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Stroke: cerebrovascular accident (CVA)

Table of Contents

The central nervous system includes the brain and spinal cord. The brain is located in the cranium, the spinal cord is located in the spinal canal.

 

For normal functioning, brain cells need oxygen and glucose, which is why their abundant and uninterrupted blood supply is so important.

All the centers of regulation of vital activity are located in the brain: the respiratory center, the center of swallowing, the centers of orientation reflexes, the maintenance of skeletal muscle tone, and many others. Accordingly, the death of brain cells during a stroke can lead to permanent disability and, in some cases, death.

The brain consists of 5 sections:

  • medulla oblongata (continuation of the spinal cord)
  • Hind brain (cerebellum and pons)
  • midbrain
  • diencephalon
  • forebrain

The forebrain is the most developed structure in the process of evolution, it is he who determines the inclinations of a person, his orientation, behavior, and the formation of a personality. Consists of two hemispheres – left and right, each of which is responsible for certain processes. The right hemisphere is responsible for orientation in space, imagination, perception of non-verbal information; left – for analytical and linguistic abilities, consistency in information processing.

The peculiarity lies in the fact that the left hemisphere controls the right side of the body, and the right – the left half.

Causes of a stroke

  1. Rupture of an aneurysm of a cerebral vessel. An aneurysm is a pathological change (thinning) of the vessel wall with the formation of a protrusion or local expansion. This changes the nature of the blood flow in this area, which can threaten the formation of blood clots, as well as lead to rupture of the vessel (spontaneously or when traumatized from the outside).
  2. Thrombosing can occur due to the pathology of the vessel itself (the presence of an atherosclerotic plaque), increased blood viscosity, due to diseases that cause thrombophilia (for example, atrial fibrillation, heart valve disease, varicose veins of the lower extremities, etc.).

Provoking factors for the development of a stroke include:

  1. Arterial hypertension (persistent increase in blood pressure) leads to a decrease in the elasticity of the vascular wall.
  2. Atherosclerosis, elevated levels of cholesterol and / or its “bad” fractions (low-density lipoprotein, LDL) in the blood increase the fragility of the vascular wall. Cholesterol plaques can also cause a blood clot.
  3. Heart rhythm disturbances change the nature of blood flow, which leads to increased thrombosis.
  4. Smoking leads to an increase in blood viscosity, including due to an increase in the number of red blood cells, which is associated with the body’s desire to compensate for the lack of oxygen. The intake of alcohol and drugs also negatively affects the blood vessels and leads to a temporary increase in blood pressure.
    1. Violation of blood supply in diabetes mellitus occurs at the microcirculatory level. An increased concentration of glucose in the blood causes a change in the vascular wall, which contributes to the development of strokes, heart attacks and damage to other organs.
    2. Taking medications that affect the rheological properties of blood – anticoagulants (thin the blood), as well as long-term use of hormonal contraceptives (thicken the blood).
    3. The presence of cerebral aneurysms. They can be both congenital and acquired as a result of infections, high blood pressure, etc.
Transient ischemic attack (TIA) is a transient (temporary) violation of the blood supply to the brain of an ischemic nature. This condition requires observation and treatment in a neurological intensive care unit to prevent the development of a stroke ( persistent circulatory disorders).

The blood supply to the brain is carried out through a separate functional system of blood vessels:

  1. Basin of the anterior cerebral artery. In violation of blood flow in this system, inadequate patient behavior, disorientation, changes in mobility and sensitivity in the limbs are possible.
  2. Basin of the middle cerebral artery. Violations in this area cause loss of memory and cognitive functions, disorientation in space, and uncoordinated movements.
  3. Basin of the posterior cerebral artery. Changes are manifested by visual impairment, neuropsychological pathologies (impaired speech, color recognition, written text, incorrect naming of objects, difficulty in choosing words), as well as impaired movements of the arms and legs.

The pools originate from the carotid and vertebral arteries. Accordingly, the defeat of these vessels will also lead to malnutrition of the brain and death of its cells.

 

Symptoms requiring immediate medical attention:

  1. Sudden blindness, loss of speech.
  2. Persistent severe dizziness.
  3. Loss of sensation or movement in the limbs.
  4. A sudden violation of facial expressions and articulation, when protruding the tongue, it may deviate to the affected side.
  1. Inappropriate behavior, the appearance of convulsions, impaired consciousness.

Stroke Diagnosis

Neurologists use neuroimaging techniques to diagnose cerebrovascular accidents, which are the “gold standard” for diagnosing stroke. These are computed tomography and magnetic resonance imaging.

Scanning of the brain, skull and surrounding tissues, which allows diagnosing various pathologies.

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