the Stroke (apopleksichesky blow) - very dangerous status calling a hemorrhage in a brain or corking by a blood clot of a brain vessel. Hypertensive illness, an atherosclerosis of vessels of a brain or their aneurysm can be the stroke reason. The vessels changed at these statuses are especially sensitive to physical and intellectual pressure. In stroke development can result as well emotional factors, especially negative.

Pered a stroke the person can have dizziness, a headache and inflow to a head, onemenie in finitenesses, speech infringement, then - consciousness loss. The person of the patient becomes purple-red, pulse is strained and slowed down, breath deep, frequent, quite often rattling, the temperature raises, pupils do not react to light. More often at once the paralysis of finitenesses, asymmetry of the person comes to light. Thus paralysed.storona always it is opposite to the defeat centre in mozge.

stroke Treatment

Lechenie strokes it is necessary to spend in several directions: the basic treatment, specific methods of treatment ischemic and gemorragicheskogo insultov.

Bazisnaja therapy at strokes vkljuchaet:

• Regulation of function of cardiovascular system. First of all it is necessary carry out the control of arterial pressure of Figure should to exceed on 15-20 mm.rt.st habitual for the patient. Are for this purpose applied beta blokatory (anaprilin, atenolol), ingibitory APF (captopril, enalapril), blokatory kaltsievyh channels (nefidipin, amlodipin), at an arterial hypotension the means rendering vazopressornyj effect (dopamin, an alpha-adrenomimetiki) and obemozameshchajushchaja therapy (dekstrany, odnogruppnaja svezhezamorozhennaja plasma).
• the Actions directed on normalisation of function of external breath and oxygenation (sanitation of respiratory ways, air line installation, intubatsija tracheas, if necessary carrying out IVL). At development of a hypostasis of a lung to patients appoint warm glikozidy (korglikon, strofantin).
• the Actions directed on reduction of a hypostasis of a brain. Apply kortikosteroidy (deksazon), osmotic diuretiki (mannitol).
• Actions for preventive maintenance and treatment of complications: a pneumonia, prolezhnej, uroinfektsii, the DVS-SYNDROME, flebotrombozov and tromboembolii a pulmonary artery, kontraktur, etc.

Treatment of an ischemic stroke

Osnovnye principles of pathogenetic treatment ischemic strokes vkljuchajut:

• blood-groove restoration in a defeat zone
• maintenance of normal job of a brain and its protection against structural damages

Dlja blood-groove restoration in a defeat zone are applied: Medicamentous trombolizis (rekombinantnyj fabric the activator plazminogena, alteplaza, urokinaza), antiagreganty (aspirin, dipiridamol, tiklid, pentoksifillin), anticoagulants (fraksiparin, geparin, fenilin, varfarin), vazoaktivnye means (vinpotsetin, kavinton, nitsergolin, instenon, eufillin, tsinnarizin), angioprotektory (parmidin, prodektin, askorutin, troksevazin, etamzilat, dobezilat, vobenzim), ekstrakorporalnye methods (gemosorbtsija, ultragemofiltratsija, a laser irradiation of blood), gravitational methods (plazmaferez).

Takzhe surgical methods are applied: imposing ekstraintrakranialnogo mikroanastomoza, trombektomija, reconstructive operations on arteries.

Dlja maintenance of normal job of a brain are applied: Antioxidants (emoksipin, mildronat, vitamin E, ascorbic acid), preparations mainly nejrotroficheskogo actions ((piratsetam, tserebrolizin, semaks, glitsin, pikamilon), the preparations improving power fabric a metabolism (cytochrome With, aktovegin, riboksin, aplegin).

Treatment gemorragicheskogo a stroke

Osnovnym a direction at treatment gemorragicheskogo a stroke is reduction of permeability of a vascular wall and the prevention of destruction of the generated blood clot. For this purpose apply angioprotektory (parmidin, prodektin, askorutin, troksevazin, etamzilat), vazoselektivnye blokatory kaltsievyh channels (nimodipin), vazoaktivnye preparations (vinpotsetin, kavinton, nitsergolin, instenon, eufillin, tsinnarizin). For preventive maintenance of secondary ischemic defeats of a fabric of a brain are used low-molecular dekstrany, antiagreganty in the conditions of continuous monitoring arterial davlenija.

Neobhodimo also as at an ischemic stroke to prevent a brain hypostasis.

Naibolee effective in most cases there is a surgical treatment gemorragicheskih insultov.

Pokazanija for surgical treatment insulta:

• Intrabrain polusharnye hemorrhages in volume more than 40 ml (according to KT heads).
• the Hemorrhage in a cerebellum.
• the Obstructive hydrocephaly at gemorragicheskom a stroke.
• Aneurysms, arterio-venous malformatsii, arterio-sinus soustja, accompanied by various forms of an intracranial hemorrhage and-or a brain ischemia.
• the Heart attack of a cerebellum with expressed secondary stvolovym a syndrome, deformation of a trunk of a brain (according to KT or MRT heads), an obstructive hydrocephaly.