Hemorrhagic brain stem stroke: symptoms, consequences and treatment
In the modern world the strokes – one of the most common causes of deaths. Distinguish between ischemic and hemorrhagic strokes, which, in turn, are divided into several subtypes according to the localization and degree of complexity.
Types of hemorrhagic stroke.
Hemorrhagic stroke of the brain stem.
It should be noted that the stroke of the brain stem leads to almost instant death. Only in rare cases it is possible to save the life of a patient with this diagnosis. Thus, the probability of returning to normal life is missing.
The brain stem is the center of all systems of the body, and is directly connected with the spinal cord. He serves as a liaison between the teams brain centers and nerves of the body: thanks to him, we are able to move, breathe, swallow, see, hear and so on. The brain stem also regulates the circulatory system, thermoregulation, palpitations. That's why his damage in stroke often leads to death.
Depending on the location of the following types of hemorrhagic stroke:
- Hemorrhage in the periphery of the brain or in the thickness of the fabric;
- Venticular hemorrhage is localized in the lateral ventricles;
- Subarachnoid – bleeding into the space between hard, soft and arachnoid membranes of the brain;
- Combined type: meets with extensive hemorrhage affecting several parts of the brain.
Peripheral hemorrhage is much less dangerous than the intracerebral, which is necessarily provokes the formation of hematomas, edema, and subsequent death of brain tissue. Hematoma also distinguish localization:
- Medial hemorrhage damages the thalamus.
- Lateral – lesion of subcortical nuclei, localized in the white matter of the hemispheres (fence, amygdala, caudate, lenticular nuclei).
- Lobar haematoma is localized within one lobe of the brain within the cerebral cortex.
- Combined – hematoma, affecting several areas of the brain, are the most common.
By origin distinguish primary and secondary hemorrhagic stroke:
- Primary – provoked hypertensive crisis or thinning of the walls of arteries and veins caused by prolonged strain on them (for example, in connection with high blood pressure, physical and nervous overloads, etc.)
- Secondary – caused by a rupture of aneurysms, angiomas and other vascular deformations and anomalies (malformations), congenital or formed in the process of life.
Causes of the disease.
Symptoms of hemorrhagic stroke.
Hemorrhagic stroke occurs suddenly. Characterized by a piercing,
Symptoms for cerebral hemorrhage.
General clinical picture in stroke brain hemorrhage is characterized by the following symptoms.
- Hoarse and breathing ragged.
- Inconsistent and irregular heart beat;
Hemorrhagic stroke of the brain: coma.
In most cases, a hemorrhagic stroke leading to a coma. After hitting the consciousness of the patient first becomes confused, then he falls into a state of stupor: eyes open, there are reflex reactions to stimuli, but the person already does not understand and does not see. The third stage is becoming a vegetative coma – unconsciousness.
Lead to coma extensive hemorrhages which provoke the formation of hematomas in the vital centers of the brain.
Most often coma is fatal. The percentage of survivors.
Back after a coma to a full life is hardly possible: it all depends on how badly damaged the brain and what areas were affected. Possible mental disorders and partial paralysis, and profound disability or a lifelong vegetative state.
What is the prognosis for a person lapsed into a coma after a hemorrhagic stroke? Unfortunately, in most cases it is unfavorable. And even highly qualified specialist can not always predict the course of events, since the brain is a very complex system. But some information about the next state of the patient, the physician can provide by analyzing current comatose state.
The highest mortality rate is observed in patients in the first 24-48 hours after the onset of coma. If this critical moment, managed to survive, the life of the patient is likely to survive. The only question is its quality, because even after recovery from coma remain irreversible consequences, for example,
- Partial or complete loss of vision/ hearing.
- Partial paralysis of the facial nerves, limbs of one side of the body.
- Confusion and disturbance of thought processes.
- Memory disorders and the development of dementia.
- Loss of ability to speak, to perceive the information.
- Preservation of a vegetative state – that is, there are reactions to external stimuli, open/closed eyes, butthere is almost complete paralysis and loss of personality.
