Precautions for Stroke Patients Using Mannitol

Written by Liu Yan Hao
Neurology
Updated on February 09, 2025
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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 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 Sheng Wang
Neurology
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Causes of Dysphagia after Stroke

The causes of dysphagia resulting from a stroke are largely related to the location of the stroke. Dysphagia mainly involves the glossopharyngeal and vagus nerves, which are distributed in the medulla oblongata of the brainstem. Therefore, if you have a brainstem stroke, specifically at the medulla oblongata, there is a significant chance of experiencing coughing due to aspiration and dysphagia. If the stroke occurs in a different area, these symptoms are unlikely to appear. A stroke in the cerebral hemisphere, since it has bilateral nerve supply, does not lead to noticeable coughing if only one side is affected. However, if one side is affected this year and the other side next year, similar symptoms of aspiration cough and dysphagia will occur. Therefore, neurologically, the location and specific site of the stroke are crucial, as each location presents different symptoms.

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Written by Tang Bo
Neurology
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The difference between stroke and cerebral hemorrhage

Stroke includes hemorrhagic stroke and ischemic stroke. Hemorrhagic stroke refers to cerebral hemorrhage, and ischemic stroke refers to cerebral infarction. Thus, they are included in the category of stroke. If symptoms similar to stroke occur, such as facial droop and limb weakness, along with a sudden increase in blood pressure, it is essential to go to the hospital immediately. The first step should be a cranial CT scan to determine whether it is a hemorrhagic or ischemic stroke, to guide further different treatments. Therefore, one must go to the hospital promptly if such symptoms appear.

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Written by Tang Bo
Neurology
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Common clinical manifestations of stroke

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 difference between stroke and cerebral infarction

Stroke is divided into hemorrhagic stroke and ischemic stroke. Hemorrhagic stroke involves cerebral hemorrhage, while ischemic stroke involves cerebral infarction. Therefore, the difference is that stroke includes cerebral infarction, which is a type of ischemic stroke. In such cases, it is crucial to seek prompt hospital treatment and examine for risk factors related to cerebrovascular disease. Under the guidance of a doctor, the condition should be stabilized since the acute phase of a cerebral infarction might be unstable and could worsen. Thus, after stabilizing the condition, long-term oral medication will also be necessary to prevent future strokes.