The treatment goals in the early stage of stroke

Written by Tang Bo
Neurology
Updated on September 17, 2024
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Stroke includes hemorrhagic and ischemic types. Whether it is hemorrhagic or ischemic, hospitalization is necessary during the acute phase. Depending on the patient's condition, if it is hemorrhagic, the amount of bleeding should be considered to decide whether to opt for surgical treatment or conservative treatment. If it is ischemic, and the treatment is initiated within the therapeutic time window, that is within 4.5 hours, thrombolytic therapy can be administered, which may potentially reverse the symptoms of the stroke. If the time window is missed, then conservative treatment is required. Acute cerebral infarction in its acute phase can potentially worsen, so the primary goal of acute phase treatment is to stabilize the condition. After stabilization, rehabilitation and physical therapy can gradually improve the patient's symptoms.

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Written by Zhang Hui
Neurology
1min 9sec home-news-image

What is a stroke?

The English term for 脑卒中 is stroke, which generally refers to a group of cerebrovascular diseases. These diseases often onset acutely and mainly consist of two types. The first type is ischemic stroke, which includes diseases like cerebral thrombosis, watershed infarction, cerebral infarction, and cerebral embolism. The second type is hemorrhagic stroke, which primarily includes cerebral hemorrhage and subarachnoid hemorrhage among other bleeding-related disorders. Regardless of the type, the onset of stroke is very sudden, and patients rapidly develop severe neurological deficits. For example, a patient may experience sudden slurred speech, paralysis of one side of the body, or numbness and weakness on one side. There will inevitably be obvious symptoms like dizziness, headache, nausea, vomiting, and stiffness of the neck. If a stroke is suspected, it is crucial to rush to the hospital immediately. Doctors will make an accurate diagnosis and provide appropriate treatment based on the patient's medical history and cranial CT scans.

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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 Tang Bo
Neurology
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Key Points in the Treatment of Different Recovery Stages of Stroke

Stroke includes ischemic stroke and hemorrhagic stroke, namely cerebral infarction and cerebral hemorrhage. Their treatments are generally opposite. If it is a cerebral infarction, thrombolytic therapy is needed within 4.5 hours of the acute phase. It is necessary to consider whether there are indications and contraindications, and whether the patient and family members agree to undergo thrombolytic therapy. Regardless of whether thrombolytic therapy is administered, it is essential to subsequently check the condition of the cranial vessels to determine if surgical treatment is needed. If surgery is not required, hospitalization for conservative treatment might be necessary. Typically, about 7 to 14 days after the acute phase, rehabilitation treatment may be needed once the patient's condition stabilizes. The duration of rehabilitation treatment usually depends on the patient's recovery progress. Afterwards, it is important to consider the patient's underlying diseases, such as hypertension, diabetes, and other risk factors, to perform secondary prevention, which involves medication and control of risk factors. In the case of cerebral hemorrhage, the treatment during the acute phase depends on the amount and location of the bleeding and whether there are indications for surgery to determine if surgical treatment is necessary. If conservative treatment is chosen, it also involves hospital treatment, followed by possible rehabilitation treatment once stabilized.

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Written by Zhao Zi Pan
Neurology
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Can a stroke be cured?

Stroke can result in sequelae such as deviation of the mouth, slurred speech, hemiplegia, numbness of extremities, coughing when drinking water, hoarseness, and difficulty swallowing. If the stroke affects a smaller area or is not located in a critical area, recovery tends to be better. However, if the infarct is large or occurs in a critical area like the brainstem, sequelae may persist, with partial function recovery possible within about three to six months.

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Written by Shi De Quan
Neurology
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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.