Hemorrhagic stroke: symptoms, treatment, accurate diagnosis

Causes and mechanism of development of hemorrhagic stroke

The factors that cause rupture of the vascular wall and hemorrhage may be primary and secondary diseases of the cerebral arteries. Primary diseases initially develop in one or more vessels of the brain; they are not a consequence of any other diseases and often represent congenital changes. Secondary pathologies of the cerebral arteries appear against the background of other diseases, such as diabetes mellitus or systemic lupus erythematosus.

The most common primary factors may be:

aneurysmal dilatation - an area where, due to the weakness of the vascular wall or the consequences of an injury, the artery becomes wider and adapts less well to increased blood pressure or other changes in vascular tone;
vascular malformation is a congenital disorder of the structure of a vessel, which is manifested by the formation of “vascular glomeruli” with cavities of various sizes;
other congenital anomalies of the arterial vessels of the brain.

Secondary causes that can lead to changes in cerebral vessels and their rupture include:

arterial hypertension, especially difficult to treat;
atherosclerotic damage to the vascular wall;
vasculitis - inflammatory changes in the wall of blood vessels;
thrombosis of intracranial veins, which lead to hemorrhage;
diseases manifested by pathology of the coagulation system (blood and liver diseases);
uncontrolled use of drugs that affect blood clotting (anticoagulants, antiplatelet agents, fibrinolytics);
pronounced metabolic disorders that develop during long-term severe illnesses.

The most common cause of hemorrhagic stroke in elderly patients is arterial hypertension - this is about 80% of “vascular accidents”. The second place is occupied by atherosclerosis.

In age groups under 40 years, congenital local dilations of blood vessels (aneurysms) and malformations predominate among the causes of hemorrhagic stroke.

Due to the differences in the causes of the disease in different age groups, early and most accurate diagnosis of the pathology comes first. On our website you can find comprehensive information about methods for identifying risk factors for stroke, as well as find out in which centers they are carried out.

Types of intracranial hemorrhages

Depending on the location of the vessel from which the blood leaked, this type of stroke is divided into:

parenchymal hemorrhage, characterized by the formation of a hematoma inside the brain or hemorrhagic impregnation of the nervous tissue;
subarachnoid, which occurs when blood accumulates between the arachnoid and pia mater of the brain.

With parenchymal hemorrhage, depending on the caliber and location of the vessel, blood may break through into the ventricles of the brain. Such strokes are often characterized by an extremely severe course and loss of a relatively large amount of blood.

Hemorrhages

Extensive hemorrhages in the cerebral hemispheres can be complicated by secondary stem syndrome. About half of the cases of hemorrhage end with a breakthrough of blood into the ventricles of the brain. This causes a sharp deterioration in the person’s condition, a coma occurs, protective reflexes and chaotic motor restlessness are observed in non-paralyzed limbs. Disturbances in the autonomic system appear - chills or increased body temperature, active sweating. Coma is one of the indicators of the severity of the patient’s condition (can last from an hour to several days).

If the hemorrhage occurs in the cerebellum, then pain appears in the neck and occipital region, dysarthria (disorders of the speech apparatus), hypotension or atony of muscle tone.

If the hematoma is limited lateral, then over time the condition becomes stable, improvements appear (consciousness becomes clearer, disorders of the autonomic nervous system are restored).

What happens during a stroke

Regardless of the cause of hemorrhagic stroke, the mechanism of damage to brain cells is the same. The pathological effect has several directions:

Impaired tissue nutrition - due to the fact that the brain receives blood from several main vessels, this effect is partially compensated.
Mechanical damage due to the fact that blood leaves the vessel under pressure and “pushes” the tissues apart.

In the case of parenchymal damage and hematoma formation, the second pathway is more pronounced, resulting in a disruption of communication between brain cells. Hemorrhagic permeation is a relatively uniform distribution of blood between the tissue structures of the brain, therefore the clinical course of such hemorrhage is more favorable.

