What Is Cerebral Vascular Disease?

Brain disorders caused by impaired blood supply to the brain. Most of the clinical cases are acute onset, mostly middle-aged and elderly patients, manifested as hemiplegia, speech disorders, etc., commonly known as stroke or stroke. Acute cerebrovascular disease is generally divided into two categories, ischemic and hemorrhagic.

Cerebrovascular disease is a group of diseases that occur in the blood vessels of the brain and cause damage to brain tissue due to intracranial blood circulation disorders. "Cerebrovascular accidents", "strokes" and "strokes" in our lives are all cerebrovascular diseases. Most of the clinical cases are acute onset, mostly middle-aged and elderly patients, manifested as hemiplegia, speech disorders and so on. Acute cerebrovascular disease is generally divided into two categories, ischemic and hemorrhagic.

Western Medicine Name: Cerebrovascular disease
Chinese Medicine Name: Stroke
Other name: Stroke
Affiliated Department: Internal Medicine-Neurology
Disease site: Intracranial

The main symptoms: hemiplegia
Main cause: Atherosclerosis
Multiple groups: Middle-aged and elderly
Contagious: Non-contagious
Whether to enter health insurance: Yes

Cerebrovascular disease disease profile

Cerebrovascular disease disease classification

Cerebrovascular disease-vascular malformations 1. Transient ischemic attack:

(1) Disorders in the carotid artery system.

(2) Impairment of the vertebral-basal artery system.

2. Subarachnoid hemorrhage:

The following aneurysms rupture:

(1) Congenital aneurysm.

(2) Arteriosclerotic aneurysms.

(3) Infectious aneurysm.

(4) Obstruction of vascular malformations.

(5) Impairment of intracranial abnormal vascular network disease.

3. Cerebral hemorrhage:

(1) Hypertension causes cerebral hemorrhage.

(2) secondary to bleeding caused by infarction.

(3) Tumorous bleeding.

(4) Hematopathy causes cerebral hemorrhage.

Cerebrovascular disease-vascular malformations

(5) Cerebral hemorrhage of amyloid cerebrovascular disease.

(6) Arteritis causes cerebral hemorrhage.

(7) Drugs cause cerebral hemorrhage.

(8) Cerebral vascular malformations or aneurysms cause cerebral hemorrhage.

(9) Cerebral hemorrhage caused by other reasons.

(10) The cause is unknown.

4. Cerebral infarction :

() Atherosclerotic thrombotic cerebral infarction.

(2) Cerebral infarction caused by cerebral embolism.

(3) Lacunar infarction causes cerebral infarction.

(4) Hemorrhagic infarction causes cerebral infarction.

(5) Asymptomatic cerebral infarction.

(6) Other causes of cerebral infarction.

(7) The reason is unknown.

5. Intracranial aneurysms:

Disease check (1) Congenital aneurysm.

(2) Arteriosclerotic aneurysms.

(3) Infectious aneurysm.

(4) Traumatic pseudoaneurysms.

(5) Others.

6. Intracranial vascular malformations:

(1) cerebral arteriovenous malformations.

(2) cavernous hemangioma.

(3) Venous vascular malformations.

(4) Galen venous tumor.

treatment (5) Cavernous sinus fistula of internal carotid artery.

(6) telangiectasia.

(7) Capillary hemangiomas.

(8) Brain-facial hemangioma.

(9) Intracranial-extracranial vascular communication arteriovenous malformations.

(10) Others.

7.Cerebral arteritis:

(1) Infectious arteritis.

Cerebrovascular disease-eat more fruits (2) Takayasu arteritis (aortic arch syndrome).

(3) Systemic lupus erythematosus.

(4) Nodular polyarteritis.

(5) Temporal arteritis.

(6) Occlusive thrombotic vasculitis.

(7) Other.

8.Other arterial diseases:

(1) Cerebral arterial steal syndrome.

(2) Intracranial abnormal vascular network disease.

(3) Arterial muscle fiber dysplasia.

(4) Amyloid angiopathy.

(5) Dissection of artery wall.

(6) Other.

9.Intracranial venous disease:

(1) Cavernous sinus thrombosis.

(2) Upper sagittal sinus thrombosis.

(3) straight sinus thrombosis.

(4) Transverse sinus thrombosis.

(5) Others.

Ischemic cerebrovascular disease

Cerebral infarction Focal damage due to blood supply disturbances in the brain is common in the following:

1. Transient ischemic attack (TIA): Most of the small fragments of atherosclerotic plaques are scattered in the blood, or microemboli, enter the cerebral circulation and cause focal small infarction, transient hemiplegia, Monoplegia, sensory loss, aphasia, blindness, etc., symptoms and signs disappear within 24 hours, but can recur.

2. Cerebral thrombosis: Focal cerebral infarction due to cerebral atherosclerosis, stenosis of the lumen, and obstruction of blood flow, corresponding symptoms and signs such as hemiplegia and aphasia. Most cases occur at night or at rest, with the peak incidence at the age of 60 to 70 years. Symptoms can worsen within hours or even within 1 to 2 days, and gradually recover later.

