

  • numbness, weakness or constriction of hands, faces, legs, especially if only one side of the body is affected;
  • speech disorder (difficult pronouncement, frustration, misunderstanding);
  • loss of balance and / or coordination when combined with other warning signs;
  • swelling or dizziness, walking insecurity or sudden falls, along with other symptoms;
  • sudden blur or loss of vision, especially at one eye;
  • sudden, severe headaches, without a clear cause, especially if accompanied by vomiting;
  • a disturbance of state of consciousness has arisen.
     

Risk Factors for Stroke: Which can not be affected

  • age
  • sex
  • race
  • heritage
  • stroke in family history
  • pre-stroke information and / or previous transit ischemic attacks
  • Which can be affected:

Related to style / lifestyle:

  • smoking
  • alcohol
  • abuse of drugs
  • physical inactivity and obesity
  • unhealthy diet
  • stress
  • use of oral contraceptives
     

Diseases and illnesses:

  • hypertension - elevated blood pressure
  • cardiac diseases - atrial fibrillation and other cardiac arrhythmias, heart valve disorders, cardiomyopathy, extensive myocardial infarction, endocarditis, heart aneurysm, open foramen ovale, left ventricular hypertrophy
  • transitional ischemic attacks
  • significant stenosis of carotid arteries (stenosis> 75% lumen)
  • elevated cholesterol
  • diabetes
  • hyperhomocysteinemia
  • hypercoagulability (increased blood clotting)
  • elevated hematocrit and blood hypervisor status
  • vasculitis

 

There is ample evidence that the various circumstances, conditions, behaviors, habits and illnesses are significantly related to the frequency of stroke and are therefore called risk factors for the emergence of cerebrovascular diseases such as stroke as the most important .

Various diagnostic methods play an important role in preventing stroke. They can point to initial changes in the body that are still reversible, and a proper choice of treatment and preventive measures can prevent serious and lasting consequences.

When there is a doubt about changes in the blood vessels that supply the brain, it is necessary to perform a doppler-ultrasound scan that quickly, painlessly and, most importantly, reliably provides insight into the vascular interior, direction and velocity of the blood circulation, indicating the possible existence of atherosclerotic plaques and narrowing vessels. By examining the neck vein of extracranial colours with carotid and vertebral artery doppler and within the brain with the transcranial doppler of the Willis Circle and the VB Basin, we get a clear picture of events in the cerebral blood vessels, enabling us to determine the therapy plan.

Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain give us a detailed insight into the condition of the brain tissue, reveal the old and new changes and the possible way of their development, and are of great use to further preventive and therapeutic procedures.

Headache

Headache is one of the most common symptoms we encounter in our everyday life, but it is often a symptom of many diseases. Although headache is a very common symptom and seems to occur in every man at least once in a lifetime, fortunately most of them are not a sign of a dangerous disease, but 90% is a symptom of mild disorder that can be relatively easy to remove. Most commonly occurs between the ages of 25 and 65, more often in women, in the urban population and the population of the developed world, and in people whose occupation requires sitting in enclosed rooms with sitting, psychic effort and increased concentration.

Migraine is a benign, recurring, pulsating half head pain, occurs periodically and affects 8-20% of the population. Along with eating, stress factors, fatigue, lifestyle, hormones and meteorological conditions are also mentioned as important factors in the emergence of migraine.

In the area of ​​the face and head there are also neuralgic pains called ' neuralgia or pain caused by irritation in the nerve region that is responsible for the stimulation of stimuli in the area. Usually these neuralgia are caused by viral inflammation, various toxic disorders, and which times the cause can not be detected. The pains are very strong, appear in seizures, always in the same place, and the treatment is persistent and long lasting.

Cerebral circulation disorders are common causes of headaches, and can also be associated with degenerative changes in the cervical spine. And in stroke, rupture of aneurysm, headache meningitis may be the first sign of the disease, but then it occurs abruptly and is always followed by other neurological symptoms.

Headaches may be related to an earlier injury, head trauma, and then we are talking about posttraumatic headaches.

Tensile type headaches are the result of stress and lifestyle, which causes muscle and pain tension. Sometimes the cause of headaches may be metabolic disorders or headaches may be a consequence of taking some substances, drugs, or termination of their taking.

Brain tumors, benign or malignant, can cause headaches.

Headache can also be accompanied by a symptom of disturbance in the organs located in the head including vision disorders, ear, throat and nose disorders, and gum and gum problems.

Given the type and countless causes, headache treatment is different from case to case. In any case, it is first and foremost necessary, if at all possible, to identify the cause and remove it. Most commonly used are various pain medications, lifestyle changes, psychotherapy or psychopharmaceuticals, physical therapy, inflammatory drugs. If the cause of the headache is of a neurological nature, the treatment is in the neurological domain and also depends on the type and cause. In addition to painkillers, sedatives, muscle relaxants, medicines that reduce stroke, antiepileptics, blood pressure medications, or various medicines acting on brain circulation may also benefit.

Dizziness
Dizziness is an indeterminate expression that patients use to describe several completely different subjective conditions. It is therefore necessary to have a detailed description of the patient's subjective experience, not just the words "spin on me".

Tumors can be central (damage to different brain structures) or peripheral (internal ear damage) of origin. In peripheral lesions, diarrhea, dizziness, nausea, vomiting, sweating, and specific neurological signs (nonsmoking disturbed eyeballs in a certain direction) are more commonly reported in diarrhea, which is an indicator of disturbed inner balance function. Depending on the location of the damage, the speed and direction of the gall bladder disturbances are different. Usually there are other neurological signs and outcomes.

  • Vertigo - The feeling of dizziness can be described as turning, rotation around the axis, swinging or tilting, often accompanied by nausea, vomiting, feeling of fear, imbalance, and nystagmus with or without blur.
  • Sink or Presyncope - Impart a sense of immediate loss of consciousness or unconsciousness. They were often accompanied by unpleasant feelings, nausea, fear and transient loss of sight. Synchope comes when the blood supply drops below the levels required for sufficient oxygen and glucose supply.
  • Balance Disorder - A feeling of imbalance, insecurity or "drunkenness" without dizziness. Patients with a systemic disturbance system (vestibular), sensitive (proprioceptive), cerebral (cerebellar) and the one responsible for unwanted movements (visual or extrapyramidal) will often describe their own a feeling of imbalance like a dizziness.
  • Uncertain dizziness occurs in patients with emotional disturbances, resulting from accelerated breathing (hyperventilation). Usually it is a mild dizziness, like fear of falling, which is different from the dizziness, presynaptic or imbalance described above. All forms of dizziness can greatly cause the patient's anxiety.

Treatment of dizzy patients requires knowledge of the interaction of the vestibular system (inner balance center) with ocular motor (eye motor), auditory and spinocerebellar systems (pathways leading from the spinal cord to the small brain). Therefore, dizziness patients are treated neurologically, internally, cardiologically, and in otorhinolaryngologists and ophthalmologists are included if needed.

In the case of severe dizziness, accompanied by nausea and vomiting, symptomatic therapy is required, which consists of the remediation of the mouth or infusion fluid, the use of nausea and calming agents.

If it is a peripheral cause, no other therapy is needed, except in cases of infectious causes when antibiotics are given.

In the central causes of dizziness, the most common is stroke, stroke in the area of ​​the stump or small brain, and in this case it is in principle subjected to therapy according to the settings of stroke treatment. In the case of demyelinating diseases, specific therapy is applied to them, and tumor therapy is operative.