Stroke

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Written by Zhang Hui
Neurology
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What does a stroke cause?

Stroke primarily causes neurological deficits such as limb paralysis in patients. This paralysis is typically hemiplegic, where one side of the body lacks strength, the affected limbs cannot walk, and the upper limbs cannot be lifted. Stroke can also cause numbness in the limbs. Patients may experience reduced pain and temperature sensation on one side of the body, unable to feel pain or temperature. Additionally, stroke can lead to headaches and symptoms such as nausea and vomiting, commonly seen in hemorrhagic strokes, such as cerebral hemorrhage. Furthermore, strokes in specific brain areas like the frontal lobe, temporal lobe, and hippocampus can cause cognitive impairments. Patients become slow to react, have significantly reduced learning and memory capabilities, and their ability to perform daily activities and work is noticeably affected. Strokes can also cause unclear speech, where patients have difficulties in expressing themselves verbally and may even be unable to understand conversations.

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Written by Liu Yan Hao
Neurology
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Can a stroke be detected through a physical examination?

Patients who have suffered a stroke can definitely be diagnosed if they undergo a head CT scan or MRI during a physical examination. Stroke is classified into hemorrhagic stroke, ischemic stroke, and tumor-induced stroke. A tumor-induced stroke is caused by a tumor, and hemorrhagic stroke includes cerebral hemorrhage and subarachnoid hemorrhage. Ischemic stroke refers to diseases such as cerebral embolism and cerebral infarction. Whether it is a hemorrhagic or ischemic lesion, over time, they tend to form a softening focus. These lesions are difficult to eliminate, and regardless of how many years have passed, these old lesions can still be seen in a head CT scan or MRI. In cases of stroke caused by brain tumors, the changes in size and location of the lesion can also be clearly seen on a head CT scan. Therefore, strokes can be diagnosed during a physical examination of the patients.

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Written by Liu Yan Hao
Neurology
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What are the types of strokes?

The common types of strokes include hemorrhagic stroke and ischemic stroke. Hemorrhagic strokes commonly involve subarachnoid hemorrhage and intracerebral hemorrhage. Subarachnoid hemorrhage often occurs due to the rupture of cerebral aneurysms, causing blood to enter the subarachnoid space. Intracerebral hemorrhage is commonly caused by hypertension leading to the rupture of cerebral blood vessels and subsequent bleeding into the brain parenchyma. Additionally, there is ischemic stroke, commonly presenting as cerebral infarction and cerebral embolism. Cerebral embolism occurs when a blood clot from another part of the body outside the brain, following the blood circulation, blocks a cerebral vessel. Cerebral infarction happens when cerebral arteriosclerosis narrows down to a certain extent, gradually obstructing and forming cerebral infarction. These are the common types of strokes.

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Written by Tang Bo
Neurology
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Common clinical manifestations of stroke

Stroke includes ischemic stroke and hemorrhagic stroke, also known as cerebral infarction and cerebral hemorrhage. The clinical manifestations of cerebral infarction depend on the location of the occlusion, and may vary accordingly. Common symptoms include slurred speech and limb weakness. It generally occurs acutely, and may also include memory decline or a series of other symptoms depending on the specific location of the occlusion. If these symptoms occur, it is crucial to seek medical attention immediately, as there is an opportunity for thrombolytic treatment within 4.5 hours. In the case of cerebral hemorrhage, patients may experience symptoms during physical activity, possibly accompanied by severe headaches, as well as symptoms of neurological deficits such as unclear speech, limb weakness, or other symptoms. Seizures may also occur. It is essential to visit the hospital immediately if these symptoms appear. If cerebral hemorrhage is confirmed, the decision for surgical treatment depends on the amount of bleeding.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Principles of Stroke Rehabilitation Treatment