3. Cerebral embolism: due to extracranial blood clots (thrombus fragments) or air, fat, parasite eggs, etc., enter the brain with the bloodstream, causing acute embolism, forming focal infarction, and corresponding symptoms and signs appear. Such as hemiplegia, monoplegia, aphasia, etc. It is more common in young adults with rheumatic heart disease and mitral valve disease. The valve vegetations become emboli and cause cerebral embolism.

Skull CT examination of ischemic cerebrovascular disease shows low-density infarcts, which may be normal in TIA, and lacunar low-density infarcts. The principle of treatment is the application of vasodilators, calcium antagonists, and anti-platelet aggregation agents.

Cerebrovascular disease hemorrhagic cerebrovascular disease

The following two are common:

1. Cerebral hemorrhage: Corruption of microaneurysms due to arteriosclerosis and formation of hematomas in the brain and corresponding clinical manifestations. The most common sites are in the inner capsule, so the common signs are hemiplegia, paralysis, and hemiopia. Sometimes paralytic gaze paralysis occurs. If the hematoma occurs in the pontine or cerebellum, signs of damage to the brainstem or cerebellum will appear. If the hematoma breaks into the ventricle, signs of denervation of the brain and damage to the brainstem will appear.

2. Subarachnoid hemorrhage: Typical clinical manifestations of severe headache due to congenital aneurysm or arteriovenous malformation, blood entering the subarachnoid space, vomiting, and meningeal irritation.

Cerebrospinal fluid pressure in hemorrhagic cerebrovascular disease is often elevated and appears pink (intracerebral hemorrhage) or bloody (subarachnoid hemorrhage). A high-density image of the hematoma can be seen on the skull CT with edema bands surrounding it. Such as breaking into the ventricle or subarachnoid space, high density shadows can be seen in the ventricle and subarachnoid space. Treatment principle Acute phase is mainly to reduce intracranial pressure and maintain acid-base balance. For subarachnoid hemorrhage, whole brain angiography should be performed, and if an aneurysm or arteriovenous malformation is found, it should be treated surgically

Causes of cerebrovascular disease

There are many causes of cerebrovascular disease. The main pathological process is based on vascular wall lesions, coupled with changes in blood composition and / or hemodynamics, resulting in ischemic or hemorrhagic diseases. Common causes are:

1. Vascular wall lesions: atherosclerosis (about 70% of patients with cerebrovascular disease), arteritis (rheum, tuberculosis, leptospira, syphilis, etc.), congenital abnormalities (aneurysms, vascular malformations, etc.), Trauma, poisoning, tumors, etc.

2. Changes in blood composition:

(1) Increased blood viscosity. Such as hyperlipidemia, hyperglycemia, hyperproteinemia, dehydration, erythrocytosis, leukemia, thrombocytosis, myeloma and so on.

(2) The coagulation mechanism is abnormal. Such as thrombocytopenic purpura, hemophilia, application of anticoagulants, diffuse vascular coagulation and so on. In addition, pregnancy, postpartum, surgery and taking contraceptives can cause coagulation.

3, hemodynamic changes: such as hypertension (accounting for 55 to 75% of non-embolic cerebrovascular disease), hypotension, cardiac dysfunction (heart failure, coronary heart disease, atrial fibrillation, conduction block), etc. .

4. Other:

(1) The influence of extravascular factors is mainly the compression of lesions adjacent to large blood vessels (such as cervical spondylosis, tumors, etc.), which affects insufficiency of blood supply.

(2) Various emboli formed outside the skull.

Cerebrovascular disease risk factors

According to neuroepidemiological studies, the risk factors associated with cerebrovascular diseases are:

1. Age.

2. Persistent hypertension.

3. Heart disease.

4. Diabetes.

5. Atherosclerosis, high cholesterol and high blood lipids.

6. Smoking.

7. Others (oral contraceptives, genetic predisposition, etc.).

The prevention and research of cerebrovascular diseases have attracted increasing attention. The current positive effect is the prevention and control of hypertension. In addition, reasonable diet control to effectively control hyperlipidemia, quit smoking, control diabetes and heart disease, maintain regular, appropriate physical exercise and physical work, etc., to prevent the progress of atherosclerosis, has a certain positive significance.

Cerebrovascular disease

The signs of cerebrovascular disease are various, and some people count as many as 40. Among the many signs, they can be roughly classified into five categories:

1. Motor nerve failure: This type of aura signs is the most common. Due to insufficient blood supply to the brain, the nerves responsible for the motor function of the human body are usually malfunctioning, such as sudden mouth crooks, drooling, difficulty speaking, speechlessness, aphasia or speech discomfort, difficulty swallowing, weakness or movement of one limb, and falling objects Walking instability or sudden fall, and some appeared limb cramps or beating.

