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Stroke
Does lacunar infarction belong to ischemic stroke?
Lacunar infarction is a type of ischemic stroke, which can be simply explained as the blockage of small blood vessels. It generally belongs to one of the categories of ischemic strokes, which also include large vessel blockage and cerebral embolism. Lacunar infarction specifically refers to blockages in small blood vessels, and this type of stroke primarily occurs due to these small vessel blockages, and it is known as lacunar infarction.
The difference between stroke and cerebral infarction
Stroke includes ischemic stroke and hemorrhagic stroke. Ischemic stroke refers to cerebral infarction, while hemorrhagic stroke refers to cerebral hemorrhage. Symptoms such as limb weakness, slurred speech, or other neurological deficits should initially suggest the possibility of a stroke. Whether it is an ischemic or hemorrhagic stroke may be related to the symptoms, but a CT scan is essential. If a CT scan rules out cerebral hemorrhage, then cerebral infarction is more likely. The treatment varies with time; within 4.5 hours, if the conditions for thrombolytic therapy are met and there are no contraindications, and the relatives have signed an informed consent, thrombolytic treatment can be administered. If this time window is exceeded, this opportunity is lost, so it is crucial to seek medical attention immediately upon symptom onset.
What medicine to take for a stroke?
Stroke includes ischemic stroke and hemorrhagic stroke, also known as cerebral infarction and cerebral hemorrhage. The medications used for these two diseases differ, so it is essential to identify which type of disease it is. When symptoms occur, such as slurred speech, limb weakness, or other symptoms, it is crucial to seek medical attention immediately. Perform a cranial CT scan first to rule out bleeding, and then consider cerebral infarction. If it is a cerebral infarction, thrombolytic therapy can be administered within 4.5 hours of the acute phase, followed by hospital treatment. During the acute phase of a cerebral hemorrhage, the decision on whether to proceed with surgery depends on the amount of bleeding. Regardless of the situation, these conditions are often underpinned by several underlying diseases, such as hypertension, diabetes, or hyperlipidemia, along with other risk factors. Therefore, medication needs to be personalized, and it is also necessary to check for any contraindications to determine what medication to use. (Medication use should be guided by a professional doctor.)
Precautions for Stroke Patients Using Mannitol
Patients with stroke, if experiencing cerebral hemorrhage, extensive cerebral infarction, or cerebral embolism, can develop cerebral edema. In such cases, it is necessary to use mannitol for dehydration to reduce intracranial pressure. Therefore, it is crucial to strictly determine the appropriate indications. For patients with cerebral hemorrhage, cerebral embolism, or extensive cerebral infarction, the peak period of cerebral edema generally occurs between five to seven days, during which time mannitol should be used to lower intracranial pressure. If the acute phase has passed, then there is no need to use mannitol. For some patients, using mannitol weeks later not only lacks therapeutic effect, it might even worsen the condition. Additionally, when using mannitol, it is important to monitor the patient's renal function. In patients with renal insufficiency, the use of mannitol may exacerbate renal damage, so monitoring changes in renal function is essential. (Please use medication under the guidance of a doctor.)
The difference between stroke and cerebral infarction
The difference between stroke and cerebral infarction lies in the scope of stroke, which is broader and includes cerebral infarction. Stroke is divided into hemorrhagic stroke and ischemic stroke. Common types of hemorrhagic stroke include cerebral hemorrhage and subarachnoid hemorrhage. Common types of ischemic stroke include cerebral infarction and cerebral thrombosis. Thus, the scope of stroke is relatively large and includes cerebral infarction. Cerebral infarction occurs when a blockage in the cerebral blood vessels leads to ischemia, edema, and necrosis of the brain tissue in the supplied area, resulting in symptoms of stroke. Additionally, cerebral embolism occurs when an embolus from another part of the body detaches and blocks a brain artery, causing ischemia and necrosis of the brain tissue in the supplied area, also leading to stroke.
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.
What is a stroke?
Stroke primarily refers to cerebrovascular disease. Acute onset of stroke usually presents with focal neurological deficits, mainly divided into ischemic and hemorrhagic strokes. Ischemic stroke, primarily referring to cerebral infarction, occurs due to an interruption in the blood supply to the brain, causing vessel occlusion and resulting in various clinical syndromes. Clinically, it presents rapidly with symptoms such as limb paralysis, slurred speech, and facial drooping. The pathogenesis of ischemic stroke is caused by central arteriosclerosis of large vessels. Additionally, stroke also includes cerebral embolism, mainly referring to atrial fibrillation-induced emboli from wall-attached thrombi, and other foreign bodies causing embolic blockage, leading to necrosis of brain tissue. Stroke also encompasses hemorrhagic stroke, with a typical condition being cerebral hemorrhage, which is due to long-term hypertension causing hyaline degeneration of the small arterial walls, eventually leading to necrosis and rupture with bleeding, resulting in neurological deficits.
Six Common Manifestations of Stroke
Firstly, patients may experience language impairment, primarily characterized by unclear speech or sensory aphasia, where they cannot understand others' conversations. Secondly, motor dysfunction is also a very common symptom, typically presenting as hemiplegia on one side of the body. Thirdly, sensory dysfunction can occur, manifested as numbness in one side of the body, an inability to feel pain, and an inability to sense temperature. Fourthly, there may be signs of ataxia, such as unstable walking or standing. Fifthly, there may be difficulties in swallowing, coughing while drinking water, and articulation disorders. Lastly, cognitive dysfunction can also occur, characterized by slow responsiveness and similar symptoms.
What medicine is used for stroke?
Stroke primarily refers to cerebrovascular disease, which is divided into two main categories. The first category is hemorrhagic stroke, including cerebral hemorrhage, subarachnoid hemorrhage, and other diseases. The second category is ischemic cerebrovascular diseases, including cerebral thrombosis, cerebral embolism, and other diseases. Thus, although both categories are classified as stroke, the medications used are different. For cerebral hemorrhage, the patient needs to rest in bed and must strictly control blood pressure, primarily using medications that strictly control blood pressure. There are no special oral medications, but intravenous medications can be given to protect brain nerves. If intracranial pressure is high, some dehydrating and intracranial pressure-reducing medications can be administered. For ischemic stroke, such as cerebral thrombosis, it is crucial to get to the hospital quickly. If it is within the thrombolytic time window, intravenous thrombolytic drugs can be administered for treatment, from which many patients may benefit. Additionally, it is necessary to take long-term medications that prevent platelet aggregation and regulate blood lipids, as well as stabilize arterial atherosclerotic plaques.
Nursing Care of Thrombolytic Therapy for Stroke
Thrombolytic therapy for stroke is an important tool in the treatment of cerebral thrombosis. If administered within the thrombolytic time window, which is currently within four and a half hours from onset, intravenous thrombolytic treatment can significantly save lives and improve the quality of life for patients. Post-thrombolysis care is also crucial, as there are some complications associated with thrombolytic therapy. It is essential to strictly monitor blood pressure after thrombolysis; typically, blood pressure should be checked every 15 minutes, as high blood pressure can significantly increase the tendency for bleeding. During the care process, it is also important to monitor for signs of bleeding such as nosebleeds, bleeding gums, the appearance of petechiae or ecchymosis on the skin and mucous membranes, and any bleeding in the urinary system. Additionally, changes in the patient’s consciousness and limb mobility should be noted. If the patient experiences worsening paralysis or significant headaches, a cranial CT scan must be promptly revisited. In summary, the nursing care following stroke thrombolytic treatment primarily involves monitoring blood pressure, watching for signs of bleeding, and observing changes in limb mobility and consciousness.