(1) Hypertension and atherosclerosis are the main and common causes of stroke.
(2) Heart disease is one of the main causes of cerebral embolism. Rheumatism, hypertension, coronary atherosclerotic heart disease and subacute bacterial endocarditis may all produce mural thrombus. When heart failure or atrial fibrillation occurs, the thrombus will fall off and flow to the cerebral artery to cause embolism.
(3) Aneurysms and arteriovenous malformations caused by abnormal intracranial vascular development are common causes of subarachnoid hemorrhage and cerebral hemorrhage, which often rupture and bleed many times.
(4) Some inflammations can invade meninges and cerebral vessels, or invade cerebral vessels alone to cause cerebral arteritis, such as suppurative, tuberculous, fungal inflammation and rheumatism, which can cause cerebrovascular diseases.
(5) Hematological diseases such as thrombocytopenic purpura, polycythemia and leukemia often cause hemorrhagic cerebrovascular diseases. A few people have ischemic cerebrovascular disease.
(6) Metabolic diseases such as diabetes and hyperlipidemia are closely related to cerebrovascular diseases.
(7) All kinds of trauma, poisoning, brain tumor and brain tumor after radiotherapy can cause ischemic or hemorrhagic cerebrovascular diseases.
In addition, changes in temperature, environment and mood, excessive tension and fatigue are also the causes of stroke. The incidence of stroke in smokers and heavy drinkers will also increase greatly.
The precursor of stroke in the elderly, stroke, is simply a sudden neurological dysfunction. Including: limb fatigue, limb numbness, blurred vision, unclear speech, unstable standing or walking, unconsciousness, dizziness and transient unconsciousness or drowsiness. Therefore, if the old man was fine a minute ago, these phenomena suddenly appeared; Or it was fine the night before, and waking up early in the morning to find these phenomena is probably the prelude to a stroke.
If there is an unbearable headache, the headache changes from intermittent to persistent, or accompanied by nausea and vomiting, which is often caused by the sudden increase of pressure in the artery and stimulation of nociceptors on the blood vessel wall. This is probably a signal of cerebral hemorrhage, so pay special attention to it.
Symptoms of stroke headache Whether it is cerebral hemorrhage or cerebral infarction, headache is very common, and it is also an important symptom and signal of stroke.
Vomiting is usually accompanied by headache, which is also common. Characterized by jet vomiting. If you vomit a brown (soy sauce-like or brown-black) liquid, it means that the condition is very serious.
Dizziness is often accompanied by vomiting or tinnitus, which is a common symptom of stroke.
Abnormal sensation of a limb and face.
Drooling is the phenomenon that the corners of the mouth are skewed, and drooling or food flows out of the corners of the mouth, which should be paid enough attention to.
Sudden visual impairment is manifested as inability to see the left and right objects or visual defects, and can also be manifested as transient darkness in front of the eyes or the feeling that a mosquito suddenly flies in front of the eyes.
Sudden speech disorder and sudden slurred speech, swallowing and coughing symptoms: manifested as slurred speech, difficulty in pronouncing words, choking when drinking water or swallowing.
Consciousness disorder is manifested as confusion, respiratory failure, snoring and severe coma.
Attention should be paid to the above symptoms:
(1) Observe the patient's vital signs and contact the neurologist urgently.
(2) Where the patient falls, rescue him on the spot, and be careful if he must move.
(3) Paralysis of hands and feet, language disorder, visual impairment, etc. It is a precursor of stroke and should be found and treated as soon as possible.
Numbness is a common sequela of cerebral apoplexy, which is characterized by ants crawling feeling, acupuncture feeling or slow response to stimulation on the affected limb, especially on the extremity, such as fingers or toes, or on the cheek of hemiplegia.
Oblique mouth and squint eyes are characterized by shallow nasolabial groove, drooping mouth and exposed teeth. When you drum your cheeks and blow your whistle, your mouth is tilted to the healthy side, and your mouth is drooling, which is more obvious when you speak.
The main manifestations of central paralysis are increased muscle tone, hyperreflexia, pathological reflex and spastic paralysis.
Peripheral paralysis is characterized by decreased muscle tone, weakened or disappeared reflex, accompanied by muscle atrophy, but no pathological reflex.
Hemiplegia, also known as hemiplegia, refers to the movement disorder of upper and lower limbs, facial muscles and sublingual muscles on one side. It is a common symptom of acute cerebrovascular disease and a common sequela of stroke.
Aphasia aphasia is a common symptom of cerebrovascular disease, which is mainly manifested in the loss of language understanding and expression ability.
Agnosia refers to the loss of cognitive ability of patients, including the loss of vision, hearing, touch and recognition of body parts, which is one of the symptoms of stroke.
Apraxia, that is, inability to use, the patient is not paralyzed, has no sensory disturbance and ataxia, but can not accurately complete purposeful movements. Apraxia includes conceptual apraxia, conceptual apraxia, structural apraxia, wearing apraxia, oral apraxia and limb apraxia.
