Post-stroke condition

Acute cerebrovascular accident, characterized by the rapid appearance of focal and/or general cerebral neurological symptoms, is called a stroke by doctors. The severity of this disease does not cause the slightest doubt. Its consequences - the post-stroke condition - can remain with the patient until the end of his days. Medical statistics are inexorable, according to them, only a third of patients who have suffered a stroke manage to fully restore their brain functions. The rest remain disabled for life.

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Causes post-stroke

With age, many people increasingly face problems related to the physiological characteristics of the cardiovascular system. Such changes can be expressed in different ways and have different degrees of severity, individually manifesting themselves in the state of the human body.

However, a stroke always happens suddenly, radically changing the life of the victim into "before" and "after". And what this "after" will be depends largely on the effectiveness of the rehabilitation period.

The mechanism of manifestation of pathological symptoms that occur after a stroke has not been fully identified, but doctors are still able to voice some of the reasons for the post-stroke condition.

The clinical picture under consideration is caused by:

• Swelling of parts of the brain.
• Problems with blood flow.
• Violation of venous blood outflow.
• Disruptions in the normal supply of oxygen to tissues, which is associated with a disruption of a number of blood vessels.
• Depressive psycho-emotional mood.
• Violation of reflex connections in the affected area.
• Pain symptoms of tension that appear in a bedridden patient with an incorrect body position.
• Almost all patients who have experienced a stroke begin to acutely feel changes in meteorological conditions, becoming weather-dependent.
• The cause of the discomfort may be the large rehabilitation loads imposed on the patient during the recovery period.
• This may be a response of the affected organism to drugs used in secondary prevention of the disease.

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Symptoms post-stroke

Immediately after the attack occurs, the patient is taken to the intensive care unit, where he receives first medical aid.

In the first days after an apoplexy stroke, the most dangerous manifestation of the attack is cerebral edema, the reaction to which is a high body temperature of the patient.

This factor is a bad sign that may indicate the development of a number of complications that are quite dangerous not only for health, but also for life:

• Swelling and the appearance of foci of necrosis of the head cells.
• The localization of stroke lesions is located in the brainstem region and extends to the thermoregulation center.
• An infectious process develops in the victim's body.

That is, the appearance of a high temperature may indicate a high risk of a repeated attack or death.

It is also necessary to voice other symptoms of the post-stroke condition that occur in the first hours and days after the “blow”.

• Cramps can be observed, which are mainly diagnosed in the lower extremities.
• Paresis is a partial paralysis of the body's muscles or facial activity, as a result of which some part of it ceases to perform its usual functions.
• Complete paralysis.
• Aphasia is a speech disorder that occurs with local damage to the cortex of the left hemisphere of the brain (in right-handed people) and the right hemisphere (in left-handed people).
• Problems with swallowing reflexes may arise.
• Headaches appear, which can be expressed in different ways and be:
  • Periodic or permanent.
  • Intense (about 7% of victims suffer from it, it is called neuropathic pain) and moderate.
  • Having accompanying symptoms (noises in the ears and head itself, midges before the eyes, etc.). Such a clinic indicates a poor state of the vascular system, which does not exclude the possibility of a repeated attack.
• Dizziness.
• Depressive mood.

If any of the above symptoms occur, especially pain symptoms and temperature readings, you should immediately notify your treating physician - a neurologist. He will conduct an additional examination and prescribe the appropriate therapy.

But the patient and his relatives should be warned that not only strong but also weak, rarely appearing pain symptoms should be the reason for them to contact a specialist.

Diagnostics post-stroke

The recovery period after a stroke is a very complex and lengthy process that can continue throughout the rest of a person’s life.

Therefore, the diagnosis of the post-stroke condition in such a patient plays a significant role in preventing repeated “blows”.

This event involves the analysis of a number of characteristics of the patient himself.

