Common clinical manifestations of stroke

Written by Tang Bo
Neurology
Updated on October 30, 2024
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Stroke includes ischemic stroke and hemorrhagic stroke, also known as cerebral infarction and cerebral hemorrhage. The clinical manifestations of cerebral infarction depend on the location of the occlusion, and may vary accordingly. Common symptoms include slurred speech and limb weakness. It generally occurs acutely, and may also include memory decline or a series of other symptoms depending on the specific location of the occlusion. If these symptoms occur, it is crucial to seek medical attention immediately, as there is an opportunity for thrombolytic treatment within 4.5 hours. In the case of cerebral hemorrhage, patients may experience symptoms during physical activity, possibly accompanied by severe headaches, as well as symptoms of neurological deficits such as unclear speech, limb weakness, or other symptoms. Seizures may also occur. It is essential to visit the hospital immediately if these symptoms appear. If cerebral hemorrhage is confirmed, the decision for surgical treatment depends on the amount of bleeding.

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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 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 Tang Ying
Physical Medicine and Rehabilitation
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Treatment of urinary retention in stroke patients

In cases of urinary retention after a stroke, some patients experience this due to psychological factors, concerns, and the sudden need to remain in bed, making it difficult to urinate in bed since they cannot stand or squat. Therefore, the first step is to alleviate psychological factors, provide patient communication and counseling, and perform massages around the navel and abdomen, along with heat treatments, to help patients urinate on their own. In a second scenario, where the patient's condition is severe or even comatose, and they have difficulty urinating, a catheter can be placed. It's important to first try to rule out a urinary tract infection, collect a midstream urine sample for analysis, and ensure the catheter is not left in longer than necessary. Once the patient's condition improves or they regain consciousness, the catheter should be removed promptly to avoid any urinary tract infections.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Stroke Rehabilitation Treatment Plan

In the rehabilitation treatment of stroke patients, we first need to conduct a comprehensive rehabilitation assessment, evaluating the patient's current primary clinical symptoms, nutritional status, and rehabilitation functional impairments. Based on the results of the assessment, we determine the patient's main functional impairments, targeting a series of functional impairments such as mobility, hand function, as well as speech and swallowing disorders. We adopt a series of therapeutic interventions including exercise therapy, occupational therapy, physical therapy, swallowing therapy, speech therapy, psychological therapy, rehabilitation engineering, and rehabilitation nursing. Generally speaking, through evaluation, we develop a personalized rehabilitation treatment plan for the patient, comprehensively promoting the patient's overall recovery, improving the patient’s ability to live independently, and helping them return to their families, society, and work positions as soon as possible.

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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.