2. Headache and dizziness: The general manifestation is that the nature and feeling of headache is different from usual, and the degree is heavier. It changes from intermittent headache to persistent headache. If the headache is fixed in a certain location, it may be cerebral hemorrhage or subarachnoid hemorrhage. Aura. Headaches, dizziness and fluctuations in blood pressure.

3. Sensory dysfunction: due to insufficient blood supply to the brain, the analysis area of the brain, sensory organs and sensory nerve fibers are often manifested as facial numbness, tongue numbness, lip numbness, and numbness or foreign body sensation on one limb; Vision is unclear, and even sudden blindness occurs; many people have sudden dizziness; some limbs have spontaneous pain; others suddenly have tinnitus and hearing loss.

4, abnormal mental consciousness: If you always want to sleep, sleep all day long, not due to excessive fatigue, but a precursor to insufficient blood supply to the brain. Some people show insomnia, some have some changes in personality, such as loneliness, dumbness or indifferent expression, some are multilingual impatience, and some will have a brief loss of consciousness or mental decline, or even lose their normal judgment These are all related to insufficient blood supply to the brain.

5. Autonomic dysfunction: Although rare and non-specific, some autonomic dysfunction symptoms occurred before the onset of a few patients with cerebrovascular disease due to cerebrovascular disease, blood pressure fluctuations, and cerebral blood supply, such as the whole body. Obvious weakness, sweating, low fever, palpitations or chest tightness; some people have hiccups, nausea and vomiting. In addition to the above five categories, a few people may develop nosebleeds and ocular conjunctival bleeding before the onset of cerebrovascular disease, but local diseases such as nasal polyps, ocular conjunctival inflammation, or small vessel bleeding should be ruled out. If fundus examination reveals retinal hemorrhage, it often indicates the possibility of cerebrovascular disease. All of the above signs are related to fluctuations in blood pressure, insufficient blood supply to the brain, and changes in blood composition. It is generally believed that the omen of ischemic cerebrovascular disease is more common with headache and dizziness.

Cerebrovascular disease diagnosis and identification

Cerebrovascular disease test

1. Determination of blood lipid, cholesterol> 200-250mg%, triglyceride> 130mg%, lipoprotein> 450 600mg%.

2. Cerebral blood flow graphs, including drug tests. Cerebral blood flow chart has prolonged rise time, weakened or disappeared weight wave, the main peak angle becomes blunt, and the amplitude of wave decreases.

3. EEG, including neck pressure induction test.

4, if necessary for cerebral angiography.

5. Brain CT often has varying degrees of brain atrophy and infarcts of varying sizes and numbers.

Cerebrovascular disease examination

1. Cerebrospinal fluid examination;

2. Cerebral blood flow map: also known as brain resistance map, is a non-invasive diagnostic method for checking blood flow in the head;

3. EEG;

4. Doppler ultrasound: use the principle of Doppler ultrasound to make non-invasive blood flow measurement on the skin;

5. Cerebral angiography: the method of injecting organic iodine contrast agent into the cerebral blood vessels to show the shape and function of the cerebral blood vessels;

6. CT: electronic computed tomography;

7. Nuclear magnetic resonance (MRI): an imaging technique that uses signals generated by magnetic resonance phenomena to reconstruct images;

8. Brain Hemorheology: A discipline that studies blood fluidity, viscosity, deformability, aggregation, and coagulation.

Cerebrovascular disease disease treatment

It should be actively controlled. However, there is currently no specific treatment for it. It can only reduce symptoms by correcting fat metabolism disorders, expanding cerebral blood vessels, and improving blood circulation in the brain.

1. Pay attention to strengthening physical strength and physical exercise. Physical exercise is conducive to improving blood circulation, promoting the consumption of lipids, reducing the deposition of lipids in blood vessels, increasing plasmin activity, and reducing weight. Therefore, you should adhere to housework and physical exercise within your ability. For people with intellectual disability, mental disability and physical disability, intensive care should be taken to prevent accidents.

2. Pay attention to diet control. The main reason is to limit the intake of high cholesterol and high fat diets to reduce the deposition of lipids in blood vessels. Such as limiting fat, lard, egg yolk, fish roe and animal viscera and other food intake, but also pay attention to avoid high-sugar diet, because high-sugar diet will also cause fat metabolism disorders. Should eat more soy products, vegetables, fruits and foods containing more fiber. Edible oil is mainly vegetable oil. Diet should be light, not too full, it is best to quit smoking and avoid alcohol.

3. Drug treatment. The purpose is to reduce blood lipid concentration, dilate blood vessels, improve blood circulation, activate brain cells, etc. Inositol nicotinate, docecan, Zhibituo, and fenofibrate can be selected to reduce blood lipid concentration. Vasodilators can be calcium antagonists such as cerebrolysin, nimodipine, flunarizine. ? Amino acid, Naoxinxin, Xidezhen, Cerebrolysin, etc., have the role of activating nerve cells, can also be selected appropriately. The combination of the three is mainly based on diet control and physical exercise, supplemented by drug therapy for better results.