• It's his age. Oddly enough, for example, severe headaches are more common among young people.
• Gender of the patient. Headaches in the post-stroke period are more common among women than among the stronger half of humanity.
• In most cases, the outpatient card of such a patient already contains pathologies associated with the brain.
• Blood pressure level. The neurologist tries to obtain its change in dynamics. It is necessary to prevent developing hypertension.
• The victim's blood condition is examined. The sugar levels (dynamically) and the relationship between its values and the manifestation of pain are analyzed.
• An echocardiogram is mandatory, which allows one to assess the characteristics of the vessels of the heart and brain.
• Magnetic resonance imaging allows us to obtain a more complete picture of the disorders that have affected the organ of interest to us.
• Checking the patency of the venous columns and smaller vessels in the neck area.
• If necessary, the attending physician may prescribe a consultation with other specialists, for example, a psychotherapist, if the patient is experiencing a depressive mood.

Based on the results of the studies, the doctor makes his verdict and prescribes the most appropriate therapy.

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Treatment post-stroke

The attack significantly changes the life of such people. All of them subsequently need long-term and competent therapy. Treatment of the post-stroke condition, depending on the severity of the pathology, can be carried out both within the walls of the hospital and at home.

The duration of rehabilitation and its effectiveness depend on the degree of brain damage, age and individual characteristics of the person.

When diagnosing the disease in question, the patient is prescribed a full range of comprehensive treatment.

In accordance with the established procedure, drug therapy is carried out with nootropic drugs, the action of which is aimed at optimizing metabolic processes in the central nervous system in order to restore its cognitive and motor functions. Among such drugs, the following should be highlighted: vinpotropil, nootobril, combitropil, nootropil, vinpocetine, amylonosar, actovegin, picamilon, stamin, mexicor, phenotropil, cereton and many others.

Hypotensive drugs are mandatory in the treatment protocol for such patients. They are prescribed to control blood pressure. They are: anaprilin, nevotens, minoxidil, lorista, nifedipine, magnesium sulfate, aminazine, barboval, veracard, papaverine, capoten and others.

Vasotonic drugs - vasostimulants that stimulate vascular tone - also play an important role in the rehabilitation process. These can be: horse chestnut, centella asiatica.

Medicines with antispasmodic properties that reduce the tone of the smooth muscles of blood vessels and internal organs are also prescribed. They also have a vasodilatory and analgesic effect. These include: barboval, aminophylline, spazmalgon, drotaverine, aprofen, vesicar, atropine sulfate, baralgin, papaverine hydrochloride, spazmalgin, dibazol, renalgan, influbene, magnesium sulfate and others.

Such a patient must also take decongestant medications: Imupret, Diacarb, Hydrocortisone, Lyoton 1000, Indomethacin, Diclobene, Lipril, Lokoid, Rinopront and others.

Antiplatelet agents are also prescribed, which have a depressing effect on the blood clotting process, which is important in the recovery process. These are arvin, heparinolds, sinkumar, papaverine, neodicumarin, carbocromen, dicoumarin, heparin, nafarin, phenylin, calcium heparinate, parmidine, omefin, indomethacin, imizin, anturan, butadion and others. They reduce blood density, preventing recurrent thrombus formation, which also reduces the likelihood of a repeated stroke. These drugs can significantly reduce the risk of relapse. They effectively normalize cerebral blood flow.

In the treatment of post-stroke condition, motor rehabilitation, designed to correct motor disorders, occupies an important place. Such methods include exercise therapy, breathing exercises, massages, physiotherapy sessions. These techniques help restore muscle tone, preventing the development of contractures in the joints and tissue trophism.

Among physiotherapeutic procedures, the most “popular” are magnetic therapy, phonophoresis, pressotherapy, laser therapy, microwave and ultrasound therapy, lymphatic drainage, amplipulse therapy and UHF.

The selection of these funds is purely individual.

Most of these patients also have to undergo speech rehabilitation, as this function is often damaged. Here, classes are conducted by a specially trained speech therapist, who starts the lesson from simple to complex.

Many people who have suffered a stroke may need the help of a qualified psychologist and psychological support from loved ones.

Nvps neural restorer for post-stroke conditions The combined drug nvps - neural restorer for post-stroke conditions - in terms of its pharmacodynamics belongs to nootropic drugs.

This medicine allows you to:

• More effectively restore motor activity and sensitivity of nerve impulses, which accordingly reduces the area of foci of necrotic cells and vascular disorders.
• Helps to normalize coordination of movements.
• Improves cerebral blood flow.
• Significantly reduces the area of secondary damage.
• Normalizes blood viscosity.
• Improves the quality of oxygen absorption by brain cells.
• Improves all functions of the brain, memory and speech centers.

