What does stroke include?

Written by Zhang Hui
Neurology
Updated on September 11, 2024
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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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What are the types of strokes?

The common types of strokes include hemorrhagic stroke and ischemic stroke. Hemorrhagic strokes commonly involve subarachnoid hemorrhage and intracerebral hemorrhage. Subarachnoid hemorrhage often occurs due to the rupture of cerebral aneurysms, causing blood to enter the subarachnoid space. Intracerebral hemorrhage is commonly caused by hypertension leading to the rupture of cerebral blood vessels and subsequent bleeding into the brain parenchyma. Additionally, there is ischemic stroke, commonly presenting as cerebral infarction and cerebral embolism. Cerebral embolism occurs when a blood clot from another part of the body outside the brain, following the blood circulation, blocks a cerebral vessel. Cerebral infarction happens when cerebral arteriosclerosis narrows down to a certain extent, gradually obstructing and forming cerebral infarction. These are the common types of strokes.

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Written by Liu Yan Hao
Neurology
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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.)

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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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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.)

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Written by Li Chao Jin Zi
Neurorehabilitation
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Basic Principles of Stroke Rehabilitation Treatment

There are several key principles for stroke rehabilitation. The first emphasizes that rehabilitation should start as early as possible. In cases of ischemic stroke, generally when the patient is conscious and vital signs are stable, rehabilitation can begin after 48 hours. For patients with high blood pressure or cerebral hemorrhage, it is generally recommended to start rehabilitation after seven days. The second principle emphasizes the active participation of the patient, encouraging patients to actively engage in rehabilitation training and communicate with therapists to achieve functional improvement. The third point emphasizes comprehensive rehabilitation; stroke patients often have issues in multiple areas such as language, cognition, swallowing, limb movement, and functional balance, so it is suggested that patients undergo comprehensive rehabilitation rather than focusing on just one aspect. The fourth point stresses the continuity of rehabilitation, as rehabilitation therapy is an ongoing process.