First, perform a CT test on the patient's brain, then determine the puncture point on the CT film, and finally determine the puncture point on the patient's head, and then the operation can be performed. The operation only requires local anesthesia, and a special electric drill is used to drill holes in the head. Needle-shaped hematoma pulverizers are used to irrigate liquid and semi-solid hematomas with a hematoma rinse agent, and then melted and discharged. The agent is sprayed uniformly and comprehensively to each part of the tight clot, which causes the blood clot to degrade quickly and simultaneously, and the liquefied liquid is discharged, and the tube can be pulled out in 3 to 5 days. Rehabilitation treatment is under way.

Cerebrovascular disease rehabilitation

Early rehabilitation of cerebrovascular disease

Patients in this stage generally show delayed paralysis, no random muscle contraction, no joint reaction, and the body is basically in a state of general relaxation; it is equivalent to Brunnstrom recovery stage 1-2.

Basic purpose

The basic purpose of early rehabilitation is to prevent comorbidities that will seriously affect the rehabilitation process in the future, such as swelling, muscle atrophy, limited joint movement, etc .; strive to improve function as soon as possible to prevent complications.

Rehabilitation methods

1. Correct posture: The church's family members and nursing staff should adopt the correct posture, including the supine position, the healthy lateral position and the affected lateral position. They are required to turn over every 2 hours and take a few back shots.

2. Turn-over exercises: Lift your hands horizontally before turning, turn to both sides, and support your feet with your feet.

3. Self-assisted exercises on the bed: raise your hands horizontally before crossing, raise your head over, raise your sides, point your nose, bend your legs to support the bed, raise your hips, and move your feet across.

4. Passive motion at the bedside-upper limbs: shoulder straps, shoulder joints, elbow joints, wrist and knuckle joints.

5. Passive motion at the bedsidethe trunk is pulled and the back muscles are squeezed and stimulated.

6. Passive motion at the bedside-lower limbs: hip, knee and ankle-toe joints.

7. Methods to promote muscle contraction: Use the sudden stretch of muscles to cause muscle contraction.

8, expectoration

9. Bed head lift sitting training: The bed head is gradually raised, and the patient can maintain 30 minutes in each position, then gradually increase the training by 10 degrees, until you can sit up by the bed, without relying on the position balance exercise.

10, face, muscle stimulation: open mouth, drum gills, palate teeth, stretch, top palate, etc., frozen cotton (or ice cubes) and taste stimulation.

11. Respiratory control exercises: Ask the patient to inhale deeplyexhale slowly and relax.

12, sitting training: before the head of the bed is not up to 90 degrees, first train the patient to support the head and shoulders with one hand until the back can be supported.

13, sitting balance: correct sitting position, bedside sitting balance, including front and back, left and right directions.

14. Seated exercises: to strengthen balance training, including flat crosses with hands crossed, side folds, fingers crossed with noses, hands crossed with fingers forward; muscle training for healthy lower limbs, etc., can teach family members and nursing staff, and then more than a day Urge patients to practice.

15. Transfer of bed to wheelchair (or chair).

16. Sit-and-stand exercises: If possible, patients can be given bed standing early to help patients regain their sense of verticality, regain control of antigravity muscles, regain their self-regulation of blood pressure, improve orthostatic balance, and overcome orthostatic hypotension. Under normal circumstances, patients with cerebral infarction are required to reach the bedside sitting position after 3-4 days in the selected treatment group. They can be trained to stand within two weeks, and the auxiliary strength depends on the condition. Patients with cerebral hemorrhage should try to reach the bedside sitting position within two weeks. Reach standing.

17, daily activities within the reach of healthy hands: eating, dressing, washing and so on.

18. Application of electrical stimulation: low frequency direct current stimulation, TENS, etc.

19. Apply EMG feedback technology.

20. Apply massage and acupuncture.

21. Apply cerebral circulation therapy to promote cerebral blood circulation.

22. Speech therapy.

23. Psychotherapy.

Rehabilitation arrangements

Instruct patients and family members to complete 1, 2, 3, 8, 9, 10, 11, 17, etc. several times a day; 4, 5, 6, 7, 12, 13, 14, 15 must be completed once a day by the therapist , 45 minutes each time; 18, 19, 20, 21, 22 can be determined by each unit on its own; 23, 24 If there is no professional training, the therapist should perform simple language training during functional training, including Simple vocal exercises, etc .; and responsible for the psychological counseling of the patient to seek the best possible cooperation and rehabilitation of the patient in the best possible state.

Cerebrovascular disease mid-term rehabilitation

At this stage, patients can obviously show the coordinated movement of the flexor muscles of the upper limbs and the extensor muscles of the lower limbs, and gradually can achieve independent movement of certain muscle joints, which is equivalent to stage 3-5 of B recovery.