Vegetative state – the most common outcome of brain hemorrhage. As a rule, people are still experiencing some emotions, even fears and hallucinations that may in any way be manifest in his eyes or possible movements. If a vegetative state lasts for a long time without a positive dynamics, the prognosis can be only one: the brain of the patient gradually loses all its functions (in particular, respiratory, metabolic, etc.) that will lead to death.
However, science knows a number of occasions that she can't explain. Some patients, moving posthemorrhagic who fell into a vegetative state from which they were able to come out a few months later, and even partially to rehabilitate themselves, to recover speech and ability to move.
It can be called "miraculous healing". Although medicine assumes that the human brain contains some hidden reserves and opportunities. Because our brain is a complex system that is not fully understood.
Another danger which conceals post-hemorrhagic coma is a repeated stroke. Usually the second shot possible in a few days after the first: it all depends on the reason which provoked this condition. That's why almost the only way to avoid recurrent stroke is surgery. With repeated hemorrhagic stroke fatal outcome is almost inevitable.
The consequences of hemorrhagic stroke.
A stroke is an unpredictable disease. The majority of patients after a stroke don't survive, but the unit still manages to not only save lives, but also to get rid of frivolous effects. And eventually (though not many) and does manage to eliminate them almost completely. And here the key thing is the localization and size of the hemorrhage, as well as the timeliness of medical care provided.
In General, the consequences of hemorrhagic stroke are similar to ischemic consequences. They differ only in severity. In addition, the mortality and the likelihood of a coma after hemorrhage significantly higher than after ischemic stroke.
In hemorrhagic stroke, the blood trapped in the brain after rupture of a vessel that damages brain tissue, causing a hematoma. Then proishodit its collapse and begins the process of disintegration of its cells. The breakdown products cause inflammation and swelling of the brain tissue, then their necrosis. The severity of the consequences depends on the amount of blood, hemorrhage localization and treatment.
As a rule,hemorrhagic stroke has the following consequences.
1. Rapid onset of death.
It is typical for patients with extensive hemorrhage, or in the case when damaged vital areas of the brain the brain stem.
2. Coma and subsequent death.
In this case, the patient is temporarily retains the ability to life. The outcome depends on the course of bruising and other factors.
3. Coma and subsequent recovery in vegetative state/ stupor.
Even in this case, the patient is still threatened by fatal, because under these conditions often is a sequential depression of all brain functions.
4. The output of the vegetative state and profound disability.
The life of the patient in this case, saved. However, it is not possible to live a full life. The organism viable but depressed the power of motion, speech, memory, partly clouded consciousness, etc.
In a minority of cases of survivors of hemorrhagic stroke patients is characterized not so serious consequences. As a rule, in these patients the hemorrhage was not as extensive or even small. And also time the surgery was performed or the appropriate intensive therapy.
5. Partial loss of motor function.
The man staggers, stumbles when walking, podrachivat a leg or has to use crutches. Experiencing weakness, difficulty walking. But the ability to move saves.
6. Violation of swallowing ability.
This is a fairly dangerous violation that requires special care for patients, as the inability to swallow can lead to contact with food and drink in the airway, resulting in asphyxia. Also the absence of swallowing movements leads to stagnation of food in the esophagus, digestive disorders and bowel function.
7. Damage to the speech center.
Complete or partial loss of ability to speak and/ or to perceive speech, difficulty writing, loss of ability to think, loss of writing skills, etc.
8. Disruption of brain areas responsible for orientation in space and perception of the world.
A person can remain excellent vision after a stroke, but he ceases to understand what is going on around. He is not able to perform even simple actions: for example, take the Cup in his hands and bring it to her mouth.style="text-align: justify;"> 9. Violation of thought process.
The patient is not capable of thinking, no logical thinking. Missing long-term memory short-term memory is disrupted, are failures. Learning becomes impossible, you lose the ability to build action plans and make decisions.
10. Behavioral violations.
Altered consciousness often leads to inappropriate behavior of the patient: unfounded fears, hallucinations, irrational anger, weeping, causeless fright, sudden emotional utterance, action, movement.
11. Psychological abnormalities.
Prolonged depression, depressed, depressed state, sleep disturbance, suspicion and anxiety, anorexia.
