the stroke

Cerebrovascular disease refers to a group of medical conditions that affect the blood vessels in the brain. The most common and well-known type of cerebrovascular disease is a stroke. A stroke occurs when there is a disruption of blood flow to a part of the brain, either due to a blockage (ischemic stroke) or bleeding (hemorrhagic stroke). Strokes are considered medical emergencies and can result in significant brain damage or even death if not treated promptly.

1、Ischemic Stroke: This type of stroke occurs when a blood clot (thrombus) or debris blocks a blood vessel supplying the brain, leading to a decrease or cessation of blood flow to that area. The lack of blood flow deprives brain cells of oxygen and nutrients, causing them to become damaged or die. Ischemic strokes are the most common type of stroke and account for about 85% of all stroke cases.

2、Hemorrhagic Stroke: Hemorrhagic strokes happen when a blood vessel in the brain ruptures and causes bleeding within the brain tissue or in the surrounding spaces. This bleeding can damage brain cells and increase pressure inside the skull. Hemorrhagic strokes are generally less common than ischemic strokes but tend to be more severe and life-threatening.

3、Common risk factors for cerebrovascular disease and stroke include:

a/High blood pressure (hypertension)

b/Smoking

c/Diabetes

d/High cholesterol

e/Obesity

f/Physical inactivity

g/Family history of stroke

h/Previous history of stroke or transient ischemic attack (TIA)

i/Age (risk increases with age)

m/Certain medical conditions, such as atrial fibrillation (a heart rhythm disorder)

4、The symptoms of a stroke can vary based on the area of the brain affected, but common signs include sudden numbness or weakness in the face, arm, or leg (especially on one side of the body), confusion, trouble speaking or understanding speech, difficulty walking, dizziness, loss of balance or coordination, and severe headache.

5、Treatment for stroke typically involves immediate medical attention to restore blood flow and minimize brain damage. For ischemic strokes, treatments like tissue plasminogen activator (tPA) 组织纤溶酶原激活剂or mechanical thrombectomy机械血栓切除术 may be used to remove the clot and restore blood flow. In cases of hemorrhagic strokes, controlling bleeding and managing the increased intracranial pressure are the main goals.

Prevention strategies for cerebrovascular disease and stroke include adopting a healthy lifestyle, managing underlying risk factors, taking prescribed medications, and seeking regular medical check-ups.

6、Antiplatelet Agents:

a/Aspirin: Often prescribed to prevent the formation of blood clots that can cause ischemic strokes.

b/Clopidogrel (Plavix): 氯吡格雷 Another antiplatelet medication used to reduce the risk of blood clots.

7、Anticoagulants:

Warfarin华法林, Dabigatran达比加群, Apixaban, 阿哌沙班 Rivaroxaban利伐沙班: These are used to prevent blood clots in patients with conditions such as atrial fibrillation心房颤动 or certain heart valve disorders.

8、Thrombolytic Therapy:

Tissue Plasminogen Activator (tPA): A clot-dissolving medication administered intravenously to quickly restore blood flow in ischemic strokes if given within a certain time window.

9、Blood Pressure Medications:

Medications like ACE inhibitors, beta-blockers, calcium channel blockers, and diuretics are used to control high blood pressure, a major risk factor for stroke.

10、Cholesterol-Lowering Medications:

Statins: These drugs are used to lower cholesterol levels and reduce the risk of atherosclerosis (narrowing of arteries) which can lead to stroke.

11、Neuroprotective Agents:

N-Acetylcysteine (NAC), N-乙酰半胱氨酸 Citicoline胞磷胆碱, and other agents are being studied for their potential to protect brain cells from damage after a stroke.

12、Antiepileptic Medications:

Seizures can sometimes occur after a stroke. Antiepileptic drugs抗癫痫药物 may be prescribed to prevent or manage seizures.

13、Surgery and Interventions:

Mechanical Thrombectomy: 机械血栓切除术A procedure to physically remove a clot from a blocked blood vessel in the brain, often used in large vessel occlusions.

Carotid Endarterectomy: 颈动脉内膜切除术Surgical removal of plaque from the carotid arteries to reduce the risk of stroke.

Aneurysm Clipping or Coiling: 动脉瘤夹闭或卷曲 Procedures to treat and prevent bleeding from cerebral aneurysms.

14、Rehabilitation Therapies: 康复治疗

Physical, occupational, and speech therapy play a crucial role in stroke recovery to regain lost functions and improve quality of life.