What department should I go to for a stroke?

Written by Tang Bo

Neurology

Updated on September 10, 2024

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Stroke is classified into ischemic stroke and hemorrhagic stroke. If symptoms of a stroke occur, such as slurred speech, limb weakness, or other neurological deficits, one should immediately seek medical attention at the emergency department of a local hospital. Emergency doctors will perform a head CT scan. If ischemia is present, the CT scan might not show changes within 24 hours, in which case a visit to the neurology department is necessary. If hemorrhage is detected, then a visit to the neurosurgery department is required. However, if the symptoms are of a chronic, old stroke, then a visit to the neurology department is needed.

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Treatment of urinary retention in stroke patients

In cases of urinary retention after a stroke, some patients experience this due to psychological factors, concerns, and the sudden need to remain in bed, making it difficult to urinate in bed since they cannot stand or squat. Therefore, the first step is to alleviate psychological factors, provide patient communication and counseling, and perform massages around the navel and abdomen, along with heat treatments, to help patients urinate on their own. In a second scenario, where the patient's condition is severe or even comatose, and they have difficulty urinating, a catheter can be placed. It's important to first try to rule out a urinary tract infection, collect a midstream urine sample for analysis, and ensure the catheter is not left in longer than necessary. Once the patient's condition improves or they regain consciousness, the catheter should be removed promptly to avoid any urinary tract infections.

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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.

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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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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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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.