Purpose of rehabilitation

Inhibit cooperative exercise modes, train muscles and joints as much as possible to allow independent and independent movement, improve the coordination of each joint, and gradually restore the patient's athletic ability.

Rehabilitation methods

Active from passive

24. Inhibit the spasm mode of the upper limbs.

25. Stretching the trunk promotes and changes the trunk's mobility, inhibits trunk tension and spasm.

26. Hold your knees lightly with both hands to control upper and lower limb spasms.

27. Shoulder flexion Use the affected hand to touch the healer's hand, then touch his forehead, and then touch his contralateral shoulder to train the elbow flexion and extension function.

28. Limb placement and holding activities: During the movement of the affected hand, instruct to stop at any angle, and stay at this position for a while to improve the space control ability of the affected upper limb.

29. The shoulder joints move autonomously in all directions: shoulder flat, front abduction, shoulder rotation.

30. The elbow joint moves autonomously in all directions: elbow, spread, forearm supination.

31. Autonomous movement of the wrist fingers: dorsal wrist extension, lateral deviation, thumb abduction, finger pointing and so on.

32. Shoulder strap activities: upward, outward, downward.

33. Bridge exercise training hip extension control.

34. Control training of hip inside and outside, abduction: do the neutral side of the affected side and the healthy side of the affected side.

35. Knee flexion and extension control training.

36. Hip extension knee flexion and extension control training.

37. The patient trains her lower limbs to prepare for weight-bearing exercise in the overhang position.

38, kneeling training in the prone position.

Seat:

39. Upper limb support training on the affected side.

40. Do a small range of flexion and extension of the elbow below the affected upper limb.

41. The affected hand pushes forward or crosses with both hands.

42. Move the object on the back of the hand.

43. Forearm rotates and presses plasticine.

44. Hip flexion of the affected lower limb.

45. Pick up a small object with your fingers (cross the center line).

46. Muscle strength training on the healthy side.

47. The affected side's lower limb flexion and extension knee movement.

Standing position:

48. Standing balance training: Move the center of gravity forward, backward, left and right.

49. Standing balance exercise: Cross your hands (depending on the situation) before lifting your head flat, lifting your torso from side to side.

50, sit-control training, and decomposition exercises.

51. Support the wall with both hands to do elbow flexion and extension exercises to promote elbow extension or independent support of the affected hand.

52. Stand with your legs back and forth, and move the center of gravity to bend and stretch the affected knee in a small range.

53, knee flexion in hip extension.

54. Bend your hips and knees and prepare to step.

55. Adduction, abduction, and descending pelvic training of the affected lower limb.

56. Stand on one leg with support.

57. Low stride training to control the pelvis to move up and down.

Chapter 58

59. Parallel bars internal walking training (three points): The upper arm of the healthy side is leaning forward-> then the lower limb of the affected side is followed-one step forward of the lower limb of the healthy side.

60. Walking training with crutches (three o'clock and two o'clock): Holding a crutch forward-the patient's lower extremity is moving forward-keeping his foot up.

61. Going up and down the stairs: up / healthy hand support--the lower limb of the healthy side--the lower limb of the affected side

Lower / Healthy Hand Support-Ill Side Lower Limb-Healthy Side Lower Limb

62. Bedside ADL training: washing, putting on and taking off clothes, and handling of two stools.

Rehabilitation arrangements

The above items basically need the help and guidance of a therapist to complete, generally 1-2 times a day, 45 minutes each time, 4-5 days a week, once a day in the family, family members can be instructed to practice once in the afternoon.

Precautions

All joints should maintain the maximum range of joint movements, and the treatment should be within the range of painlessness or tolerance of the patient. Avoid violence. It is advisable to use gentle hands; the therapist should give appropriate protection and the auxiliary force should be from large to small. Encourage patients to complete independently.

Cerebrovascular disease

Purpose of rehabilitation

Patients in this stage can use the affected limb to a large extent, which is equivalent to Brunnstorm recovery stage 5-6. The purpose of rehabilitation training is how to use the affected side more freely, how to better use the skills acquired through training in daily life, improve various ADL abilities, improve speed and maximize the quality of life on the basis of ensuring the quality of exercise.

Rehabilitation methods

Continue the training in the previous stage, further consolidate, improve and apply it to daily life

63, fine movements of fingers to strengthen training

64. Lateral walking training 7

65. Improve gait training: pelvic relaxation, knee flexion and strengthening training

66. Improve gait training: ankle dorsiflexion.

67. Promote the support ability of the lower limb of the affected side: standing position, with the healthy leg in front, the affected leg in the back, indicating that the center of gravity moves forward, and the heel of the affected foot cannot leave the ground.

68. Promote the support ability of the lower limb of the affected side, carry the weight of the affected limb, and move forward and backward.

