What are the symptoms of a stroke?

Written by Tang Bo
Neurology
Updated on September 18, 2024
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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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Treatment of urinary retention in stroke patients

In cases of urinary retention after a stroke, some patients experience this due to psychological factors, concerns, and the sudden need to remain in bed, making it difficult to urinate in bed since they cannot stand or squat. Therefore, the first step is to alleviate psychological factors, provide patient communication and counseling, and perform massages around the navel and abdomen, along with heat treatments, to help patients urinate on their own. In a second scenario, where the patient's condition is severe or even comatose, and they have difficulty urinating, a catheter can be placed. It's important to first try to rule out a urinary tract infection, collect a midstream urine sample for analysis, and ensure the catheter is not left in longer than necessary. Once the patient's condition improves or they regain consciousness, the catheter should be removed promptly to avoid any urinary tract infections.

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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.

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Causes of Dysphagia after Stroke

The causes of dysphagia resulting from a stroke are largely related to the location of the stroke. Dysphagia mainly involves the glossopharyngeal and vagus nerves, which are distributed in the medulla oblongata of the brainstem. Therefore, if you have a brainstem stroke, specifically at the medulla oblongata, there is a significant chance of experiencing coughing due to aspiration and dysphagia. If the stroke occurs in a different area, these symptoms are unlikely to appear. A stroke in the cerebral hemisphere, since it has bilateral nerve supply, does not lead to noticeable coughing if only one side is affected. However, if one side is affected this year and the other side next year, similar symptoms of aspiration cough and dysphagia will occur. Therefore, neurologically, the location and specific site of the stroke are crucial, as each location presents different symptoms.

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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 Zhang Hui
Neurology
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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.