The purpose of stroke dietotherapy is to support systemic nutrition, protect brain function and promote the repair and functional recovery of nerve cells. Individualization is required in dietary nutrition supply, that is, different dietary nutrition treatment schemes are put forward according to the patient's condition, complications, normal diet, digestion and absorption function, weight, blood lipid, blood sugar, electrolyte and other factors.
Diet therapy for severe patients: Severe or comatose patients with vomiting or gastrointestinal bleeding within 2 ~ 3 days after onset should fast and supplement nutrition through veins. Nasal feeding began after 3 days. In order to adapt to the absorption function of digestive tract, rice soup and sucrose were mainly used in the first few days, 200 ~ 250 ml each time, 4 ~ 5 times a day.
In the case of tolerance, give mixed milk to increase heat, protein and fat, and use milk, rice soup, sucrose, eggs and a small amount of vegetable oil. For those who have been in a coma for a long time and have complications, they should be supplied with high-calorie and high-fat mixed milk, with protein 90 ~ 1LOG, fat 300g and carbohydrate 300g, total heat energy/kloc-0 10.46MJ(2500kcal), total liquid 2500ml, 300 ~ 400 ml each time, and 6 ~ 6 per day. Nasal feeding speed should be slow to prevent reflux from entering trachea. If necessary, you can choose a homogeneous diet or an elemental diet.
When treating the disease, the main symptoms are hemiplegia, mouth and eyes askew, speech disorder, and even sudden fainting and unconsciousness. Under normal circumstances, the first 2 weeks after the onset of the disease is the acute phase, and after 2 weeks, it enters the recovery period, and more than half a year is the sequelae period.
In the acute stage, the combination of traditional Chinese and western medicine has the best effect, while in the recovery stage, Chinese medicine, especially acupuncture, occupies a very important position. Acupuncture can significantly improve the paralysis of limbs and language function, improve the cure rate, is the main treatment.
Stroke is a difficult disease, and there is no ideal medicine for the treatment of traditional Chinese and western medicine.
To prevent stroke, we must minimize the risk factors of stroke. Controlling hypertension is the key to prevent stroke. Patients with hypertension should take antihypertensive drugs on time according to the doctor's advice, and if possible, it is best to measure their blood pressure 1 time every day, especially in the stage of adjusting antihypertensive drugs to keep their blood pressure stable. Maintain emotional stability, do or not do things that are easy to cause emotional excitement, such as playing cards, playing mahjong, watching sports games broadcast, etc. The diet must be light and moderate, quit smoking and drinking, and keep the stool unobstructed; Moderate activities, such as walking and playing Tai Ji Chuan.
The key to prevent and treat atherosclerosis is to prevent and treat hyperlipidemia and obesity. Establish healthy eating habits, eat more fresh vegetables and fruits, and eat less fatty foods such as fat meat and animal offal; Moderate exercise increases heat consumption; Take lipid-lowering drugs.
Control diabetes and other diseases such as heart disease and vasculitis.
Pay attention to the premonitory signs of stroke: some patients often have premonitions such as hypertension, fluctuation, headache, dizziness, numbness and weakness of hands and feet before stroke, and take measures to control them as soon as possible after discovery.
Effective control of transient ischemic attack: when the patient has the aura of transient ischemic attack, he should be given quiet rest and active treatment to prevent the development of cerebral thrombosis.
Pay attention to the influence of meteorological factors: seasonal and climate changes will make hypertensive patients emotionally unstable, blood pressure fluctuate and induce stroke. At this time, it is even more necessary to prevent the occurrence of stroke.
How to prevent the recurrence of stroke (1) To prevent stroke, it is necessary to minimize the risk factors of stroke. Controlling hypertension is the key to prevent stroke. Patients with hypertension should take antihypertensive drugs on time according to the doctor's advice, and if possible, it is best to measure their blood pressure 1 time every day, especially in the stage of adjusting antihypertensive drugs to keep their blood pressure stable. Maintain emotional stability, do or not do things that are easy to cause emotional excitement, such as playing cards, playing mahjong, watching sports games broadcast, etc. The diet must be light and moderate, quit smoking and drinking, and keep the stool unobstructed; Moderate activities, such as walking and playing Tai Ji Chuan.
The key to prevent and treat atherosclerosis is to prevent and treat hyperlipidemia and obesity. Establish healthy eating habits, eat more fresh vegetables and fruits, and eat less fatty foods such as fat meat and animal offal; Moderate exercise increases heat consumption; Take lipid-lowering drugs. Control diabetes and other diseases such as heart disease and vasculitis.
(2) Pay attention to the premonitory signs of stroke: Some patients often have premonitions such as hypertension, fluctuation, headache and dizziness, numbness and weakness of hands and feet before stroke, and take measures to control them as soon as possible after discovery.
(3) Effective control of transient ischemic attack: When patients have the aura of transient ischemic attack, they should be given quiet rest and active treatment to prevent the development of cerebral thrombosis.