The form of the drug is also convenient - it is a spray that is quickly absorbed by the oral mucosa, which is especially important for such patients.

Nvps is used in a dosage corresponding to five oral injections, four to five times a day. The duration of treatment depends on the severity of the patient and can range from three months to a year.

Powerful pills for post-stroke conditions

In post-stroke conditions, complex therapy must include potent tablets. One of these are nootropic drugs, the action of which is aimed at optimizing metabolic processes in the central nervous system in order to restore its cognitive and motor functions. Among such drugs, the following should be highlighted: vinpotropil, nootobril, combitropil, nootropil, vinpocetine, amylonosar, actovegin, picamilon, stamin, mexicor, phenotropil, cereton and many others.

Actovegin is prescribed in a dosage corresponding to the severity of the pathology. This figure is selected by the doctor individually for each patient.

In the form of an injection, the drug is taken both intravenously and intramuscularly. The starting dose is 10 - 20 ml. The drug is administered, at the discretion of the doctor, daily or several times a week.

The dosage of the drug may be adjusted during treatment. The rate of administration of the medicinal solution should be approximately 2 ml/min.

Contraindications to the introduction of the drug into the treatment protocol may include pulmonary edema, decompensated heart failure, individual intolerance to the components of the drug, pathology associated with fluid retention in the body, anuria, oliguria.

Capoten is taken orally, starting with minimal doses, gradually selecting the individual amount of the drug.

You can start with 6 ml three times a day, but in most cases the maintenance daily dosage is 25 mg two to three times a day.

The maximum permissible dose taken per day is 150 mg. If signs of hypotension appear, the amount of the drug administered should be reduced.

Contraindications to the administration of the drug in question are Quincke's edema, severe renal and/or hepatic dysfunction, increased intolerance to the components, hyperkalemia, stenosis of the aortic orifice and renal arteries, problems with blood outflow, the period after kidney transplantation, pregnancy and lactation.

Dibazol is administered orally to the patient a couple of hours before or after meals. The medicine is taken 20-50 mg twice or three times a day for three to four weeks. The maximum permissible dosage: daily - 150 mg, single - 50 mg.

The drug in question is not allowed for use if the patient has a history of arterial hypotension or individual intolerance to the components of the drug.

Such a patient must also take decongestant medications: Imupret, Diacarb, Hydrocortisone, Lyoton 1000, Indomethacin, Diclobene, Lipril, Lokoid, Rinopront and others.

Many patients after a stroke fall into a state of depression, such people are prescribed antidepressants. This group of drugs includes, of varying strength: moclobemide, befol, toloxatone, pyrazidol, imipramine, amitriptyline, anafranil, pertofran, trimipramine, azafen, maprotiline, mianserin, fluoxetine, fevarin, citalopram, sertraline, paroxetine, simbalta and others. Such drugs dull the feeling of fear, panic and anxiety, stabilizing the psychological characteristics of the patient.

Pyrazidol is an effective domestic drug taken in a starting dosage of 50-75 mg twice a day. If therapeutic effectiveness is not observed, the amount of pyrazidol administered can be increased by the doctor, up to 150-300 mg daily. Then the dosage is gradually reduced.

Contraindications to the use of the drug include hypersensitivity to the components of pyrazidole, acute hepatitis or severe blood damage (eg, infection).

Antiplatelet agents are also prescribed, which have a depressing effect on the blood clotting process, which is important in the recovery process. These are arvin, heparinolds, sinkumar, papaverine, neodicumarin, carbocromen, dicoumarin, heparin, nafarin, phenylin, calcium heparinate, parmidine, omefin, indomethacin, imizin, anturan, butadion and others. They reduce the density of blood fluid, preventing the recurrence of blood clots. This reduces the risk of secondary stroke. These drugs can significantly reduce the likelihood of relapses. They effectively normalize cerebral blood flow.

Heparin is administered by injection or infusion into a vein. Maintenance therapy is designated as 20,000 – 40,000 IU daily. The drug is diluted with 1 liter of isotonic NaCl solution immediately before the procedure. If necessary, injections are administered every four to six hours, but a specialist may choose another administration regimen.

