Treatment of stroke will include first aid and follow-up therapy. Further therapy consists of a series of measures to normalize and support the functioning of the brain. The doctor tells the patient how to take nootropics with stroke and other medications, especially the nutrition of patients with stroke, clinical recommendations for stroke. The treatment of acute cerebrovascular disorders include basic and specific therapy. Basic therapy contains the following activities:
- Restore and maintain respiratory function.
- Maintaining optimal blood pressure, cardiovascular activity. The patient is given intravenous drugs (labetalol, nicardipine, sodium nitroprusside) according to indications; anaprilin, enaprilin, captopril, esmolol are used to correct blood pressure. Antihypertensive therapy depends on the type of stroke – hemorrhagic or ischemic.
- Treatment of cerebral edema.
- The fight against seizures, intracranial hypertension, various neurological complications.
Specific therapy includes:
- Conducting intravenous or intraarterial thrombolysis depending on the time of onset of the first symptoms of the disease. Aspirin is prescribed, according to the indications of anticoagulants.
- Maintaining optimal blood pressure.
- In certain cases, a surgical operation is performed to remove the brain hematoma, the hemicranectomy method is used to decompress the brain.
Treatment of stroke is carried out in a hospital. The faster the patient receives medical care, the higher the chance of recovery.
The amount of medical care for stroke or stroke will depend on the severity of the patient’s condition. It is important to get to the hospital as soon as possible. If the cause of the stroke is a blood clot, then it is necessary to take an antithrombotic agent within 3 hours after the onset of cerebrovascular accident to reduce the consequences.
Treatment of stroke occurs in a hospital, its duration is from two weeks (with mild lesions). The patient is prescribed infusion therapy, drugs to stabilize blood pressure, drugs to normalize the functioning of nerve cells. In the future, the patient will need a rehabilitation course to restore lost skills or adapt to new living conditions. Rehabilitation is a very important part of treatment. It is rehabilitation measures, with regular implementation, that contribute to the resumption of performance.
In the Yusupov hospital, you can undergo a full course of treatment for stroke and stroke, including emergency care and rehabilitation. The hospital has the best neurologists, cardiologists, surgeons in Moscow, doctors of science, doctors of the highest category who have extensive experience in the successful treatment of these conditions. The hospital is equipped with everything necessary for the speedy and high-quality recovery of patients.
Upon admission of a patient with stroke or stroke, the doctor evaluates the adequacy of spontaneous breathing and the level of oxygen in the blood. If the patient has a low level of consciousness, there is a risk of aspiration, high rates of intracranial hypertension, he needs mechanical ventilation (mechanical ventilation).
Also, mechanical ventilation is performed when:
- Violation of the central regulation of respiration;
- Obstruction of the tracheobronchial tree;
- Pulmonary embolism.
Infusion therapy starts from the moment a patient is admitted with stroke or stroke. A solution of sodium chloride 0,9% is prescribed. With stroke, hypovolemia often occurs (a decrease in blood volume), which can be eliminated by infusion therapy. Also, infusion is necessary to control the water balance in the body. Infusion therapy is canceled gradually, after confirming the normalization of the level of electrolytes and other elements in the blood test.
The first three days are critical after stroke. During this period, repeated disturbances or the development of an extensive stroke are possible. Now it is necessary to stabilize the patient’s condition and respond to any changes. One of the important indicators is intracranial pressure and blood pressure. Pressure level indicators should not exceed the permissible norm or be lower than the norm.
With ONMK, there is a high risk of seizures. However, the prevention of this condition is not carried out. Anticonvulsants are prescribed immediately when a convulsive syndrome occurs. Drugs are administered orally or intravenously.
An important area of treatment for stroke and stroke is the restoration of damaged nervous tissue and the protection of healthy tissue from the spread of “vascular catastrophe”. Treatment is performed using neuroreparants and neuroprotectors.
In case of swallowing disorders, the patient is prescribed food through a probe. At the beginning of treatment, food contains the necessary elements to maintain the functioning of the body, combined with infusion therapy. The calorie content of food increases gradually. In the future, the method of eating will depend on the severity of brain damage.
The rehabilitation course of patients after stroke and stroke includes the restoration of self-care skills, so with the proper effort and capabilities of the patient, he can again eat on his own. Food should be varied, contain all the necessary trace elements and vitamins, that is, comply with the principles of good nutrition.