12. Loss of ability to control natural needs.
Occurs involuntary urination, defecation. And constipation, difficulty work of organs of small pelvis, the lack of innervation of the bladder and a number of other problems.
13. The development of epilepsy.
A rare but possible consequence of hemorrhagic stroke, which is characteristic for 10-15% of patients surviving after stroke.
14. The attacks of pain.
A small percentage of patients after stroke to life-long exposed to the pain syndrome in different parts of the body. At the same time, such pain cannot take painkillers and antispasmodics, as it is not due to external stimulus or spasm, and lesions of the Central nervous system.
Further the prognosis of stroke.
Unfortunately, accurate prediction in stroke can give any doctor. In medical practice there are known cases of survival after a massive stroke in situations where chance seemingly gone. Also abound of deaths from hemorrhages of small size. In each case all individually. However, some General criteria for prediction do exist.
For example, a patient who is unconscious, but it has all the basic reflexes and functions of the body, is likely to remain alive. The patient, who has no consciousness and reaction to any stimulus, but the muscles contract and retained the ability to swallow, also has high chances of survival. If the person is in a coma, and all life functions as special medical devices, the chances of survival had virtually none.
As for the survivors of patients who only partially lost his legal capacity, with a great desire and work, andwith the support of loved ones possible significant improvement. After all, a partially paralyzed limb can be developed, conduct the appropriate therapy to restore innervation, to learn to walk again or speak.
In General, even the fact that the patient remained alive after the impact, says major luck. Therefore, the relatives of the patient can only trust professionals and to patiently wait for improvements, rejoicing that your loved one was still alive. And, of course, to do everything possible to recover it.
Brain surgery is often the only way of saving life in hemorrhagic shock. However, she has a lot of contraindications and features. So, for any scenario, surgical intervention:
- When putaminal and lobar hematoma.
- When thalamic hematoma when struck by the middle part of the brain.
- If the amount of damage to the thalamus is more than 10 cm3, is used to assess the feasibility of the operation.
- When the hematoma of the brain stem, surgery is possible but not always advisable, since such damage is, by definition, deadly.
It is absolutely contraindicated and inappropriate operation of the brain in deep coma (at a level of 7 on a scale of Glasgow), because, firstly, facing lethal outcome, and secondly, may not make sense due to global brain damage.
There are also a number of relative contraindications to the operation:
- The age limit is 70 years;
- Cardiovascular disease;
- Kidney disorder and liver;
- Diabetes mellitus;
What is the meaning of the operation:
Surgery for hemorrhagic stroke involves the extraction of clots from the hematoma to prevent the negative effects of toxins decaying blood on brain cells. Also the operation is aimed at normalizing the blood circulation, stabilize
Speaking about the treatment of hemorrhagic stroke, one should consider the fact that the brain hemorrhage has already occurred, and the process of damage and death of tissues in this situation very quickly. If the process of ischemic stroke from the beginning to the final stage takes several days, giving the doctors enough time for its elimination and treatment, in the case of bleeding in the brain the speed and time play a crucial role. The faster the ambulance gets here, the sooner diagnosis and treatment begins,the better the patient's chances to survive and even recover after surgery. Action needs to be clearly and coherently, decisions must be made quickly, and the margin for error in such a case no doctors.
With extensive hemorrhage and number of the above indications is assigned to the operation for the removal of hematomas of the brain. Hematoma should be removed in the first two days, because clotted blood not only hinders the work and power of the brain, but decaying, causes its inflammation, edema and necrosis of surrounding tissues. The sooner it is resolved the hematoma, the greater the chance of survival and recovery.
Small hemorrhages surgical intervention is not required, and are eliminated by means of conservative therapy. However, neurosurgical treatment should be applied to her in the complex.
- Correction of blood pressure.
For his correction and stabilization prescribe taking ACE inhibitors, beta-blockers and spasmolytics. The pressure is back to normal in accordance with the individual characteristics of the organism of the patient. As a rule, hemorrhagic stroke almost always occurs on the background of hypertension.
- Removal of edema of the brain.