In subarachnoid hemorrhage (SAH), there is a space where blood gets trapped. For this reason, mechanical damage is less than during the formation of a hematoma, but blood loss and malnutrition of brain tissue can be pronounced.

Cerebral hemorrhage (no matter how mild it may initially seem) is a condition that requires urgent diagnostic and therapeutic measures. Prescribing the correct treatment is possible only after neuroimaging, that is, magnetic resonance or computed tomography.

On our website you can get reliable information about the current discounts and promotions at various diagnostic centers for brain research this month. And also find out where it is possible to conduct an inspection at night, if necessary.

How does a hemorrhagic stroke occur?

Cerebral hemorrhage during a stroke is a spontaneous phenomenon. The functioning of the brain requires large amounts of oxygen from the blood. Nutrition is produced thanks to two carotid and two vertebral arteries, which form a circle between themselves passing through the base of the brain.

When a vessel is damaged, acute blood failure occurs, which is necessarily compensated by healthy vessels. However, over time, the effectiveness of such a mutual assistance system decreases. The appearance of cerebral hemorrhage during a hemorrhagic stroke is caused by sudden ruptures of the vascular walls or their increased permeability due to other chronic diseases.

During a cerebral hemorrhage, the death of brain cells that are damaged by blood contact occurs. In nearby areas of the brain, oxygen deficiency begins, since blood does not reach them and cannot move further through the vascular system.

Manifestations of hemorrhagic stroke

Symptoms and signs of hemorrhagic stroke are very diverse, they depend on:

process localization;
prevalence of the lesion;
volume and duration of blood loss;
the degree of swelling of brain tissue and increased intracranial pressure.

The shorter the period from the onset of the disease to the provision of qualified care to the patient, the fewer complications and the better the prognosis. In order not to waste time, you need to know the general signs of a stroke:

sudden weakness in the arm/leg;
numbness of half the face, arms/legs on one side;
new facial asymmetry;
speech disorder;
a sharp decrease in vision in one eye or blindness;
causeless loss of consciousness, especially in combination with previous symptoms.

If any of the symptoms occur against the background of complete well-being, it is necessary to carry out an accurate diagnosis as soon as possible in a specialized medical institution.

All available information about the nearest medical centers where urgent computer or magnetic resonance imaging of the brain can be performed can be obtained by calling 8 (812) 317-00-37.

Different types of hemorrhagic stroke may occur in different ways, but they also have common features. The disease is often characterized by:

abrupt onset;
rapid deterioration of the condition;
loss of consciousness;
development in the afternoon, at the peak of physical or emotional stress.

Taking into account the peculiarities of the course of the disease, the most important factor for a successful outcome is time. This means that you should not wait for the condition to improve; you should urgently seek qualified medical help.

It is possible to carry out a timely and accurate diagnosis of this disease by dialing a phone number. Our employees will help you quickly select a medical center that meets your needs: the nearest location, the qualifications of specialists, the quality of diagnostic equipment, the cost of the study and the availability of current promotions.

First aid for hemorrhagic stroke

Having identified the symptoms of a stroke in a person who is next to you, try not to panic and use the following algorithm:

assess your general health: breathing, level of consciousness, heart rate, blood pressure;
identify obvious signs of a stroke (read about the FAST test below);
call an ambulance;
try to find out the circumstances of the deterioration in health if the patient is able to communicate;
place the person correctly - on his side, bending his upper leg at the knee;
take care to create conditions in which sufficient oxygen will be supplied;
Monitor the patient’s condition until medical workers arrive and arrange for his transportation to the nearest hospital.

FAST test
It explains the obvious signs of a stroke and helps to quickly understand that a person has had a “stroke”:
Face
The face becomes weak or sagging, the effect is usually more noticeable on one side.
Arm
One arm becomes numb or weak, and it may be difficult to lift it.
Speech
It becomes difficult to speak, and the victim's voice becomes slurred.
Time to call (Time)
If any of the above are noticed, you should immediately call emergency services.