If the symptoms of this pathology are formed, the therapy is carried out exclusively in stationary conditions, under the supervision of doctors and medical staff. This is important in order not to waste precious time and minimize the degree of damage to the nervous tissue by hematoma or ischemia. If an ambulance is called and a patient with suspected stroke is delivered within the first 4-6 hours, prognoses for further treatment and rehabilitation will be most favorable.
To begin with, we will consider the basic principles of how to treat a violation of cerebral circulation. These include an ambulance call in cases of suspected stroke and hospitalization in the neurological department or ICU (intensive care unit).
- At the initial stage, actions are taken to maintain the vital functions of all internal organs, especially the cardiovascular system and pulmonary ventilation, pressure control is important so that damage during a stroke or TIA (transient ischemic attack) is not amplified.
- Important procedures to combat swelling and swelling of the brain, to ensure the full functioning of its shells. Correction of water-salt metabolism disorders is carried out by introducing solutions, maintaining vascular tone and removing their spasm, correction of rheological and coagulation properties of blood.
- Further therapy is aimed at eliminating the cause that caused all the changes that have occurred, and at preventing relapse, rehabilitation measures are carried out in the presence of motor, sensory or cognitive disorders.
In the presence of symptoms of a chronic disorder, treatment is carried out comprehensively, with an effect on the root cause of the problem and on the normalization of blood flow in the arteries and veins of all organs. Purposefully used drugs: inside, intramuscularly, intravenously.
The complex of procedures must necessarily include funds that normalize blood pressure:
- basic therapy;
- means for the prevention of crises.
It is also important to reduce cholesterol and atherogenic lipid fractions – “harmful” fats that contribute to the formation of cholesterol plaques on the inner surface of blood vessels. Among physiotherapeutic techniques, magnetotherapy is recommended.
Carrying out such measures improves blood pressure indicators, the state of blood vessels, normalizes blood flow and helps to stabilize indicators. In this regard, sleep and general well-being gradually improve, headaches and dizziness, tinnitus and other symptoms associated with the disease are eliminated.
A complete review of the diet is necessary, including for the correction of excess weight, often concomitant hypertension and malfunctioning of blood supply, therapy is supplemented by regimen moments, dosed physical exercises and physiotherapy, psycho-preventive measures, sedative therapy and the elimination of possible cognitive disorders (exercises for training memory, thinking reading books, solving crosswords).
In case of acute headache, numbness of the body part, paralysis of the face, extremities, malaise, loss of consciousness and nausea, vomiting, it is necessary to immediately call an ambulance, take the patient to a hospital and not make any attempts to self-medicate, especially with the help of traditional medicine or various alternative methods. Precious time may be lost, which may lead to irreversible consequences.
In the acute period, all necessary activities are carried out in a stationary manner, but in the future the role of relatives and the person who has suffered from the problems is great.
In case of cerebrovascular accident, treatment and drugs are selected individually. The following drug groups are used in accordance with clinical standards:
- neuroprotectors that help restore cell health;
- sedatives, eliminating stress and anxiety, fear of death and disability;
- multivitamin, especially containing complexes of B vitamins, contributing to the restoration of nerve conduction of those sites that partially took over the functions of the affected areas;
- venotonic drugs that normalize the outflow of blood through venous vessels and reduce swelling of the brain;
- agents with a vasodilating (vasodilating) effect;
- antioxidants that help protect cells from hypoxia and the effects of free radical and aggressive compounds.
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The method of use of antiplatelet agents
The most studied are three groups of drugs: acetylsalicylic acid (aspirin), ticlopidine and dipyridamole (chimes).
Aspirin is used once a day in the morning before meals at a dose of 1 mg per 1 kg of patient weight (75-100 mg) constantly. Side effects are possible – gastrointestinal bleeding, dyspeptic phenomena. Their frequency is significantly reduced when using small doses, as well as drugs with enteric coating (aspirin-cardio, thrombosis).
Ticlopidine (ticlide) – reduces blood viscosity, lengthens bleeding time. Assigned to 0,25 g 2 times a day. Side effects – thrombocytopenia, bleeding, diarrhea. Treatment is carried out under the control of blood tests (1-2 times a month).
Dipyridamole (chimes) – reduces platelet aggregation activity. Apply 25-50 mg three times a day before meals. It is also prescribed in cases where aspirin is contraindicated.
A combination of small doses of aspirin (50 mg per day) with the administration of chimes 200 mg twice a day is possible.
Preventive antiplatelet therapy should be carried out continuously and for a long time (several years).
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