Subscribe
Stroke
What is a stroke screening?
Screening for stroke primarily targets high-risk groups, conducting relevant examinations to identify individuals at high risk of stroke and provide timely preventive treatment to prevent the formation of cerebral thrombosis. For example, stroke screening requires thorough checks of blood sugar, blood lipids, and homocysteine levels. It is also necessary to measure the patient's blood pressure and assess the condition of the patient’s blood vessels. This includes carrying out ultrasound scans of the bilateral common carotid, internal carotid, and vertebral arteries, as well as transcranial Doppler or cranial MRA examinations. If a patient exhibits significant cerebral arteriosclerosis with arterial narrowing, they are considered part of a high-risk group and must undergo appropriate interventional treatments.
Stroke and Its Treatment
Stroke primarily refers to cerebrovascular disease, characterized by the sudden onset of symptoms that develop within minutes. This rapid development of symptoms is why it is called a stroke. Stroke commonly affects middle-aged and elderly people who often have certain risk factors. For example, high blood pressure, high blood cholesterol, smoking, drinking, obesity, and heart diseases like atrial fibrillation can increase the risk of stroke. For the treatment of stroke, it is crucial to reach the hospital as soon as possible, as earlier treatment leads to better outcomes. Generally, if it is suitable, the patient may receive intravenous thrombolysis. Additionally, treatment may involve anti-atherosclerosis measures, nutritional support for nerves, and rehabilitation training, which is also very important.
Is lacunar infarction considered a stroke?
Lacunar stroke is a type of stroke, mainly characterized by the blockage of small blood vessels, comprising 21 syndromes. There are motor types, sensory types, mixed types, as well as those combined with speech disorders, swallowing disorders, and unstable walking. If it progresses to become severe or worsens, it can also include dementia and significant cognitive impairment, all of which fall under the category of stroke.
Manifestations of Stroke
First, if the patient has a large-area ischemic stroke, or if there is a significant amount of cerebral hemorrhage, consciousness disorders will occur rapidly, and the patient may even fall into a coma. Second, in the case of general strokes, patients will experience reduced mobility in their limbs, primarily manifesting as unilateral limb paralysis, with symptoms varying from mild to severe. Patients with milder symptoms show clumsiness in fine movements, while more severe cases may require bed rest. Third, a common clinical symptom is numbness in one side of the body. Fourth, patients with a stroke generally also suffer from symptoms such as deviation of the corners of the mouth, shallowing of the nasolabial folds, drooling, and unclear speech.
Does lacunar infarction belong to ischemic stroke?
Lacunar infarction is a type of ischemic stroke, which can be simply explained as the blockage of small blood vessels. It generally belongs to one of the categories of ischemic strokes, which also include large vessel blockage and cerebral embolism. Lacunar infarction specifically refers to blockages in small blood vessels, and this type of stroke primarily occurs due to these small vessel blockages, and it is known as lacunar infarction.
The difference between stroke and cerebral infarction
Stroke includes ischemic stroke and hemorrhagic stroke. Ischemic stroke refers to cerebral infarction, while hemorrhagic stroke refers to cerebral hemorrhage. Symptoms such as limb weakness, slurred speech, or other neurological deficits should initially suggest the possibility of a stroke. Whether it is an ischemic or hemorrhagic stroke may be related to the symptoms, but a CT scan is essential. If a CT scan rules out cerebral hemorrhage, then cerebral infarction is more likely. The treatment varies with time; within 4.5 hours, if the conditions for thrombolytic therapy are met and there are no contraindications, and the relatives have signed an informed consent, thrombolytic treatment can be administered. If this time window is exceeded, this opportunity is lost, so it is crucial to seek medical attention immediately upon symptom onset.
What medicine to take for a stroke?
Stroke includes ischemic stroke and hemorrhagic stroke, also known as cerebral infarction and cerebral hemorrhage. The medications used for these two diseases differ, so it is essential to identify which type of disease it is. When symptoms occur, such as slurred speech, limb weakness, or other symptoms, it is crucial to seek medical attention immediately. Perform a cranial CT scan first to rule out bleeding, and then consider cerebral infarction. If it is a cerebral infarction, thrombolytic therapy can be administered within 4.5 hours of the acute phase, followed by hospital treatment. During the acute phase of a cerebral hemorrhage, the decision on whether to proceed with surgery depends on the amount of bleeding. Regardless of the situation, these conditions are often underpinned by several underlying diseases, such as hypertension, diabetes, or hyperlipidemia, along with other risk factors. Therefore, medication needs to be personalized, and it is also necessary to check for any contraindications to determine what medication to use. (Medication use should be guided by a professional doctor.)
Precautions for Stroke Patients Using Mannitol
Patients with stroke, if experiencing cerebral hemorrhage, extensive cerebral infarction, or cerebral embolism, can develop cerebral edema. In such cases, it is necessary to use mannitol for dehydration to reduce intracranial pressure. Therefore, it is crucial to strictly determine the appropriate indications. For patients with cerebral hemorrhage, cerebral embolism, or extensive cerebral infarction, the peak period of cerebral edema generally occurs between five to seven days, during which time mannitol should be used to lower intracranial pressure. If the acute phase has passed, then there is no need to use mannitol. For some patients, using mannitol weeks later not only lacks therapeutic effect, it might even worsen the condition. Additionally, when using mannitol, it is important to monitor the patient's renal function. In patients with renal insufficiency, the use of mannitol may exacerbate renal damage, so monitoring changes in renal function is essential. (Please use medication under the guidance of a doctor.)
The difference between stroke and cerebral infarction
The difference between stroke and cerebral infarction lies in the scope of stroke, which is broader and includes cerebral infarction. Stroke is divided into hemorrhagic stroke and ischemic stroke. Common types of hemorrhagic stroke include cerebral hemorrhage and subarachnoid hemorrhage. Common types of ischemic stroke include cerebral infarction and cerebral thrombosis. Thus, the scope of stroke is relatively large and includes cerebral infarction. Cerebral infarction occurs when a blockage in the cerebral blood vessels leads to ischemia, edema, and necrosis of the brain tissue in the supplied area, resulting in symptoms of stroke. Additionally, cerebral embolism occurs when an embolus from another part of the body detaches and blocks a brain artery, causing ischemia and necrosis of the brain tissue in the supplied area, also leading to stroke.
Clinical manifestations of stroke
Firstly, the patient may experience aphasia, such as not understanding others' conversations and being unable to accurately express their own opinions. Signs of facial paralysis, such as a skewed mouth, drooling, and nasolabial fold, may also appear. Secondly, limb paralysis is a common clinical symptom, generally presenting as hemiplegia. There may also be hemisensory disturbances, such as numbness on one side of the body. Thirdly, patients may experience a decline in cognitive functions, exhibiting slow reactions, reduced memory capabilities, and decreased computational skills. If a stroke affects the posterior circulation, the patient may experience symptoms such as dizziness, double vision, and hemianopia.