Key Points in the Treatment of Different Recovery Stages of Stroke

Written by Tang Bo
Neurology
Updated on November 24, 2024
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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 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.

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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 Zhang Hui
Neurology
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Post-stroke depression

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 Zhang Hui
Neurology
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Six Common Manifestations of Stroke

Firstly, patients may experience language impairment, primarily characterized by unclear speech or sensory aphasia, where they cannot understand others' conversations. Secondly, motor dysfunction is also a very common symptom, typically presenting as hemiplegia on one side of the body. Thirdly, sensory dysfunction can occur, manifested as numbness in one side of the body, an inability to feel pain, and an inability to sense temperature. Fourthly, there may be signs of ataxia, such as unstable walking or standing. Fifthly, there may be difficulties in swallowing, coughing while drinking water, and articulation disorders. Lastly, cognitive dysfunction can also occur, characterized by slow responsiveness and similar symptoms.

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Neurology
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Main manifestations of pre-stroke warning signs

The precursor of cerebral thrombosis in neurology is called transient ischemic attack (TIA). As the name suggests, this is a transient disease, mainly characterized by symptomatic speech impairment, facial droop, drooling, episodic dizziness, blurred vision, and episodic numbness and weakness of limbs. These symptoms are generally transient, usually lasting from several minutes to a few hours and can be completely relieved. The precursor of cerebral thrombosis is regarded as an emergency in neurology and must be treated promptly. Delayed treatment can possibly progress to cerebral infarction, severely affecting the patient's quality of life and physical health. In considering this disease, one must immediately rush to the hospital for appropriate treatment with antiplatelet drugs, lipid-regulating drugs to stabilize plaques, and treatments such as volume expansion and fluid supplementation.