The first condition for removing the swelling of the brain is intense and saturated with oxygen and all necessary nutrients. Therefore, the patient is administered oxygen to the lungs through the respirator, nebulizer, or other devices. Another important condition is the elimination of the causes of edema – hematoma, which is accomplished through surgical intervention. In some cases the recommended installation of a drainage system to drain excess fluid. To restore blood circulation, venous and liquor outflow from the tissues are assigned sosudoukreplyayuschee and anticonvulsant drugs. It is also necessary to eliminate all external stimuli – bright lights, noise, to limit the movement of the patient. The use of pain medication also helps to relieve swelling of the brain. It is necessary to reduce the body temperature of the patient to normal. In some cases, appointed by diuretics to drain excess fluid.
- Hemostatic therapy.
On the one hand, to reduce the possibility of blood clots, on the other – to prevent the resumption of bleeding. So the damaged vessel docked surgically, appointed vasoconstrictor drugs. Is strictly prohibited the entry of drugs that stimulate blood clotting.start="4">
- Sedative therapy.
This type of therapy is aimed at elimination of external stimuli and the stable emotional state of the patient rest and sleep. Assigned fenozepam, valium, sleeping pills.
Folk remedies for the treatment of hemorrhagic stroke.
On the treatment the popular methods it is possible to speak only when the patient's condition stabilized and his life is not in danger. Such funds are aimed at addressing the effects of stroke, stimulation of the nervous tissue, in the active rehabilitation therapy for brain tissues, nerves and muscles and for the whole body. In General, intensive rehabilitation after hemorrhagic and ischemic stroke devoted a large article "Rehabilitation after stroke", available on our website.
Strict power correction is the first step to a successful recovery after a stroke. It is necessary to refuse fat meat, sweet foods and alcohol, to optimally balance the ration.
And many folk remedies perfectly, and safely stimulate cell regeneration and recovery of innervation.
- The infusion of young pine cones.
Young pine cones insist on vodka in a month. Take it three times a day for 1 teaspoon. This infusion helps to strengthen the vascular wall, normalizes blood pressure, restores skin sensitivity in the innervation of the limbs, strengthens the muscle tissue.
History: as an infusion from the cones helped the patient recover after a stroke:
- Or pine pollen.
Pollen is a potent natural remedy for strengthening the vascular wall, nourishes the body's cells and fills them with antioxidants and vitamins. Recommended daily usage as a food Supplement. A day can be used up to a tablespoon of product.
- A decoction of birch leaves.
A wonderful tonic that cleanses the blood and vessels of toxins, improves the immune system. Shredded birch leaves boil for about 15 minutes, and then insist a few hours in a thermos. The broth can be replaced by infusion of birch leaves in alcohol.
- Walnut walls + hawthorn.
Alcohol tincture of hawthorn, pour a small amount of partitions, young nuts and insist 2 weeks.
- Shilajit aloe.
Shilajit promotes the active resorption of the thrombus, stimulates the regeneration of cells. PowderShilajit is mixed with aloe Vera juice and drink the resulting medicine for 10 days. A break is 4 days, and then the course is carried out again.
Another name of a plant is Echinops. Its alcohol infusion promotes elimination of paralysis, as it stimulates the innervation of the muscle. Infused for 21 days and the treatment lasts a few weeks.
- Chestnut tincture.
The medicine is prepared from the rind of the horse chestnut, which is crushed and insist on alcohol 3 days. Chestnut successfully relieves swelling of the brain after a stroke.
The above folk remedies promote a more rapid treatment of stroke and recovery of lost abilities.
Of course, among the methods of treatment of a stroke is present and puncturing the vein with consequent bleeding, applying ice to the head and other radical and dangerous means. In the modern world of science and medicine allow us to do everything possible to prevent shock and its consequences.
And, of course, it is important to remember that prevention of diseases, timely prevention is the best method of dealing with it. If you have seen a constant malaise, headaches, weakness and other health problems, it is better to go to the clinic and once again a complete examination of the body.
Hemorrhagic stroke carries a heavy burden. Nevertheless, it is possible to avoid, adhering to a healthy lifestyle and doctor's recommendations.