Stroke, Stroke, Stroke
For many people, a stroke occurs unexpectedly …
A stroke occurs as a result by a sudden interruption of blood flow in the brain ( ischemia ) or by a brain hemorrhage , which particularly affects a circumscribed place. Through this process, the nutrition and oxygenation of neurons is disturbed and this perish. Nerve cells, which are only slightly damaged are able slowly to regenerate, but dead nerve cells can not be replaced.
Arises for a vascular occlusion or blockage of blood vessels by a blood clot (80 percent of cases).
Cerebral hemorrhages account for 20 percent of strokes.
A stroke occurs unexpectedly, suddenly out of the blue. The risk of stroke increases with age, but also many younger patients are affected. About twenty percent of all patients over 65 years and five percent of those younger than 40 years. In Germany alone each year suffer a stroke 350 000. people, it has a mortality rate of about ten percent.In Germany, the Stroke is the third leading cause of death. She is also, according to the European diagnostic guidelines, the most common cause of permanent disability in industrialized countries.
Causes of stroke
The causes of stroke may be different. come in question:
It is the most common cause of stroke, 40-50 percent of all cases are to atherosclerosis due. In atherosclerosis, the blood vessels are narrowed by plaque (fatty deposits) over time. Especially patients with high cholesterol (> 300 mg / l) and / or diabetes mellitus prone to plaque formation and are therefore more vulnerable. This leads to a chronic hypoperfusion of the brain.
In healthy patients with stable cardiovascular function supplying the brain but still ensures sufficient. Only when worsen the cardiovascular functions and an acute oxygen deficiency in the brain occurs, patients are at risk. A deterioration of cardiovascular function can be triggered by a low blood pressure (especially at night and early in the morning), an irregular pulse and a co-existing heart failure and in patients with viscous blood, due to lack of fluid intake (often in elderly patients).
Among the most important risk point for atherosclerosis include high blood pressure, diabetes mellitus, obesity, high blood lipids and smoking.
A thrombosis is a blood clot (collection of cells that form a graft), which arises in a particular place. The embolus, however, is a blood clot that occurs in another vessel in the system, then solves and will eventually travel through the bloodstream into the brain. They clogged there then a narrow vessel. Blood clots consist mainly of old cells, platelets, fibrin and plaque (cholesterol plaques).
Especially in places where the blood flow is low, the risk of clot formation, for example in the extended leg veins or aneurysms (aneurysms). The fact is that in both cases, a blood vessel is closed by a clot. With this closure, the entire coverage area of the vessel is no longer a sufficient blood supply. This further results in a lack of oxygen. Most commonly, the cerebral artery is affected media (middle cerebral artery) and their coverage area.
Cerebral hemorrhages occur relatively rarely. They usually arise following the rupture of a cerebral artery . The cause is in most cases a morbid outgrowth of the vessel wall (aneurysm). The cerebral hemorrhage often occurs after a sudden rise in blood pressure, causing a rupture of a cerebral artery. Therefore people with hypertension particularly vulnerable. Situations that can trigger a sudden rise in blood pressure, are eg sudden excitement and stress. If possible, avoid such situations hypertension patients, because 80 percent of all fatal cerebral hemorrhage.
Symptoms of a stroke
A stroke is always very serious, because with timely medical assistance possible late effects can be minimized. Therefore, one should know at least the most important signs of a stroke. Particularly patients who belong to the risk group and their family members should recognize these symptomsn.
Nost cases, go to the actual stroke shorter bouts with temporarily occurring language disorders , memory loss , paresthesia , or even paralysis ahead that must be interpreted as a warning signal. These are known as TIA (transient ischemic attacks) and are characterized in that they are temporary, they are formed within minutes to a maximum of 24 hours before.
The neurologic deficits may vary greatly depending on the location of the closure.
Computed tomography (CT)
Computed tomography is one of the most important examination for the diagnosis of stroke. With the CT can, firstly, identify the location of the bleeding and see the other, whether the stroke was caused by a thrombus. Through these findings, ie whether a stroke or a Hinblutung exists, you can then initiate a consistent therapy.
Through various methods of ultrasound can represent blood flow or circulation of a vessel. With this method you win ultimately information on the flow conditions of the blood. The most frequently used examination is the Doppler duplex sonography, with which you can demonstrate stenosis and occlusions of cerebral blood vessels. There is an arteriosclerosis, one can determine the extent of atherosclerosis using this method.
(In particular, the determination of coagulation parameters)
An ECG should always be performed to rule out disease and arrhythmias heart, which could come as a trigger of an embolism in question.
Lumbar puncture (puncture of cerebrospinal fluid, ie, brain or spinal fluid)
The lumbar puncture is only performed if the CT is inconspicuous, but is suspected to have a subarachnoid hemorrhage.
high blood pressure
Stroke is a medical emergency that needs to be immediately medical attention. It is an acute, life-threatening situation that should be intense medical treatment in a hospital. Primarily, the vital body functions are monitored and stabilized, these are cardiovascular function, respiration, temperature, and water and electrolyte balance. If the vital signs stable, the vessel closure are opened below and preventing further damage.