Post-stroke depression

Written by Zhang Hui
Neurology
Updated on December 16, 2024
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Recent studies have confirmed that in addition to language dysfunction, cognitive impairment, and motor dysfunction, stroke patients also exhibit many signs of depression. According to guidelines published in China in 2016, about 33% of stroke patients experience post-stroke depression, which is a very high proportion. The main symptoms of post-stroke depression include a lack of interest in anything, unwillingness to communicate with others, being quiet and reticent, non-compliance with medication, and non-cooperation with rehabilitation training. Post-stroke depression significantly affects the recovery of patients and their future quality of life. Some patients may even turn to suicide due to depression. Therefore, it is crucial to pay attention to depression after a stroke, as the incidence rate of post-stroke depression is very high, reaching up to 33%. Clinicians must carefully identify it, and family members of patients must be attentive in their care.

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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 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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What are the symptoms of a stroke?

Stroke, also commonly referred to as cerebrovascular accident, is caused by the rupture or blockage of blood vessels within the skull, leading to necrosis of brain tissue and a series of symptoms. It is divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke, commonly known as cerebral infarction or stroke, while hemorrhagic stroke refers to cerebral hemorrhage. Generally, ischemic strokes account for 80% of cases. Ischemic stroke is caused by blockage of blood vessels leading to necrosis of brain tissue, presenting with a series of symptoms such as hemiplegic numbness. Cerebral hemorrhage results from rupture of brain blood vessels causing damage to brain cells and symptoms of compression, and may also present with symptoms such as hemiplegic numbness. Both types can be differentiated by their symptoms, and can also be definitively diagnosed through a CT scan.

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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 Zhang Hui
Neurology
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Can stroke paralysis be cured?

For a disease like stroke, if paralysis occurs, a small portion of patients can be completely cured without any sequelae. These patients generally are younger in age, receive timely treatment, and do not have a particularly large area of cerebral infarction. However, for the majority of patients, some degree of sequelae is likely to remain. After a stroke, it is crucial to go to the hospital as quickly as possible. If thrombolytic treatment can be administered during the intravenous thrombolysis time window, it can be very effective, and a few patients may even be completely cured. For most patients, further treatment with antiplatelet therapy and rehabilitation training is needed. Although symptoms can significantly improve, complete recovery is relatively difficult.