What is a stroke?

Written by Zhang Hui
Neurology
Updated on January 04, 2025
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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.

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Written by Zhang Hui
Neurology
1min home-news-image

Main manifestations of pre-stroke warning signs

The precursor of cerebral thrombosis in neurology is called transient ischemic attack (TIA). As the name suggests, this is a transient disease, mainly characterized by symptomatic speech impairment, facial droop, drooling, episodic dizziness, blurred vision, and episodic numbness and weakness of limbs. These symptoms are generally transient, usually lasting from several minutes to a few hours and can be completely relieved. The precursor of cerebral thrombosis is regarded as an emergency in neurology and must be treated promptly. Delayed treatment can possibly progress to cerebral infarction, severely affecting the patient's quality of life and physical health. In considering this disease, one must immediately rush to the hospital for appropriate treatment with antiplatelet drugs, lipid-regulating drugs to stabilize plaques, and treatments such as volume expansion and fluid supplementation.

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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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What does "brain stroke dnt" mean?

The term "DNT" refers to the time from when an acute stroke patient arrives at the hospital to the start of intravenous thrombolytic treatment. Both domestic and international guidelines recommend the DNT to be within 60 minutes—the earlier, the better. This standard was established by the National Health and Family Planning Commission. The time it takes for pre-hospital emergency care and in-hospital medication administration is approximately 60 minutes each. It is only by improving the time from pre-hospital treatment to medication administration within this golden window that we can enhance the patient's survival rate, prognosis, and quality of life, while minimizing disability rates.

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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.