(4) Pay attention to the influence of meteorological factors: seasonal and climate changes will make hypertensive patients emotionally unstable, blood pressure fluctuate and induce stroke. At this time, it is even more necessary to prevent the occurrence of stroke.
(5) Eating more fruits and vegetables is not easy to get a stroke. First of all, because it contains a lot of vitamin C, according to research, the concentration of vitamin C in blood is closely related to stroke. The higher the concentration, the lower the risk of stroke. In addition, vitamin C is an effective antioxidant, which can scavenge free radicals in the body. The increase of free radicals will increase the risk of heart disease and stroke. Secondly, vegetables and fruits are rich in dietary fiber, which can inhibit the increase of total cholesterol concentration, thus preventing arteriosclerosis, cardiovascular diseases and stroke. A study in the United States shows that taking a certain amount of water-soluble dietary fiber from vegetables and fruits every day can reduce the cholesterol content in blood by 3% ~ 5%. Based on this understanding, people in developed countries quickly adjust their diet structure, eat less meat, sugar and fat and eat more fruits and vegetables.
What should the elderly do after a stroke? General first aid measures (1) Check vital signs. If breathing and heartbeat have stopped, do cardiopulmonary resuscitation immediately.
(2) If the patient is conscious, he can lie flat on his back with his head slightly tilted back to open the airway without a pillow and cover it with a cotton blanket to keep warm.
(3) Patients who have lost consciousness should maintain a coma posture, keep the airway unobstructed, and do not use pillows.
(4) Cold can cause vasoconstriction, so keep the room temperature warm and pay attention to indoor air circulation. People who have incontinence should take off the patient's pants and put on toilet paper.
First aid measures when vomiting (1) Turn your face to one side and let it vomit.
(2) The rescuer wraps a clean handkerchief on his finger and sticks it into his mouth to remove vomit, so as not to block the airway.
(3) If dentures are installed, they should be removed.
(4) Don't let the patient eat or drink without the doctor's permission.
Family rescue of stroke (1) should make the patient lie on his back, without putting a pillow or slightly raising his head and shoulders, so as to slightly raise his jaw. Unbutton neckline buttons, ties, belts and bras, and remove dentures if any.
(2) tilt your head to one side to prevent sputum or vomit from flowing back into the trachea and causing suffocation.
(3) If the patient is awake, pay attention to comfort the patient and relieve his nervousness.
(4) For coma patients, if the doctor can't come for the time being, you can take ice cubes out of the refrigerator and put them in plastic bags and carefully put them on the patient's head.
(5) If the patient snores obviously, it means that the airway is blocked by the tongue root falling off. At this time, the patient's mandible should be lifted upward, and the patient's vomit should be wiped off with a towel at any time.
(6) avoid light.
(7) Call the emergency center or hospital neurology department for help.
(8) Don't give drugs to patients without a clear diagnosis by a doctor.
The elderly can't take medicine because of a sudden stroke (1). Many stroke patients will have difficulty swallowing. If you take medicine yourself or your family members force you to take medicine, it is easy to choke medicine and water into your lungs, which will not only cause respiratory problems, but also cause aspiration pneumonia, which is extremely dangerous.
(2) lie flat. People who have a sudden stroke are prone to vomiting. Lying flat can cause vomit to be inhaled into the trachea by mistake, leading to life-threatening airway obstruction. It is also easy for the patient's tongue root to fall backwards and get stuck in the throat, causing suffocation. The correct way is to let the patient's head lean to one side or lie on his side.
(3) Move the patient at will. Holding the patient on his back at will is easy to cause vomiting, and it is best to wait for professional medical staff to take it out. In the process of waiting, keep the patient quiet, try to appease the patient, avoid emotional tension, high blood pressure and aggravate the condition.
(4) pinch people. Many patients will find it difficult to breathe and need to breathe. At this point, family members should not pinch the patient, otherwise it will make the patient's mouth closed and affect breathing.
Many people think that a stroke comes suddenly and cannot be prevented. Actually, this is a misunderstanding. Before a stroke, many people will have some symptoms of "mini-stroke", which is an early warning signal of stroke, because the early warning signal often only appears for a few minutes, so it is easy to be ignored. "For example, someone suddenly has numbness or weakness on one side, speaks Lickitung, suddenly one eye or even two eyes can't see clearly or have a black shadow, walking is difficult or out of balance, suddenly dizzy, and suddenly has a severe headache, which lasts for a long time." Once the above symptoms appear, don't hesitate to go to a nearby hospital for examination. "Time is the brain", only race against time can reduce brain damage.
Therefore, once a family member or friend is found to have a stroke, you should immediately call the emergency number and arrange the patient smoothly. You can lie on your side. If you want to lie flat, tilt your head to one side and raise your head. While calming the patient's mood, he unbuttoned his clothes. If the patient has false teeth, it is best to take them off to prevent accidental swallowing. Remember the onset time of patients, the golden treatment time of stroke is 4~5 hours after onset, during which treatment can minimize the risk. Don't wait until the patient can't move half his body before going to the hospital, so he loses the best opportunity to rescue, causing paralysis and even life-threatening.