Stroke

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Written by Tang Ying
Physical Medicine and Rehabilitation
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What is the goal of rehabilitation during the acute phase of a stroke?

Rehabilitation goals during the acute phase of stroke. In the acute phase, we usually can intervene with rehabilitation treatment 48 hours after the patient’s vital signs have stabilized. The main goals of rehabilitation during the acute phase are to prevent complications such as pressure ulcers, atelectasis pneumonia, urinary tract infections, deep vein thrombosis, and muscle atrophy. Additionally, it aims to improve impaired neurological functions such as sensory, motor, and speech therapies, and to enhance the patient’s ability for self-care and mobility.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Rehabilitation Treatment Plan for Stroke

The rehabilitation treatment plan for stroke involves rehabilitation physicians and therapists who, through comprehensive assessment of the patient's overall medical condition and functional impairments, develop individualized plans. These plans focus primarily on the patient's functional impairments, and accordingly, design treatments for movement, speech, swallowing, and attention to promote the patient's overall rehabilitation and improve their ability to perform daily activities independently. Common rehabilitation treatment options include not only medication but also occupational therapy, speech therapy, physical therapy, psychological support, and traditional rehabilitation methods. Through these personalized and comprehensive rehabilitation treatments, the aim is to facilitate the patient's early recovery, allowing them to return to their family and work environment sooner.

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Written by Tang Bo
Neurology
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Is a stroke a cerebral infarction?

Stroke includes cerebral infarction. Stroke is divided into ischemic stroke and hemorrhagic stroke. Therefore, ischemic stroke is cerebral infarction, and hemorrhagic stroke is cerebral hemorrhage. Thus, one cannot say it is solely a cerebral infarction; it includes cerebral infarction. If symptoms of stroke appear, such as unclear speech or limb weakness, it might be either hemorrhagic or ischemic stroke. In such cases, it is crucial to seek medical attention immediately. For hemorrhagic stroke, one should visit the neurosurgery department, and for ischemic stroke, the neurology department is appropriate. Initially, a CT scan should be performed to make a clear diagnosis.

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Written by Tang Bo
Neurology
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The difference between stroke and cerebral infarction

Stroke is divided into hemorrhagic stroke and ischemic stroke. Hemorrhagic stroke involves cerebral hemorrhage, while ischemic stroke involves cerebral infarction. Therefore, the difference is that stroke includes cerebral infarction, which is a type of ischemic stroke. In such cases, it is crucial to seek prompt hospital treatment and examine for risk factors related to cerebrovascular disease. Under the guidance of a doctor, the condition should be stabilized since the acute phase of a cerebral infarction might be unstable and could worsen. Thus, after stabilizing the condition, long-term oral medication will also be necessary to prevent future strokes.

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Written by Gao Yi Shen
Neurosurgery
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What are the symptoms of a stroke?

Symptoms of stroke vary greatly, and it is crucial to judge based on the circumstances. The symptoms are mainly divided into two major categories: hemorrhagic stroke and ischemic stroke. The most common symptoms of hemorrhagic stroke are severe headaches, projectile vomiting, and the gradual onset of consciousness disorders. Some people might also experience limb numbness, weakness, speech impediments, and other conditions. The most common symptoms of ischemic stroke include dizziness, limb numbness, and speech impediments; sometimes, these symptoms alternate, so it is essential to pay attention to clinical observations and focus on differential diagnosis. There are also other types of symptoms, such as cognitive decline, urinary and fecal incontinence, unstable gait, swallowing difficulties, and coughing while swallowing. Therefore, it is imperative to visit a hospital in a timely manner for testing to clearly understand the specific changes in the patient's condition at that time, thus better facilitating the patient’s recovery.

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Written by Tang Bo
Neurology
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What are the symptoms of a stroke?

Stroke, also commonly referred to as cerebrovascular accident, is caused by the rupture or blockage of blood vessels within the skull, leading to necrosis of brain tissue and a series of symptoms. It is divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke, commonly known as cerebral infarction or stroke, while hemorrhagic stroke refers to cerebral hemorrhage. Generally, ischemic strokes account for 80% of cases. Ischemic stroke is caused by blockage of blood vessels leading to necrosis of brain tissue, presenting with a series of symptoms such as hemiplegic numbness. Cerebral hemorrhage results from rupture of brain blood vessels causing damage to brain cells and symptoms of compression, and may also present with symptoms such as hemiplegic numbness. Both types can be differentiated by their symptoms, and can also be definitively diagnosed through a CT scan.

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Written by Zhao Zi Pan
Neurology
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Can a stroke be cured?

Stroke can result in sequelae such as deviation of the mouth, slurred speech, hemiplegia, numbness of extremities, coughing when drinking water, hoarseness, and difficulty swallowing. If the stroke affects a smaller area or is not located in a critical area, recovery tends to be better. However, if the infarct is large or occurs in a critical area like the brainstem, sequelae may persist, with partial function recovery possible within about three to six months.

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Written by Tang Bo
Neurology
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The treatment goals in the early stage of stroke

Stroke includes hemorrhagic and ischemic types. Whether it is hemorrhagic or ischemic, hospitalization is necessary during the acute phase. Depending on the patient's condition, if it is hemorrhagic, the amount of bleeding should be considered to decide whether to opt for surgical treatment or conservative treatment. If it is ischemic, and the treatment is initiated within the therapeutic time window, that is within 4.5 hours, thrombolytic therapy can be administered, which may potentially reverse the symptoms of the stroke. If the time window is missed, then conservative treatment is required. Acute cerebral infarction in its acute phase can potentially worsen, so the primary goal of acute phase treatment is to stabilize the condition. After stabilization, rehabilitation and physical therapy can gradually improve the patient's symptoms.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Rehabilitation nursing for stroke patients

For the rehabilitation and nursing care of stroke patients, first and foremost, we need to monitor the patient's vital signs, food intake, sleep, as well as bowel and bladder function. Secondly, we should pay attention to their psychological state, checking for signs of tension, anxiety, and depressive emotional reactions. Thirdly, we encourage patients to overcome their illness and to establish confidence in their recovery. Fourthly, we guide patients to actively engage in physical function exercises, as well as daily activities such as eating and dressing to practice their daily living skills. Fifthly, we manage proper limb positioning and patient turning, prevent pressure sores, and also prevent a series of complications such as venous thrombosis and urinary tract infections.

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Written by Zhang Hui
Neurology
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Can a stroke be cured?

Stroke is mainly divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke, also known as cerebral thrombosis, can benefit many patients if they can reach a hospital quickly and receive intravenous thrombolysis within the time window, such as within 4.5 hours, leaving them with only mild neurological deficits followed by proper rehabilitation training. Some patients can be cured. However, if the stroke is severe from the onset, resulting in complete paralysis or even consciousness disorders such as drowsiness, stupor, or coma, the treatment outcomes can be significantly less effective, potentially leaving some degree of disability. Generally speaking, whether a stroke can be cured depends closely on the initial severity of the stroke, the overall condition of the patient, and the timeliness of the treatment. Some conscious patients who receive timely treatment can be cured, whereas those with severe conditions typically suffer from long-term complications.