The treatment goals in the early stage of stroke

Written by Tang Bo
Neurology
Updated on September 17, 2024
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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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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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Written by Tang Bo
Neurology
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What department should I go to for a stroke?

Stroke is classified into ischemic stroke and hemorrhagic stroke. If symptoms of a stroke occur, such as slurred speech, limb weakness, or other neurological deficits, one should immediately seek medical attention at the emergency department of a local hospital. Emergency doctors will perform a head CT scan. If ischemia is present, the CT scan might not show changes within 24 hours, in which case a visit to the neurology department is necessary. If hemorrhage is detected, then a visit to the neurosurgery department is required. However, if the symptoms are of a chronic, old stroke, then a visit to the neurology department is needed.

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Written by Zhang Hui
Neurology
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What does stroke include?

Stroke, translated from the English word "stroke," refers to rapidly occurring pathological changes. Stroke mainly includes two types of diseases: ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease, with ischemic cerebrovascular disease being the most common. Ischemic cerebrovascular disease includes large artery atherosclerotic cerebral infarction, small artery occlusive cerebral infarction, as well as cardiogenic cerebral embolism and other causes of cerebral infarction. Hemorrhagic cerebrovascular disease mainly includes cerebral hemorrhage caused by hypertension, subarachnoid hemorrhage, and cerebral hemorrhage caused by aneurysms or vascular malformations. The onset of a stroke is very aggressive and can severely threaten the patient's health. Once a stroke is suspected, it is critical to rush to the hospital for appropriate diagnostic tests to confirm the diagnosis and provide the most suitable treatment plan.

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Written by Liu Yan Hao
Neurology
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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.

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Manifestations of Stroke

First, if the patient has a large-area ischemic stroke, or if there is a significant amount of cerebral hemorrhage, consciousness disorders will occur rapidly, and the patient may even fall into a coma. Second, in the case of general strokes, patients will experience reduced mobility in their limbs, primarily manifesting as unilateral limb paralysis, with symptoms varying from mild to severe. Patients with milder symptoms show clumsiness in fine movements, while more severe cases may require bed rest. Third, a common clinical symptom is numbness in one side of the body. Fourth, patients with a stroke generally also suffer from symptoms such as deviation of the corners of the mouth, shallowing of the nasolabial folds, drooling, and unclear speech.