69. Do two feet alternately in cross position.

70. Family ADL guidance.

71. Living room renovation.

Rehabilitation arrangements

Same as before. This period of training is mainly based on the help of community rehabilitation doctors, family members and volunteers, 3 to 4 times a week. Home or outpatient visits every two weeks.

About the use of assistive devices

72.Foot rest-foot drop

73. Wrist extension splint-wrist flexion spasm.

74, crutches to help clamor.

75. Wheelchair.

About family and volunteer training

The training is conducted every two weeks, and the rehabilitation therapist visits the home or the family members to the hospital. The training content is the patient's family training method. The family members and volunteers of the patients are required to record the training content every two weeks.

Records on rehabilitation

The therapist is required to record once a week in the early stage and once every 2 weeks after the second month of the disease course. The records include: the patient's functional status, current problems; the purpose of rehabilitation at the current stage; Fill in the content number, and fill in the other columns with supplements.

Cerebrovascular disease venous sinus thrombosis

Disease Overview

Intracranial venous sinus thrombosis is a special type of cerebrovascular disease. In the past, the incidence was considered low and clinically rare. With the development of imaging in recent years, the diagnosis rate has gradually increased.

Symptoms and signs

Headaches with varying degrees of headache, with nausea, jetting vomiting, decreased vision, same-eye blindness, convulsive continuation of epilepsy, combined with deep vein thrombosis of the left lower limb during the course of the disease, unilateral eyeball protrusion with limited movement gradually affecting the contralateral side, both eyes Insufficiency, hemiplegia, Xiang Qiang, positive bilateral Knig sign, disturbance of consciousness to varying degrees, and urinary and stool disorders.

Treatment and results

First of all, for the treatment of the cause, a sufficient amount of antibiotics is given inflammatoryly, and if necessary, the combination is applied for a period of 15 to 28 days. Give fluid to dehydrated patients. Defibrillation therapy was given without bleeding and fibrinogen elevation. Dongling Thrombolytic Enzyme was given the first 10BU 5BU twice a day for a total of 2 times. After the end, anticoagulation was given and blood test indicators were monitored. Patients with platelet elevation were given anti-platelet aggregation, and blood lipid elevation was given lipid-lowering treatment. All patients without bleeding tendency were given anticoagulation therapy. Low-molecular-weight heparin sodium 5000AxaIU was injected subcutaneously once a day in the abdomen, and the blood test indexes were monitored. If there were no abnormalities, it was used continuously for 15-20 days. Caution anticoagulation with a small amount of bleeding. Cranial pressure was lowered, and the medication was continued for 14-28 days.

cavernous sinus thrombosis: vision loss, eye pain. Eyelid edema, conjunctival congestion and edema, conjunctival sclera veins dilate and bend significantly. Eyeball protrusion; fundus optic disc edema, retinal vein dilatation and retinal hemorrhage; cerebral nerve palsy and so on.

Upper sagittal sinus thrombus: decreased vision, even dark, diplopia; paralysis of one or both abductor nerves; hemiopia, disc edema, and retinal hemorrhage

Cerebrovascular disease disease prevention

1. Symptoms occur early in the period when cerebral blood is reduced or the supply is interrupted. The characteristics of early symptoms of stroke should be grasped and timely treatment measures taken.

2. Pay attention to understand and prevent the risk factors that induce stroke, such as hypertension, heart disease, diabetes, smoking, alcoholism, abnormal blood lipids, carotid stenosis, and obesity.

3. Know how to use medicine or change your lifestyle to control high blood pressure.

4, to actively prevent the occurrence of atherosclerosis, to avoid blood clots infarcting cerebral blood vessels.

5. To prevent the recurrence of stroke. The highest risk of stroke recurrence is within 6 months after the first stroke, and some studies have limited the early recurrence of stroke to 90 days after the first onset of stroke.

Cerebrovascular disease health diet

First, eat more foods rich in potassium and calcium. Potatoes, eggplants, kelp, and lettuce contain higher potassium. Milk, yogurt, shrimp skin and other calcium-rich, are ideal foods for patients with cerebrovascular disease.

Second, eat more fresh vegetables and fruits. Vegetables and fruits are rich in vitamins, especially vitamin C, carotene and minerals calcium, phosphorus, potassium, magnesium, etc. and more dietary fiber. Vitamin C can reduce cholesterol and increase the compactness of blood vessels. Calcium can prevent bone and tooth looseness. Magnesium participates in the metabolism of myocardial enzymes. Potassium can maintain the balance of osmotic pressure in the body and participate in the activities of the enzyme system. Cerebrovascular patients are advised to eat no less than 8 taels of fresh vegetables and 2 to 4 taels of fruits per day. Vegetables are preferably fresh, dark green or yellow. Strawberries, oranges, and kiwis contain more vitamin C, while mangoes and apricots contain more carotene.