In addition, hemorrhagic stroke is characterized by:

weakness, loss of sensation in the arm, leg, most often on one side of the body;
decrease or loss of vision;
loss of speech and inability to understand someone else’s speech;
Strong headache;
loss of orientation and perception, loss of balance.

General cerebral symptoms

General cerebral symptoms include:

Headache of great intensity, which occurs suddenly and is accompanied by dizziness. Some patients describe it as “a blow to the head.” It does not stop on its own and is not relieved by painkillers. Often SAH is accompanied only by this symptom.

Vomiting without previous nausea, caused by cerebral edema and increased intracranial pressure.
Loss of consciousness followed by the development of a coma. This symptom may be the only manifestation of a hemorrhagic stroke. It is important that there is a person with the patient who saw what happened.
Stunnedness, causeless drowsiness. However, often at the initial stage of development of hemorrhagic stroke there is increased emotional and motor excitability, which is then replaced by inhibition.
Signs of dysfunction of the autonomic nervous system: cold sweat, feeling hot, dry mouth.
An increase in body temperature to high values can be observed in severe cases.

What is a left hemisphere hemorrhagic stroke?

With the development of a hemorrhagic stroke, there is a high risk of death, especially during the first 48 hours, since there is swelling of the brain or its compression by the hematoma that forms during the lesion.

The occurrence of hemorrhagic stroke, especially in young patients, requires in-depth examination to identify the causes and prevent recurrent hemorrhages.
A key role is played by studies of the vascular bed for the presence of aneurysms and other structural anomalies.

Neurologist, reflexologist, hirudotherapist

Kislitsyna Ekaterina Nikolaevna

10 years of experience

The manifestation of symptoms directly depends on the location of the lesion - right or left hemisphere.

If there are visible speech impairments, these are clear signs of damage to the left hemisphere. Since the symptoms are early and pronounced, diagnosis is carried out much faster.

In addition, people susceptible to left-sided stroke seek medical help earlier, and therefore receive the necessary and timely treatment. It is important to know that it is advisable for a person to receive first aid in the first three hours, then it will be more effective.

Focal symptoms

Focal manifestations are a group of symptoms characterized by a number of specific neurological signs that occur depending on the location of the lesion.

The most common focal manifestations are:

weakness in the arm/leg/half of the body, up to paralysis;
violation of the movement of facial muscles, due to which the eyelid does not rise, the corner of the mouth drops and the cheek “sails” when exhaling;
impaired skin sensitivity;
pathology of speech, vision, hearing;
exotropia;
swallowing disorder;
spatial disorientation of varying severity - staggering, tilting and turning to the side when walking, inability to assume a vertical body position.

Sometimes, based on characteristic focal manifestations, the localization of the pathology can be assumed:

When the lesion is located in the frontal lobe, characteristic symptoms may be a forced rotation of the patient’s head and eyes in the direction of the hemorrhage. The so-called “frontal psyche” often develops, which manifests itself in an inadequate assessment of the state of health and a decrease in criticism of one’s actions.
The localization of the hematoma in the temporal lobe may be indicated by early epileptic seizures.
Hematomas of the parieto-occipital localization can sometimes have scant symptoms and are detected by chance during CT or MRI of the brain, which indicates the importance of neuroimaging methods.
Hemorrhagic stroke in the brainstem often manifests as breathing and heartbeat disturbances.
Damage to the cerebellum is characterized by loss of consciousness, vomiting, severe dizziness and loss of coordination.

It should be noted that these clinical manifestations can be seen with small hematomas. With its significant size, cerebral edema rapidly increases and the patient’s condition becomes so severe that it becomes impossible to determine focal symptoms.

Meningeal symptoms

Signs of irritation of the meninges can occur with parenchymal hemorrhage due to cerebral edema, but they are more characteristic of subarachnoid hemorrhage.

The most typical sign is a stiff neck, when the patient is unable to press the chin to the chest when lying down.

If the patient bends his knees while checking for rigidity, this is another sign of irritation of the meninges, which is called Brudzinski's sign.