Principles of stroke rehabilitation treatment. First is the issue of timing; it is crucial to choose the appropriate time for rehabilitation intervention. Rehabilitation treatment should start as early as possible when the patient's condition is stable. Secondly, rehabilitation assessment, also known as rehabilitation evaluation, should be performed throughout the treatment process. This allows for comparability before and after treatment, clarifying the treatment results for the patient and determining if there is a need to modify the treatment plan during the process. Thirdly, it is essential to have rehabilitation treatment goals and plans. Based on assessments, short-term and long-term rehabilitation plans must be developed for the patient to achieve certain rehabilitation objectives. Fourth, the principle of gradual progression must be adhered to in rehabilitation treatment. It should not be rushed, and active participation from both the patient and their family members is crucial, incorporating daily life and exercise opportunities. Fifth, rehabilitation treatment primarily involves comprehensive therapy, which includes physical exercise, speech therapy, occupational therapy, physiotherapy, and traditional rehabilitation treatments such as acupuncture and moxibustion, as well as psychological therapy, rehabilitation engineering, and assistive devices. Sixth, conventional pharmacological treatments and necessary surgical interventions are involved. These include essential medications that must be used, and when rehabilitation methods alone cannot restore function, appropriate medical advice from relevant departments should be considered, and surgical treatment may be needed to assist the patient in better recovery.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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What is the goal of rehabilitation during the acute phase of a stroke?

Rehabilitation goals during the acute phase of stroke. In the acute phase, we usually can intervene with rehabilitation treatment 48 hours after the patient’s vital signs have stabilized. The main goals of rehabilitation during the acute phase are to prevent complications such as pressure ulcers, atelectasis pneumonia, urinary tract infections, deep vein thrombosis, and muscle atrophy. Additionally, it aims to improve impaired neurological functions such as sensory, motor, and speech therapies, and to enhance the patient’s ability for self-care and mobility.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Rehabilitation Treatment Plan for Stroke

The rehabilitation treatment plan for stroke involves rehabilitation physicians and therapists who, through comprehensive assessment of the patient's overall medical condition and functional impairments, develop individualized plans. These plans focus primarily on the patient's functional impairments, and accordingly, design treatments for movement, speech, swallowing, and attention to promote the patient's overall rehabilitation and improve their ability to perform daily activities independently. Common rehabilitation treatment options include not only medication but also occupational therapy, speech therapy, physical therapy, psychological support, and traditional rehabilitation methods. Through these personalized and comprehensive rehabilitation treatments, the aim is to facilitate the patient's early recovery, allowing them to return to their family and work environment sooner.

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Written by Tang Bo
Neurology
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Is a stroke a cerebral infarction?

Stroke includes cerebral infarction. Stroke is divided into ischemic stroke and hemorrhagic stroke. Therefore, ischemic stroke is cerebral infarction, and hemorrhagic stroke is cerebral hemorrhage. Thus, one cannot say it is solely a cerebral infarction; it includes cerebral infarction. If symptoms of stroke appear, such as unclear speech or limb weakness, it might be either hemorrhagic or ischemic stroke. In such cases, it is crucial to seek medical attention immediately. For hemorrhagic stroke, one should visit the neurosurgery department, and for ischemic stroke, the neurology department is appropriate. Initially, a CT scan should be performed to make a clear diagnosis.

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Written by Tang Bo
Neurology
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The difference between stroke and cerebral infarction

Stroke is divided into hemorrhagic stroke and ischemic stroke. Hemorrhagic stroke involves cerebral hemorrhage, while ischemic stroke involves cerebral infarction. Therefore, the difference is that stroke includes cerebral infarction, which is a type of ischemic stroke. In such cases, it is crucial to seek prompt hospital treatment and examine for risk factors related to cerebrovascular disease. Under the guidance of a doctor, the condition should be stabilized since the acute phase of a cerebral infarction might be unstable and could worsen. Thus, after stabilizing the condition, long-term oral medication will also be necessary to prevent future strokes.

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Written by Gao Yi Shen
Neurosurgery
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What are the symptoms of a stroke?

Symptoms of stroke vary greatly, and it is crucial to judge based on the circumstances. The symptoms are mainly divided into two major categories: hemorrhagic stroke and ischemic stroke. The most common symptoms of hemorrhagic stroke are severe headaches, projectile vomiting, and the gradual onset of consciousness disorders. Some people might also experience limb numbness, weakness, speech impediments, and other conditions. The most common symptoms of ischemic stroke include dizziness, limb numbness, and speech impediments; sometimes, these symptoms alternate, so it is essential to pay attention to clinical observations and focus on differential diagnosis. There are also other types of symptoms, such as cognitive decline, urinary and fecal incontinence, unstable gait, swallowing difficulties, and coughing while swallowing. Therefore, it is imperative to visit a hospital in a timely manner for testing to clearly understand the specific changes in the patient's condition at that time, thus better facilitating the patient’s recovery.