Third, the appropriate amount of protein. Eating fish protein 2-3 times a week can improve vascular elasticity and permeability, improve the central nervous system's regulation of blood pressure, and promote the excretion of sodium ions from the urine, thereby reducing blood pressure and the incidence of cerebrovascular disease. It is recommended to eat more foods rich in high-quality protein, such as fish, milk, eggs, tofu, etc., and eat less animal internal organs, such as liver, kidney, roe and so on. If hypertension is associated with renal insufficiency, protein intake should be restricted.

4. Appropriate eating of seafood. Marine fish contain unsaturated fatty acids, which can oxidize cholesterol, thereby lowering plasma cholesterol, can also prolong platelet aggregation, inhibit thrombosis, and prevent stroke. Marine fish also contains more linoleic acid, which has a certain effect on increasing the elasticity of microvessels, preventing rupture of blood vessels and preventing complications of hypertension. In addition, kelp, seaweed and other seafood products have high potassium content, which also has a better effect on relieving cerebrovascular disease.

Fifth, limit food calories. As we all know, the main ingredient of food is carbohydrates. Excessive intake of carbohydrates may be converted into triglycerides in the body and increase blood lipids. Long-term hyperlipidemia can cause hypertension and arteriosclerosis. Cerebrovascular patients are more obese, and usually do not exercise enough, so diet must be moderate, not overeating, three meals full, can reduce a lot of trouble.

6. Limit fat absorption. Most patients with cerebrovascular disease have high blood lipids, and the intake of fat, especially saturated fat, must be strictly restricted. Fatty meat, animal fats, viscera, cream, butter, and foods with high cholesterol content contain a large amount of saturated fatty acids, which can increase cholesterol and triglycerides in the blood and cause arteriosclerosis. Therefore, try not to eat this kind of food, so as not to aggravate the disease. Also pay attention to the amount of vegetable oil.

Seven, limit the amount of salt. High salt content in the diet can easily cause high blood pressure, which in turn can lead to cerebrovascular disease. For cerebrovascular patients, it is particularly important to limit the amount of salt used. The amount of salt used per day should be reduced to less than 10 grams, and the most ideal is about 6 grams. How much is 6 grams? You can pick up a beer bottle cap, and a bottle full is about 6 grams. Those with a more "heavy" taste should pay more attention to limiting the amount of salt.

8. Limit irritating foods. Try to eat less spicy food, alcohol and coffee should not stick. Alcohol plays a dilating role in blood vessels, which accelerates blood flow and increases cerebral blood flow, so acute cerebral hemorrhage attacks often occur after drinking. Coffee not only has an exciting effect, but also can cause cerebral vasoconstriction, which gradually reduces cerebral blood flow. Therefore, patients with diseases such as cerebral arteriosclerosis, hypertension, transient cerebral ischemia, and cerebral infarction, if they drink coffee, are likely to cause the disease to worsen. ^[1]

1. Onion: It has the function of reducing fat, blood pressure and cholesterol.

2. Corn: It has a good prevention and cure effect on hypertension, arteriosclerosis, coronary heart disease, and some cancers.

3. Oatmeal, also known as oatmeal, has the functions of reducing serum cholesterol, triglycerides, and lipoproteins.

4. Apple: It can prevent the increase of blood cholesterol and reduce the sugar content in the blood.

5. Kiwi fruit: It can prevent gastric cancer, reduce blood cholesterol and triglyceride levels, stabilize blood pressure and reduce blood pressure.

6, vinegar, vinegar eggs: good prevention and treatment of arteriosclerosis, cerebral thrombosis, hypertension, myocardial infarction and so on.

7. Mung bean: It has obvious functions of clearing heat and detoxifying, clearing heat and diuretic. Particularly suitable for patients with hyperlipidemia accompanied by obesity or diabetes.

8. Hawthorn: can promote the secretion of digestive juice, promote appetite, and help digestion, such as: silt dispersal, elimination of phlegm, phlegm elimination, detoxification, blood circulation, refreshing, stomach cleansing, refreshing and other effects. Modern medical pharmacological studies have proven that hawthorn has the effects of strengthening and regulating the heart muscle, increasing ventricular and atrial motion amplitude and coronary blood flow to prevent arrhythmia due to electrolyte imbalance, and reducing cholesterol, blood pressure, diuretics and sedation. Become a good medicine for preventing and treating cardiovascular and cerebrovascular diseases.

9. Shiitake mushrooms: Shiitake mushrooms have the functions of lowering blood pressure, digesting and degreasing, anti-virus and anti-cancer. Clinical observation: For patients with hyperlipidemia and arteriosclerosis, taking fried shiitake mushrooms or shiitake mushroom lipid-lowering soup has obvious lipid-lowering effects.

10. Natural hirudin:

Hirudin can irreversibly bind to the catalytic center of thrombin and the fibrinogen binding center, inactivate thrombin, and thus can effectively prevent the formation of thrombus.

Pharmacological effects:

Anticoagulation and antithrombotic: Hirudin can prolong or inhibit the coagulation process. Because hirudin directly targets thrombin, it can effectively prevent fibrin from binding to blood cells to form a blood clot, so it can prevent the formation and extension of various thrombi.