Complications of hemorrhagic stroke

The most common complication of non-traumatic hemorrhage is epileptic seizures. They are divided into early, which arose in the first week after a stroke, and late, which developed 7 days after a cerebrovascular accident.

To a serious life-threatening illness, the human body responds with a systemic inflammatory response - an increase in body temperature, changes in blood tests. Such a complication may indicate a deterioration in the patient’s condition. Then the doctor assumes an increase in the source of hemorrhage or the addition of an infection.

The consequence of maintaining a recumbent position may be the development of deep vein thrombosis of the legs, which will entail the development of other, no less dangerous, diseases.

Diagnosis of hemorrhagic stroke

In order for a person without medical education to be able to promptly suspect the initial signs of a stroke in a relative or friend, special recommendations have been developed.

The “Face-Hand-Speech” test involves detecting the most typical signs of pathology:

Detection of facial asymmetry.
The patient needs to extend both arms in front of him. If one of them involuntarily descends, then there is a possibility of a vascular accident.
The patient is asked to give his full name, address, time of year to determine speech impairment and the person’s orientation in space and time.

There are simplified versions of the tests, for example, UZP - smile, speak and raise your hands. If there are noticeable deviations in these actions, emergency measures should be taken to transport the patient to the hospital, that is, call an ambulance.

Before providing effective treatment, the doctor must answer two questions:

Is there a stroke?
If yes, what type of stroke developed?

Determining the nature of brain damage is only possible using CT or MRI - without these highly accurate research methods, the diagnosis of stroke is incomplete.

There are signs that are more likely to indicate the occurrence of a hemorrhagic stroke:

The patient was previously diagnosed with arterial hypertension. In this case, the medications did not have the desired effect or the person did not take them.
Deterioration of the condition is associated with a peak in physical activity or emotional stress.
A sharp and significant deterioration in health with pronounced cerebral and focal symptoms.

For subarachnoid hemorrhage, slightly different signs have been identified, including:

Young age of patients.
Often the primary symptom is a severe headache.
Insignificant severity of focal symptoms.

Often an important distinguishing feature of hemorrhagic stroke from ischemic stroke is the increase in impairment of consciousness with unchanged motor and sensory pathology. This may be a sign of an enlarged hematoma.

Differential diagnosis is vital because treatment for different types of stroke can vary dramatically.

Clinical picture of hemorrhagic stroke

The clinical picture of hemorrhagic stroke directly depends on the lesion and its size. Based on which brain structures are affected, symptoms can be observed and characterized. In most cases, the clinical picture is associated with disorders of motor activity and sensory organs. If there is damage to the cerebral hemispheres, then the speech apparatus is also impaired. If the focus of a hemorrhagic stroke is in the brain stem, then disorders appear in the respiratory system and in the vasomotor center. In this case, the risk of death is very high.

Signs of hemorrhagic stroke are divided into two groups:

Focal: when the symptoms depend on the location of the source of the disease (where the vessel was located at the time of rupture) and the affected brain structures.
General cerebral, associated with hemodynamic disorders. General cerebral symptoms include severe headaches, nausea and vomiting, dizziness, and disturbances of consciousness.

Particular attention should be paid to headaches, which may portend a brain catastrophe. Most often, a stroke develops very quickly, and neurological symptoms progress.

Instrumental diagnostics

Computed tomography is the gold standard for detecting cerebral hemorrhage. This study is distinguished by its accessibility, information content and short scanning time.

A CT scan performed in the first hours of the disease will help the doctor establish an accurate diagnosis and prescribe the correct treatment.

If the cause of the vessel damage is a malformation, then to identify it using CT, it is necessary to administer a contrast agent. Magnetic resonance scanning without any problems will allow you to localize pathologically altered vessels without paramagnetic enhancement.

MRI is more sensitive to small foci of hemorrhage and helps to more accurately determine the stage of the process. However, in order to clarify the hemorrhagic nature of the stroke, an MRI scan should be done 24 hours after the onset of the disease. Even many years after a vascular accident, an MRI of the brain will reveal pathology.

