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 Li Chao Jin Zi
Neurorehabilitation
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Basic Principles of Stroke Rehabilitation Treatment

There are several key principles for stroke rehabilitation. The first emphasizes that rehabilitation should start as early as possible. In cases of ischemic stroke, generally when the patient is conscious and vital signs are stable, rehabilitation can begin after 48 hours. For patients with high blood pressure or cerebral hemorrhage, it is generally recommended to start rehabilitation after seven days. The second principle emphasizes the active participation of the patient, encouraging patients to actively engage in rehabilitation training and communicate with therapists to achieve functional improvement. The third point emphasizes comprehensive rehabilitation; stroke patients often have issues in multiple areas such as language, cognition, swallowing, limb movement, and functional balance, so it is suggested that patients undergo comprehensive rehabilitation rather than focusing on just one aspect. The fourth point stresses the continuity of rehabilitation, as rehabilitation therapy is an ongoing process.

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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 Zhang Hui
Neurology
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Stroke and Its Treatment

Stroke primarily refers to cerebrovascular disease, characterized by the sudden onset of symptoms that develop within minutes. This rapid development of symptoms is why it is called a stroke. Stroke commonly affects middle-aged and elderly people who often have certain risk factors. For example, high blood pressure, high blood cholesterol, smoking, drinking, obesity, and heart diseases like atrial fibrillation can increase the risk of stroke. For the treatment of stroke, it is crucial to reach the hospital as soon as possible, as earlier treatment leads to better outcomes. Generally, if it is suitable, the patient may receive intravenous thrombolysis. Additionally, treatment may involve anti-atherosclerosis measures, nutritional support for nerves, and rehabilitation training, which is also very important.

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Written by Zhang Hui
Neurology
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Clinical manifestations of stroke

Firstly, the patient may experience aphasia, such as not understanding others' conversations and being unable to accurately express their own opinions. Signs of facial paralysis, such as a skewed mouth, drooling, and nasolabial fold, may also appear. Secondly, limb paralysis is a common clinical symptom, generally presenting as hemiplegia. There may also be hemisensory disturbances, such as numbness on one side of the body. Thirdly, patients may experience a decline in cognitive functions, exhibiting slow reactions, reduced memory capabilities, and decreased computational skills. If a stroke affects the posterior circulation, the patient may experience symptoms such as dizziness, double vision, and hemianopia.

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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.