Causes, symptoms, diagnosis, treatment and prevention of lacunar infarction
In most people, the term "stroke" causes an association with neurological disorders of special severity, paralysis, speech disorder, nutrition and altogether normal life activity. They consider the changes in the brain irreversible and terrible. After all, in this case, the life-style of the patient and his close environment completely changes. Although sometimes it is possible to meet such strokes, the symptoms of which are little manifest, and even the person affected by this disease does not mean what happened to him. Infringements do not lead to the expressed, serious infringements, and the organism quickly is restored after gone through. To pathologies of this type is the lacunar infarct of the brain.
Lacunar cerebral infarction implies the appearance of a small foci of necrosis in the deep branches of the brain, including its trunk. The main cause of its appearance is the banal lesion of perforating arteries. As these vessels differ in a small caliber, and the foci themselves are small (no more than 10 mm in radius). Therefore, the lacunar stroke does not damage the cerebral cortex of the cerebral hemispheres, being located exclusively in its depth.
This disease of the brain is attributed to ischemia of the organ caused by arterial hypertension and vascular pathologies. Although there are occasional cases of minor hemorrhages.
- Causes of the disease
- Symptoms of the disease
- Diagnosis of the disease
- Tactics of treatment of disease
- Preventive actions
Causes of the disease
The cerebral infarction of the brain is manifested after disturbances in the blood flow, at least one perforating artery. More than eighty percent of all cases are based on the white cerebral substance of the subcortical structures, and much less often - in the bridge and brain stem. The direct cause of stroke - microangiopathy - pathological changes in the walls of blood vessels.
The most common factors in the development of microangiopathy are:
- Arterial hypertension. And thus it is completely unimportant, a crisis it or simply high blood pressure. In any case, a stroke can occur.
- Atherosclerosis of blood vessels. For him, appearance in small vessels is uncharacteristic. Whereas in large brain arteries, the formation of cholesterol plaques can lead to a general disturbance of blood flow.
- Microembolia of small arteries. Most often, such a pathology occurs after a previous myocardial infarction, when the normal rhythm of the heart is disturbed.
- Diabetes mellitus, which is accompanied by an elevated blood glucose level, can also cause a lacunar stroke.
Attention: Increasing the level of glucose just causes angiopathy of the vessels. And the heavier the diabetes, the more pronounced atherosclerosis.
- The pathology of the kidneys with functional organ failure, which increases the creatinine content in the blood.
- Autoimmune diseases.
- Smoking. It promotes thickening of blood and the appearance of vasospasms.
Symptoms of the disease
More often lacunar cerebral infarction is characterized by rapid development of symptoms. Literally in two or three hours it becomes clear that something serious has happened. But sometimes there is a gradual increase in individual symptoms between three and six days. When lacunar lesions of GM people usually do not lose consciousness, which leads to underestimation of their condition.
Distinguish the following variants of clinical symptoms:
- motor infarction is accompanied by insignificant limb movements from one or both sides;
- a sensitive stroke suggests lowering the sensitivity of half of the body or limb;
- Coordinator's stroke is characterized by the difficulties of normal coordination of movements and location in space. In this case, the victim may stagger on the move or feel dizzy;
- In a stroke with predominantly intellectual impairment, there are, first of all, problems with higher mental functions. So, the victim can badly remember, think long and make decisions, including violations of attention and concentration.
It is important to note that such a disease can pass unnoticed for the victim. Because consciousness and normal orientation in space are not necessarily violated. Sometimes there are situations when a stroke occurs during sleep. This is characteristic of his motoric clinical manifestation: there are paresis of limbs or facial muscles..
Important! If after a stroke the victim continues to work and lead a habitual way of life, then it is almost impossible to not notice the difficulty in the issue of focusing on the performance of a specific task. In any case, a person can not fulfill his basic duties as before..
Stages of the disease are as follows:
- the sharpest period is three days;
- acute - twenty-eight days;
- the early recovery period lasts six months after the first violation of the blood flow;
- The late recovery period lasts two years after a stroke.
Since the symptoms with this form of stroke are smeared, this separation is secondary, it is difficult to single out the manifestations in practice in each specific period.
Diagnosis of the disease
You can presume the course of a lacunar infarction on the basis of complaints. But to make an accurate diagnosis only on the results of examination and collection of anamnesis will not work. The patient is assigned a survey using high-tech and sensitive equipment and devices capable of detecting the slightest discrepancies in brain function.
Most often this is a tomography, the results of which provide an opportunity to see the brain at different levels, because this device produces step-by-step virtual slices.
After identifying the disease, it is important to determine the cause of its appearance. Therefore, other studies are being carried out in parallel:
- general analysis of blood and urine;
- a blood test for sugar;
- biochemical blood test with determination of cholesterol level;
- To find a vessel with signs of atherosclerosis, ultrasonic duplex scanning is performed.
To fully treat stroke, it is important to follow all the prescriptions and recommendations of a doctor. This will minimize the consequences of the disease and their severity. Otherwise, you can "wait" for a basal stroke - a serious and deadly disease.
Tactics of treatment of disease
To prevent recurrence of episodes of circulatory disorders that lead to another stroke, doctors prescribe a patient with aspirin, which reduces the aggregation of blood and increases its fluidity. The standard dosage of this drug is 75 mg. If you can not use acetylsalicylic acid for some individual characteristics (intolerance), you can replace it with dipyridamole. However, the dosage is increased to 200 mg.
To restore blood flow in the vessels, it is necessary to take medications that help improve microcirculation: nicergoline, vinpocetine or pentoxifylline. In this case, the patient is initially placed with droppers, and then they switch to standard medications in the form of tablets.
For normal supply of the brain with oxygen it is recommended to use neurotrophic drugs, for example, actovegin, cerebrolysin. If dementia, expressed inhibition is observed, it is recommended to take anticholinesterase medications, for example, proserine, galantamine..
Important! When prescribing a course of medicines to restore normal vital activity, the age of the victim, the severity of the symptoms, including the presence of concomitant diseases, for example, sugar diabetes..
After experiencing lacunar stroke, pretend that nothing has happened, and you can not continue living as before. Without correcting the lifestyle, eliminating bad habits and normalizing the diet, reducing the risk of a second stroke does not work.
- Approach at least somehow to an active lifestyle: move more, walk in the fresh air and every morning perform light physical exercises (gymnastics);
- Normalize the power mode. It is recommended to eat 4-5 times a day and control its composition. It is important to exclude or minimize products containing cholesterol.
- Refuse from smoking and abuse of alcoholic beverages. Cigarettes - strictly no! While alcohol is occasionally possible. But it's a glass of red dry wine. And only in the case when the state of health is normal, and there are no other contraindications.
- Follow the appointment and recommendations of the attending physician in the treatment of hypertension and diabetes mellitus (if any). Otherwise, the severity of the disease and the restoration of normal life is impossible.
- If, in the course of diagnosis, an atherosclerotic lesion is detected, additionally, and a diet with the use of medicines, which will reduce the level of cholesterol in the blood.
- At a high risk of embolism, it is recommended to take medications that promote blood thinning. In this case, it is strictly forbidden to engage in self-medication, as this can lead to death due to dangerous hemorrhages.
Important! If the attending physician prescribes the use of drugs to reduce cholesterol in the blood, throughout the time treatment, it is recommended that you regularly take a biochemical blood test and consult a vascular the surgeon... ..