Since MRI shows the structures of the brain in more detail, this type of tomography is preferable to determine the root cause of a hemorrhagic stroke.

Each method has its own advantages and disadvantages, so before using them, it is recommended to examine a specialist - a neurologist.

Since the patient’s further well-being depends on the time of initiation of treatment, the primary diagnosis is carried out using computed tomography. Later, after starting the necessary therapy or surgical treatment, an MRI will help clarify the cause of the stroke.

Diagnostics

Knowing the symptoms that occur during a stroke, making a correct diagnosis, as a rule, is not difficult and is done immediately after the attack, but recognizing the type, location and volume of hemorrhage is labor-intensive work, but this is necessary for prescribing the correct treatment.

How to restore vision after a stroke

Stroke is a pathology associated with the rupture of a cerebral vessel or its blockage.

For the most accurate diagnosis, the following methods are prescribed:

Examination by a neurologist. An anamnesis is collected based on external signs, and neurological abnormalities are determined.
Laboratory tests: general and biochemical examination of blood and urine.
Coagulogram - carried out to determine the level of platelets in the blood, to establish the coagulability index and the protective function of the body from bleeding.
Determination of the functioning the cardiovascular system: total blood pressure, ultrasound examination of the heart, electrocardiogram.
Computer and magnetic resonance imaging of the brain - to determine the type, location of the lesion, and the volume of hemorrhage.

Angiography is often prescribed - a study of brain vessels with the introduction of contrast agents.

Treatment of hemorrhagic stroke

After identifying signs of a stroke, relatives or friends need to provide emergency assistance to the victim, which consists of:

positioning the person on the right side (especially when vomiting) to prevent stomach contents from entering the respiratory tract;
raising the upper half of the body by approximately 30 degrees;
measuring blood pressure and helping to take medication for high blood pressure (in this case, you should not give medications that need to be washed down with water, because a stroke may be accompanied by a swallowing disorder);
organizing optimal air access, that is, loosening the collar, tie, belt and freeing from restrictive clothing.

Upon arrival of the ambulance team, any information about the disease will help in correct diagnosis. To do this, you need to tell doctors about:

time of onset of the disease;
the nature of the development of the pathology: the condition worsened sharply or gradually;
the symptoms with which the disease began;
signs of a stroke that occurred later;
chronic diseases (especially those that could be the cause of the development of a vascular accident);
constant use of medications;
blood pressure numbers (if it was measured).

The medical professional should tell everything that happened to the victim.

General principles of treatment

After admission to the hospital, the neurologist assesses the severity of the condition, and then determines whether the patient needs to be operated on or whether it is better to treat him conservatively.

Many doctors agree that the most dangerous are the 3rd day after a vascular accident, and stabilization of the condition occurs on days 5-7-14, depending on the severity of the pathology.

Regardless of the type of stroke, treatment begins with:

Bed rest.
Elimination of any physical stress. For this purpose, laxatives and other symptomatic drugs may be prescribed, for example, antitussives for severe dry cough.
Organization of patient care for the prevention of infectious complications and bedsores.
Adequate nutrition depending on the level of consciousness: if the patient can swallow on his own, he eats gentle food through the mouth, if he cannot, through a tube.
Prescription of drugs that regulate blood clotting. This is necessary to stop bleeding or prevent its recurrence.

The use of neuroprotectors - medications that reduce the “suffering” of brain cells from oxygen starvation.

Medicines are prescribed only when they are necessary and not contraindicated.

Treatment after stroke and prognosis

First aid to a person should be early - only timely treatment and full recovery will help to recover. First aid includes ensuring a lying position, complete rest and an urgent call for an ambulance. Reducing blood pressure sharply is strictly prohibited! Only a doctor begins the administration of antihypertensive drugs, more often in an ambulance, using a special algorithm.