Hirudin can reduce platelet surface activity, inhibit platelet aggregation, and reduce platelet adhesion.

Effect on blood flow: Leech decoction can reduce blood viscosity and reduce fibrinogen content in plasma.

Lowering blood lipids: Intragastric administration of experimental animals with decoction of Leech decoction can reduce the triglyceride and lipoprotein content in the blood of rats, and can also reduce the cholesterol and triglyceride content in the blood of rabbits with food-induced hyperlipidemia Aortic and coronary atherosclerotic plaques disappeared and cholesterol crystals were reduced.

Hirudin can increase cerebral blood flow, promote the absorption of experimental cerebral hematoma in rats, reduce inflammatory reactive edema around the hematoma, relieve intracranial hypertension, improve local blood circulation, and protect brain tissue.

Cerebrovascular disease protects blood vessels

Protect the blood vessels and pay attention to the five natural enemies!

Due to the poor lifestyle of modern people, vascular diseases continue to increase. How to maintain blood vessels, Professor Hu pointed out: Pay attention to diet, exercise, drink less tea and stay up late.

The blood vessels all over the body are like tap water and gas pipes in a house. It takes a long time and the inner wall of the pipe is easy to scale and rust. Some bad habits will make blood vessels age faster. How to raise blood vessels, Professor Hu Dayi, Chairman of the Cardiology Branch of the Chinese Medical Association, has unique insights.

Among the vascular "natural enemies" blacklist, the following 5 are the most lethal.

"Four high" diet blocked blood vessels. High-sugar, high-oil, high-fat, high-salt "four high" diets can be said to be the number one natural enemies of blood vessels. They increase the risk of hypertension and easily cause cholesterol and blood lipids to adhere to the walls of blood vessels. Arteriosclerosis, resulting in obstruction of blood vessels.

Old stay up late tired of blood vessels. Staying up late for a long time, the body will secrete hormones such as epinephrine, which will lead to increased heart rate, increased blood pressure, and then increase the pressure on the cardiovascular system. If continuous rest is not good, coupled with emotional anxiety, blood pressure fluctuations can easily induce stroke or even sudden death.

Smoking can easily "poison" blood vessels. Tobacco is a recognized enemy of cardiovascular health. Toxic substances in tobacco smoke can easily induce coronary spasm, cause myocardial ischemia and hypoxia, accelerate the process of atherosclerosis, and easily form blood clots.

Less aerobic exercise and more blood vessel garbage. Sedentary weight gain can increase the burden on the heart and affect the heart's blood circulation. These can indirectly trigger high blood pressure and worsen coronary heart disease. If you do not exercise for a long time, garbage in the blood vessels will gradually accumulate, forming atherosclerotic plaques. In fact, even when walking, the elasticity of blood vessels will be enhanced by the contraction of leg muscles.

Accumulate bad mood and lose blood vessels. Mental stress can cause intimal contraction of blood vessels and accelerate blood vessel aging. Old and angry, stressed, blood vessels also tend to harden. In fact, many cardiovascular and cerebrovascular diseases are related to excessive emotional fluctuations. To have a healthy blood vessel, maintaining a good attitude is the easiest and most economical way.

So how do we defeat these five "natural enemies"? In short, it is a sentence: 80% of the food is full, the day goes by, and the balance between eating and moving.

Eat blood vessels "Scavenger". Hawthorn, oats, black fungus, kumquat, eggplant, sweet potato, garlic, and onion are the eight major foods that can clear the blood vessels and maintain the elasticity of the blood vessel walls. Vinegar can also soften blood vessels and lower blood lipids. Of course, the most important thing is to adhere to a balanced diet, eat more fruits and vegetables, and be alert to the "four high" foods.

Continuous exercise is not lazy. British studies have found that long-term, continuous exercise can significantly improve vascular function in patients with cardiovascular disease and even prevent recurrence of myocardial infarction. Many cardio-cerebral vascular experts are masters of persistent exercise. For example, Professor Hu Dayi has been adhering to "every day in a thousand steps" for 12 years, and he is uninterrupted in Tibet's Ali Plateau. Jogging, brisk walking and other gentle exercises are suitable for most patients.

Two pieces of dark chocolate a week. Dark chocolate contains natural antioxidant flavonoids, which can prevent blood vessels from hardening, increase myocardial vitality, relax muscles, prevent cholesterol from accumulating in blood vessels, and have certain effects on the prevention and treatment of cardiovascular diseases.

Drink less green tea. Catechol in green tea can reduce the content of bad cholesterol in the blood, enhance the flexibility and elasticity of blood vessels, and prevent blood vessel sclerosis. Drinking blood vessels is not recommended. Drinking a lot of alcohol raises blood pressure and blood triglycerides, leading to atrial fibrillation, alcoholic cardiomyopathy, fatty liver, cirrhosis, and even sudden death in severe cases.