What are the types of strokes?

Written by Liu Yan Hao
Neurology
Updated on October 31, 2024
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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 Tang Bo
Neurology
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Key Points in the Treatment of Different Recovery Stages of Stroke

Stroke includes ischemic stroke and hemorrhagic stroke, namely cerebral infarction and cerebral hemorrhage. Their treatments are generally opposite. If it is a cerebral infarction, thrombolytic therapy is needed within 4.5 hours of the acute phase. It is necessary to consider whether there are indications and contraindications, and whether the patient and family members agree to undergo thrombolytic therapy. Regardless of whether thrombolytic therapy is administered, it is essential to subsequently check the condition of the cranial vessels to determine if surgical treatment is needed. If surgery is not required, hospitalization for conservative treatment might be necessary. Typically, about 7 to 14 days after the acute phase, rehabilitation treatment may be needed once the patient's condition stabilizes. The duration of rehabilitation treatment usually depends on the patient's recovery progress. Afterwards, it is important to consider the patient's underlying diseases, such as hypertension, diabetes, and other risk factors, to perform secondary prevention, which involves medication and control of risk factors. In the case of cerebral hemorrhage, the treatment during the acute phase depends on the amount and location of the bleeding and whether there are indications for surgery to determine if surgical treatment is necessary. If conservative treatment is chosen, it also involves hospital treatment, followed by possible rehabilitation treatment once stabilized.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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The soft paralysis phase of a stroke refers to a few weeks after the onset.

The recovery of stroke patients is generally divided into four phases: the flaccid phase, also known as the hypotonic phase, the spastic phase, the recovery phase, and the sequelae phase. The symptoms of the flaccid phase mainly include muscle relaxation, low muscle tone, and lack of autonomous movement. The majority of patients maintain the flaccid phase for about one to three weeks, and depending on the individual's condition, they generally begin to enter the spastic phase after one to three weeks. A small portion of patients with severe conditions and poor initiative, who have not undergone formal rehabilitation training, may extend their flaccid phase to more than a month or even longer. Therefore, receiving early formal rehabilitation training to improve muscle strength and spasticity treatment can allow patients to smoothly transition through the flaccid phase and gradually enter the spastic phase. Good management of spasticity is even more beneficial for the patient’s recovery. Rehabilitation training can help stroke patients recover sooner and faster.

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Written by Zhang Hui
Neurology
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Post-stroke depression

Recent studies have confirmed that in addition to language dysfunction, cognitive impairment, and motor dysfunction, stroke patients also exhibit many signs of depression. According to guidelines published in China in 2016, about 33% of stroke patients experience post-stroke depression, which is a very high proportion. The main symptoms of post-stroke depression include a lack of interest in anything, unwillingness to communicate with others, being quiet and reticent, non-compliance with medication, and non-cooperation with rehabilitation training. Post-stroke depression significantly affects the recovery of patients and their future quality of life. Some patients may even turn to suicide due to depression. Therefore, it is crucial to pay attention to depression after a stroke, as the incidence rate of post-stroke depression is very high, reaching up to 33%. Clinicians must carefully identify it, and family members of patients must be attentive in their care.

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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 Liu Yan Hao
Neurology
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Can a stroke be detected through a physical examination?

Patients who have suffered a stroke can definitely be diagnosed if they undergo a head CT scan or MRI during a physical examination. Stroke is classified into hemorrhagic stroke, ischemic stroke, and tumor-induced stroke. A tumor-induced stroke is caused by a tumor, and hemorrhagic stroke includes cerebral hemorrhage and subarachnoid hemorrhage. Ischemic stroke refers to diseases such as cerebral embolism and cerebral infarction. Whether it is a hemorrhagic or ischemic lesion, over time, they tend to form a softening focus. These lesions are difficult to eliminate, and regardless of how many years have passed, these old lesions can still be seen in a head CT scan or MRI. In cases of stroke caused by brain tumors, the changes in size and location of the lesion can also be clearly seen on a head CT scan. Therefore, strokes can be diagnosed during a physical examination of the patients.