For intracerebral hematoma, surgical intervention is indicated to evacuate the blood and stop the bleeding. If surgery is not possible, drug therapy is carried out. The following types of medications are used:

diuretics, calcium channel blockers - to reduce blood pressure;
neuroprotectors - to protect brain cells;
antibiotics - to prevent infectious complications;
electrolyte solutions - to normalize the water-alkaline balance;
hemostatic agents or drugs for the prevention of thromboembolism (as indicated).

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Rehabilitation includes a strict daily and sleep schedule, proper nutrition (for swallowing disorders - through a tube). For recovery you will need breathing exercises, classes with a speech therapist, a psychologist, massage, exercise therapy (including passive gymnastics), physiotherapy, hydrotherapy, and treatment in sanatoriums.

The prognosis for a stroke will depend on the quality of treatment provided and the size of the hemorrhage. Mortality reaches 40%; of those who survive, approximately 25% die from a second stroke within a year. 30% of those who survived the disease become deeply disabled; the maximum threshold of survival is considered to be 10-15 years, but with timely surgery and proper rehabilitation it is possible to live a longer, full life.

Management of patients with subarachnoid hemorrhage

If the diagnosis of subarachnoid hemorrhage is confirmed, the patient must remain in the hospital for at least a month. Treatment consists of:

Monitor blood pressure and lower it with medications if necessary.
Prescriptions of drugs that relieve headaches and agitation.
Normalization of breathing and metabolic disorders.
Reduce intracranial pressure by administering osmotic diuretics and elevating the head of the bed for several weeks.
Carrying out therapeutic measures to prevent complications in the form of spasm of cerebral vessels, that is, the prevention of ischemic disorders.

The danger of SAH lies in the fact that many patients consult a doctor only some time after the onset of the pathology. Therefore, treatment may be less effective.

Management of patients with intracerebral hemorrhage

Hemorrhagic stroke is a condition that requires emergency diagnosis, adequate treatment and observation.

To do this you need:

Conduct constant monitoring of the patient’s condition, especially in the first days after the onset of the disease: monitoring breathing and indicators of the state of the cardiovascular system.
Monitor blood pressure numbers. They are often not reduced to normal levels, so as not to impair blood supply to the brain and provoke vasospasm.
Prescription of hypoglycemic drugs - in almost half of patients, blood glucose levels increase.
Use of antipyretic drugs. An increase in body temperature entails worsening cerebral edema, increased intracranial pressure and can lead to a significant deterioration in the patient’s general condition.
Carrying out symptomatic therapy and treatment of complications.

Rehabilitation after hemorrhagic stroke

Recovery of post-stroke patients is an important stage in improving a person’s quality of life. Carrying out these activities helps eliminate existing movement and sensitivity disorders.

Medical rehabilitation should be:

individual - developed for a specific patient;
timely - start as early as possible;
adequate - depend on the patient’s condition and his capabilities;
staged - gradual, slow complication of exercises and an increase in the variety of rehabilitation methods;
long-term;
comprehensive - for greater efficiency, the maximum possible rehabilitation methods are used to influence the human body from different angles;
successive - when a patient moves from one medical institution to another, recovery measures must continue each other.

The main criterion for starting rehabilitation measures for hemorrhagic stroke is not only normal hemodynamics (blood pressure, heart rate), but also the reverse development of changes in the brain (for example, signs of a decrease in cerebral edema).

The most important factor influencing the quality of recovery is the active participation of the patient in the rehabilitation process.

The transition to more complex exercises is made only if the condition of the patient’s cardiovascular and respiratory systems is monitored.

Consequences and complications

With a hemorrhagic stroke on the left side, hemorrhage is correspondingly observed in the left hemisphere of the brain, and this type of stroke is more common on the right side (in approximately 60% of all cases).

Accordingly, the right side of the body is paralyzed, and the paralysis affects not only the limbs, but all parts, including even the right side of the tongue and larynx, so many patients pay attention to unnatural sensations when swallowing.

In addition, when walking, a person pulls his right leg behind him, and his arm is bent at the elbow with the palm extended forward, the fingers are closed in the form of a “boat”, from the outside it seems that he is begging.

In many medical schools, for better memorization by students, they use the so-called rule: “the leg squints, the hand asks.” When walking, a person deviates to the side, although he is sure that he is moving in a straight line.

Restoring speech after a stroke

Impaired speech skills are one of the possible consequences of a stroke.

Serious consequences also include violations of speech function, when a person cannot logically express his thoughts (build cause-and-effect sentences), forgets important dates for himself, speech itself becomes slurred (sometimes you can recognize fragments of words or individual sounds); writing disorder - handwriting changes, a person forgets how to write numbers and letters correctly.

Thanks to all of the above, the patient often begins to develop complexes, so he tries to avoid society, withdraws into himself, and limits his circle of contacts.

Rehabilitation in the intensive care unit

12-24 hours after a vascular accident, it is already possible to carry out restoration measures. Before they begin, a test is performed to assess independent swallowing, after which the patient’s feeding method is selected.

The following rehabilitation methods are used during the acute period of a stroke:

Treatment by position. The position of the patient's head/arms/legs should be changed approximately every two to three hours, as well as turned to the side (if the condition allows it). In order to hold a person in a certain position, bolsters or pillows are used.
Verticalization - giving the patient an upright position. This can happen passively (with the help of a functional bed or table), passive-active and active. However, to carry out this rehabilitation method, it is necessary to ensure the stability of the circulatory system. More often, verticalization begins in the neurological department.
Breathing exercises can be carried out in various ways depending on the patient’s condition: vibration with the hands while exhaling, in a position that facilitates breathing, contact breathing (stimulation by touching the hands to the chest) and others.
Therapeutic gymnastics includes assistance in restoring not only the large muscles of the limbs, but also the muscles of the neck and eyes. At the initial stage, passive gymnastics is performed, when flexion/extension of the patient’s fingers, arms and legs is performed by a qualified physical therapy nurse.

Also during this period, physiotherapeutic treatment is actively used: magnetic therapy, magnetic laser therapy, reflexology, electrical stimulation, darsonvalization and other methods.

Rehabilitation

A stroke is an acute circulatory disorder in the brain. This condition is accompanied by loss of consciousness, as well as paralysis.

After a hemorrhagic stroke, a long recovery period is required for a person to live a normal life or close to it.

In medical practice, recovery methods are used:

speeches;
vision;
memory;
motor skills;
motor function.

With an integrated approach, techniques individually selected by a doctor will be incredibly effective.

The more difficult question is timing.

The amount of time it takes to recover depends on several factors:

The type of stroke suffered. Thus, with a hemorrhagic stroke, the recovery period is shorter than with an ischemic stroke.
Number of lesions and extent of damage.
When did rehabilitation begin? One rule applies here: the sooner measures were taken, the better.
Correctly selected treatment and quality of therapy.
Psychological state of the patient.
Other diseases and individual characteristics.

If rehabilitation is successful, improvements will be noticeable within the first 20 days. As a rule, people have the opportunity to communicate within a period of 10 days to 3 calendar months.

It will take 1 to 5 months to restore limb function.

But the timing is individual and depends on each individual person.

Recovery after a stroke: how to restore speech, vision, memory and motor skills?

Medications

Immediately after a diagnosis of hemorrhagic stroke has been made, hemostatic drugs must be taken. Among them:

Ditsian (800 rub.).
Cyclomed (845 RUR).
Etamzilat (180 RUR).

Angioprotectors are used simultaneously with them. Among them:

Pentoxifylline (250 RUR).
Troxevasin (280 RUR).
Trental (450 rub.).

Since a stroke is characterized by an increase in blood pressure, its reduction is required. For normalization, Clonidine (68 rubles) and Droperidol (72 rubles) are used.

If the above drugs do not help, then ganglion blockers are used. The most common of them are Benzohexonium and Pentamin.

Patients are required to be prescribed neuroprotectors. These drugs promote accelerated rehabilitation. Among them are Cerakson and Cinnarizine.

Exercise therapy

Therapeutic exercise is designed to combat movement disorders.