The use of heparin is not permitted in acute leukemia, diathesis and other pathologies associated with poor blood clotting, bleeding of any genesis, inflammatory processes occurring in the internal cavity of the heart, embolic infarction of the lung or kidneys, severe dysfunction of the kidneys and/or liver, any form of anemia, venous gangrene and similar physiology.

Motherwort in post-stroke conditions

The average person perceives this medicinal plant as a sedative. But, as long-term observations show, motherwort is quite effective in hypertension, allowing to reduce blood pressure readings, and its intake also has a beneficial effect on the functioning of the central and peripheral nervous system of a person. And, surprisingly, studies have noted a clear decrease in the amount of "bad" cholesterol in the blood of a person taking this medicine.

In light of the above, motherwort in a post-stroke state is a good solution to a number of pathological problems that arise after a heart attack.

The composition of this gift of nature is quite impressive. These are flavonoids, saponins, organic acids, glycosides, alkaloids, vitamins C, A and E, tannins and sugars, as well as numerous macro- and microelements.

Motherwort tincture, which can be easily purchased at any pharmacy, is administered to the victim 30-50 drops (can be diluted with a small amount of water), three to four times a day.

Motherwort has a calming effect, normalizes sleep and heart function, and also has moderate hypotensive, antispasmodic and diuretic properties.

Motherwort extract is available in tablet form and is taken three to four times a day, immediately before meals.

At the same time, the herbal medicine is well tolerated by the body, but it should be limited or completely excluded from the treatment protocol if the patient has a history of hypotension (low blood pressure), as well as a slow heart rate and hypersensitivity to the product itself.

Prevention

It is worth noting right away that prevention of post-stroke conditions largely depends on the severity of the disease suffered by the victim, belonging to a certain age category, the nature of neurological changes affecting the brain tissue and a “bouquet” of other pathologies present in the patient’s medical history.

The patient's psychological attitude also plays an important role in the recovery process. Therefore, the support of his family and friends is very important. If necessary, the attending physician can involve psychological training from a specialist.

Much depends, naturally, on the experience of the doctors treating this pathology.

Proper nutrition is also essential. The diet of such a patient should contain a sufficient amount of polyunsaturated fatty acids. Products from modern supermarkets that contain stabilizers, emulsifiers, various dyes and flavor enhancers should disappear from his diet.

The patient will also have to forget about bad habits. Alcohol, nicotine, drugs - this is death for the damaged brain.

Walking in the fresh air, moderate physical activity. All this can also be attributed to preventive measures.

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Forecast

Many probably know that a stroke is a disease with a high mortality rate. But the essence of the problem is not only in this fact. The prognosis for the post-stroke condition is quite uncertain. After all, as statistics show, only 10 percent of patients can fully recover from an apoplectic stroke, about a third only partially regain their former mobility, speech and thinking abilities. The rest, those who managed to survive the attack, remain disabled for the rest of their days. The severity of their disability ranges from mild to complete paralysis and comatose state.

And this ending is observed even against the backdrop of innovative technologies that come to the aid of modern medicine.

However, as recent studies have shown, an important factor in a satisfactory prognosis is the rehabilitation period, whether or not complicated by other pathologies and complications.

Doctors note that the first six to ten months after a stroke are the most difficult and fateful. It is during this period that the quality of the patient's future life is decided. Although one can understand the relatives of a bedridden patient when they understand what awaits them in this period of time.

The relatives of such a patient are seized by panic, they do not know how to cope in such a situation. Here the advice of doctors is the same. At least part of the care for the patient should be transferred to an experienced nurse who will be able to professionally care for the patient, helping to overcome the post-stroke period more effectively.

Stroke – this diagnosis sounds like a death sentence in the memory of many. But you should not despair and give up. If you or your loved one were lucky enough to survive an apoplectic stroke, you should make every effort and have faith so that the post-stroke condition that was determined after the attack has a favorable prognosis. In such a situation, it is possible to overcome the disease only with joint efforts. The patient’s desire for a full life, the help and support of relatives and the professionalism of doctors are the guarantee that the disease will be defeated, and the person will return to a normal, full life in society.

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