Can a stroke be detected through a physical examination?

Written by Liu Yan Hao
Neurology
Updated on November 06, 2024
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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.

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Written by Zhang Hui
Neurology
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Can a stroke be cured?

Stroke is mainly divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke, also known as cerebral thrombosis, can benefit many patients if they can reach a hospital quickly and receive intravenous thrombolysis within the time window, such as within 4.5 hours, leaving them with only mild neurological deficits followed by proper rehabilitation training. Some patients can be cured. However, if the stroke is severe from the onset, resulting in complete paralysis or even consciousness disorders such as drowsiness, stupor, or coma, the treatment outcomes can be significantly less effective, potentially leaving some degree of disability. Generally speaking, whether a stroke can be cured depends closely on the initial severity of the stroke, the overall condition of the patient, and the timeliness of the treatment. Some conscious patients who receive timely treatment can be cured, whereas those with severe conditions typically suffer from long-term complications.

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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 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 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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Written by Tang Ying
Physical Medicine and Rehabilitation
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Principles of Stroke Rehabilitation Treatment

Principles of stroke rehabilitation treatment. First is the issue of timing; it is crucial to choose the appropriate time for rehabilitation intervention. Rehabilitation treatment should start as early as possible when the patient's condition is stable. Secondly, rehabilitation assessment, also known as rehabilitation evaluation, should be performed throughout the treatment process. This allows for comparability before and after treatment, clarifying the treatment results for the patient and determining if there is a need to modify the treatment plan during the process. Thirdly, it is essential to have rehabilitation treatment goals and plans. Based on assessments, short-term and long-term rehabilitation plans must be developed for the patient to achieve certain rehabilitation objectives. Fourth, the principle of gradual progression must be adhered to in rehabilitation treatment. It should not be rushed, and active participation from both the patient and their family members is crucial, incorporating daily life and exercise opportunities. Fifth, rehabilitation treatment primarily involves comprehensive therapy, which includes physical exercise, speech therapy, occupational therapy, physiotherapy, and traditional rehabilitation treatments such as acupuncture and moxibustion, as well as psychological therapy, rehabilitation engineering, and assistive devices. Sixth, conventional pharmacological treatments and necessary surgical interventions are involved. These include essential medications that must be used, and when rehabilitation methods alone cannot restore function, appropriate medical advice from relevant departments should be considered, and surgical treatment may be needed to assist the patient in better recovery.