The main goal of physical education is to increase the range of motion, as well as strengthen the cardiovascular and respiratory systems. In addition, simple exercises and proper breathing can activate the brain.

Massage

Massages are used that are aimed at strengthening tissues and improving the functioning of the nervous system. The massage must be performed by a medical professional in strict accordance with the instructions of the attending physician. Massage is carried out several times a week. Performing this type of treatment on your own is unacceptable, as there is a high risk of aggravating the situation.

Working with a speech therapist

Individual sessions with a speech therapist are conducted in the first stages of recovery . Further, group attendance at classes is possible. According to psychologists, this is the most effective measure to return to normal life.

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The speech therapist selects programs individually, depending on the characteristics of the stroke and recovery of each patient

Physiotherapy

The main goal of physiotherapy is to prevent recurrence of stroke , reduce pain, improve blood circulation, increase immunity, and therefore the result of treatment. Additionally, the passage of nerve impulses improves, sleep normalizes and swelling is eliminated.

Depending on individual cases, patients are offered various types of physiotherapy. Among them:

electrophoresis;
vibration therapy;
manual therapy;
magnetic therapy;
heat therapy;
acupuncture.

Psychotherapy

Many patients, realizing their helplessness after a stroke, refuse to recover and move on with their lives. Therefore, communication with a psychotherapist is important. He will help you find the strength to live, sort out problems, and also find motivation to improve your condition.

Important! As practice shows, in 83% of cases, after communicating with a psychotherapist, the patient developed a desire to live.

Rehabilitation in the acute period

At this stage (from 24 hours to 3 weeks), maintaining the achieved effect and improving exercise tolerance plays a significant role. For this purpose, methods such as:

treatment by position;
massage, which is equivalent to passive gymnastics;
breathing exercises;
active verticalization in the absence of contraindications (if necessary, using additional support);
mechanotherapy;
training on cyclic simulators.

During this recovery period, active correction of speech disorders is carried out with the involvement of speech therapists.

Rehabilitation in the early recovery period

This stage begins 21 days from the onset of the disease and lasts up to six months.

Early recovery can take place in rehabilitation centers, clinics or at home. Self-execution of exercises is possible only if they are performed correctly and there is no need for constant monitoring of the patient. Therefore, all exercises at home are selected strictly individually.

The period of early rehabilitation should be a continuation of the inpatient recovery phase. Nowadays, more attention is paid to everyday skills: renewing them or teaching possible alternatives. Equally important is assistance in a person’s social adaptation.

Rehabilitation in the late recovery period

This stage lasts from six months to a year after the stroke, and sometimes longer (with persistent changes). Rehabilitation in the late recovery period involves preparing the patient for the maximum independence that he can achieve.

In addition to physical rehabilitation, work continues on social adaptation and restoration of professional skills or reorientation.

Most experts point to the positive effects of occupational therapy, especially work related to the earth.

During this period, a person may need psychological support, so psychotherapeutic consultations are carried out.

Forecast

It is difficult to say unambiguously about the patient’s prognosis and possibility of recovery, since it depends on the following factors:

The degree of manifestation of neurological symptoms.
The severity of disturbances in mental consciousness and the occurrence of pelvic disorders.
How much pressure is below normal.
muscle and joint disorders
Serious comorbidities .
The degree of increased muscle tone that impedes movement, gait and speech.

The presence and severity of the above deviations significantly worsen the prognosis for further quality of life and full recovery for the patient.

According to statistics, the recovery period with a left-sided hemorrhagic stroke lasts less, while at the same time, cell death is slower than with a right-sided hemorrhage. The reasons for this have not yet been fully elucidated.

After suffering a severe stroke, about 30% of patients die within the first 30 days, approximately 50% die within a year. Most often, people of advanced age and with concomitant heart disease die.

After a hemorrhagic stroke of the left side, 70% become disabled; the patient’s life expectancy also depends on the above factors and further lifestyle. To increase it, you need to constantly monitor your blood pressure and minimize stress. The same measures are used to prevent strokes.