Right-sided ischemic stroke
Causes and risk factors of ischemic stroke
Causes and risk factors for development of acute ischemia of the right hemisphere of the brain do not differ from those in left-hand shot.
The direct cause of the development of infarction of the right hemisphere of the brain is a blockage of blood vessels that nourish it. To block the flow of blood may atherosclerotic plaque, embolus, thrombotic mass, the vessel may be squeezed from the outside or spazmiruyutsya for a long time. Also to the development of ischemic stroke can causes hemodynamic disturbances that are accompanied by drop the system
Classification of ischemic stroke
There are several classifications of ischemic stroke, but the practical importance is the distribution of ischemia on the rate of development as it determines the treatment tactics and the direction of prevention.
The rate of development of acute cerebral ischemia are distinguished:
- A TIA (transient ischemic attack). This is an acute violation of cerebral circulation, which is accompanied by a characteristic stroke, focal neurological symptoms, but takes place within 24 hours after the start. Leaves no neurological deficit. However, this condition is a kind of warning that in the near future the patient may happen complete cerebral infarction.
- A small stroke. It is acute ischemia of the brain whose symptoms disappear completely within 2 to 21 days after onset of stroke. Has a favorable prognosis, but increases the risk of subsequent cerebral infarction, because it is necessary to pay special attention to preventive measures.
- Progressive cerebral infarction. This clinical variant of the stroke, when symptoms of cerebral and focal neurological) do not develop immediately, but over several hours or even days. It is very common. Diagnosis is difficult because symptoms develop gradually.
- Completed ischemic stroke. This is when the infarction focus is already fully developed, and the patient is having persistent focal symptoms depending on the localization and size of brain damage.
Functions of the right hemisphere of the brain
In order to understand why in ischemic stroke of the right hemisphere affects those and not other functions of the body, you need to understand for what answers right hemisphere of the brain.
The main functions of the right hemisphere:
- control of active movements of the left half of the body;
- ensure expressions of the left part of the face;
- the sensitivity of the left side of the body;
- sight, hearing, smell;
- the sense of intuition;
- orientation in space and locationperson;
- perception of nonverbal information (signs, symbols, images);
- recognition of emotions of other people at the intonation and facial expression, movements;
- responsible for understanding metaphors and metaphorical meanings of words;
- responsible for the perception of music, a penchant for it;
- determines the propensities for drawing;
- provides the functions of the brain, which is multi-tasking, i.e. simultaneous processing of multiple streams of information;
- provides the ability to dream, to dream;
- allows to perceive the subject as a whole, not a collection of individual parts;
- responsible for recognizing faces;
- responsible for the perception of different colors;
- allows you to find differences between something;
- gives people the capacity for concrete thinking.
Accordingly, with the defeat of this hemisphere can be, and as a result lost all of the described functions. The first effects a right-hand stroke, which can be seen, is a left-sided paralysis of the arm and leg (hemiparesis) or one of the limbs, Central paralysis of mimic muscles on the left, impaired vision (blurred, double vision, loss of visual fields), hearing problems, sense of smell. Of speech problems does not happen. This symptom (aphasia) may occur only in people with a dominant right hemisphere.
Much later manifest other symptoms of defeat of the right hemisphere of the brain that are associated with the loss of one or more of the above-described functions. A person can lose the ability to recognize people's faces, familiar objects, can't understand humor and metaphors (takes everything literally). Loses inclinations to music, drawing and painting. Impaired ability to focus on familiar terrain, the ability to find differences, learn colors, understand the emotions of others.
The clinical features of right-sided cerebral infarction
As has been said, often rapid diagnosis of the disease difficult, as there are no problems with it. On the development of a right-hand stroke indicate the symptoms:
- headache, spinning head, nausea, vomiting;
- there may be a violation of consciousness or its loss;
- decreased muscle strength and inability to complete movements in the left extremities;
- paralysis of the left side of his face (drooping of the left corner of his mouth, sagging of the left lower eyelid and cheek);
- visual symptoms;
- sudden loss of orientation in the surrounding;
- violation of the sensitivity on the left side (tingling, numbness);
- sudden loss of coordination and balance;
- palpitations, shortness of breath;
- excess paroobrazovaniya;
- dry mouth;
- change the normal color of the skin;
- increase in blood pressure.
Incase of such signs, you should immediately seek medical help or call an ambulance. After all, every lost minute could stand the patient's health or even life.
Diagnosis of ischemic stroke
For rapid diagnosis of a stroke you can apply the following test, which consists of 4 steps:
- Ask the victim to smile. If the smile curve, you should smell a rat.
- Ask the person to say any suggestion. If he can't do or slurred speech – call an ambulance.
- Ask the person to raise both arms first and then both legs. If this does not work to raise one of the extremities, it is necessary to suspect a stroke.
- Check the orientation of the person in itself and in space. If he can't call his name, to remember where it is and what day it is, you should suspect a problem.
In the hospital, the person with stroke are required to appoint a neurologist, neurosurgeon, cardiologist. Conduct complete laboratory blood and urine tests, CT or MRI of the brain, ECG, radiography chest, ultrasound of the heart, control blood pressure. All these tests allow to determine the type of stroke, its localization and size, to create a proper treatment program, to diagnose concomitant pathology
Treatment of cerebral infarction
Treatment of right-sided ischemic stroke does not differ from lesions of the left hemisphere of the brain. Conduct basic and specific therapy.
Basic treatment includes the following activities:
- support the basic functions of human life (breathing, cardiovascular system, support of homeostasis);
- normalization of pressure (in the case of increasing reduce pressure gradually, as a sharp drop only increases the brain damage);
- normalization , as hyperthermia in stroke negatively affects the prognosis;
- prevention and treatment of complications (pneumonia, pulmonary embolism, deep vein thrombosis of the limbs, bedsores);
- symptomatic therapy (removal of the tachycardia, arrhythmia, seizures, vomiting and other pathological symptoms);
- prevention and treatment of cerebral edema.
Specific treatment includes:
- the thrombolysis (if the stroke was not more than 6 hours), to this end, special intravenous drugs, thrombolytics that can dissolve the blood clot that blocked the blood flow in the brain, this decreases the area of brain damage and significantly improves the prognosis (chances for recovery);
- the appointment of anticoagulants and antiplatelet agents, drugs thatthin the blood and prevent the re-formation of blood clots;
- neuroprotection is the administration of drugs that protect still viable neurons from damage.
Video about first aid for stroke: