What is the Difference Between an Ischemic Stroke and a Hemorrhagic Stroke?

1. Sudden numbness, weakness, crooked mouth, drooling on one side of the face or upper and lower limbs. This is due to insufficient blood supply to the brain, which damages the neural pathways that govern the trunk.

Ischemic stroke

It refers to hemiplegia and disturbance of consciousness caused by cerebral infarction and cerebral artery blockage based on cerebral thrombosis or cerebral thrombosis. Cerebral thrombosis usually starts after the age of 50, and there are more men. Symptoms often occur during rest, rest or sleep, and the incidence is slower than that of cerebral hemorrhage. There are often aura symptoms, such as dizziness, numbness or weakness of one limb, etc., which are more likely to occur when blood pressure is low.

Clinical symptoms of ischemic stroke

Ischemic stroke symptoms

1. Sudden numbness, weakness, crooked mouth, drooling on one side of the face or upper and lower limbs. This is due to insufficient blood supply to the brain, which damages the neural pathways that govern the trunk.

2. Sudden difficulty in speaking or incomprehensible to others. This is due to insufficient blood supply to the cerebral cortex, which affects the language center.

3. Suddenly feel dizzy and unstable. This is due to insufficient blood supply to the cerebellum, which affects its balance function. The aforesaid signs may be temporary, disappear after a while, or they may recur, or gradually worsen.

Ischemic stroke

A small number of patients may have a shallow or moderate coma, which gradually wakes up in about 24 hours, and the cerebrospinal fluid examination is normal. The clinical manifestations vary according to the location of the diseased blood vessel. Cerebral thrombosis may stabilize in a few days after the onset of disease, and the symptoms gradually decrease after 2-3 weeks due to the edema subsidence and the establishment of collateral circulation. Patients with cerebral embolism often have heart disease, fractures, tumors, and the impact of certain clinical operations such as intravenous injection, artificial pneumothorax, pneumoperitoneum, and cerebral angiography. When sudden neurological symptoms occur, the possibility of cerebral embolism must be considered. Cerebral embolism is rapid and may have a transient disturbance of consciousness. It often occurs in the small and medium arteries of the brain. Hemiplegia, aphasia, or limited epilepsy may occur. Cerebral embolism emboli may be pushed to the distal end of the artery by blood flow, or they may be broken up and dispersed into smaller arteries, so symptoms and signs may improve significantly in the short term.

Ischemic stroke prevention

Ischemic stroke due to cerebral thrombosis is most common in the elderly. Usually pay attention to the following points, which will greatly help prevent this disease.

1) According to the ancient Chinese medicine books, there are many descriptions of stroke and hemiplegia. For example, the Yuan Dynasty physician Luo Tianyi wrote in "Health Poems": "Everyone feels numb or insensitive to the first and second fingers, and they will have strokes within three years." These symptoms are the same as what is known in modern medicine as transient ischemic attacks. Transient ischemic attack is a neurological symptom that lasts for a short time, has mild symptoms, and can be completely relieved within 24 hours. It is often the same as the early manifestations of cerebral thrombosis. The former is a blockage of the brain's microvasculature, or the brain cells are mildly hypoxic. If the collateral circulation can be established and opened in time, the function of the brain cells in the ischemic site can be restored; the latter is a large thrombus, which causes a branch of the brain Vascular infarction, ischemic necrosis of some brain cells. According to some statistics, after a transient ischemic attack, strokes occur in 40% to 60% within 12 to 36 months. Transient ischemic attacks can manifest as dizziness, dazzling, unstable walking, sudden unilateral limb weakness, numbness of the tongue, slurred speech, and difficulty swallowing. Although these symptoms can go away by themselves, you must go to the hospital for examination and treatment immediately, and you can't be fine for the symptoms to disappear. Otherwise, hemiplegia, skewed corners, blindness in one eye, etc., will actually cause a stroke.

2) Reasonable diet Elderly people should eat a diet that is high in fat and cholesterol as little as possible, and should be based on vegetarian foods and foods rich in vitamins. This can avoid too much lipid in the blood, prevent arteriosclerosis, and reduce the possibility of thrombosis.

3) Use drugs with caution. Taking antihypertensive drugs excessively, especially in large quantities before sleep, can greatly reduce blood pressure, affect the blood supply to the brain, slow blood flow, and promote cerebral thrombosis. Taking a large amount of diuretics for a long time will cause the body's water to be excreted from the urine. If it is not replenished in time, the body will lose too much water, the blood will condense, the viscosity will increase, the blood flow will slow down, and blood clots will easily form. When applied with hemostatic agents such as hemostatic and anluoxue, thrombosis is promoted due to increased blood coagulability. Therefore, the elderly should strictly follow the doctor's order when applying the above drugs, and can not increase the dose and change the method of taking without authorization.

4) Yiqi Huoxue Chinese medicine believes that Qi is the commander of blood, while Qi is the blood. Codonopsis, Astragalus and other supplementary qi are commonly used; salvia miltiorrhiza, Chuanxiong, Dilong, safflower, motherwort, Wangbuluoxing, Zelan leaf and other blood circulation can prevent cerebral thrombosis. Buyang Huanwu Decoction is a very practical prescription: raw astragalus 30g, angelica 12g, red scallion 15g, dilong 9g, peach kernel 9g, and safflower 6g. Decoction, one dose daily for 14 days.

5) Physical exercise Proper physical exercise or physical activity can maintain the heart's better function, even if there are some potential pathogenesis factors in blood and blood vessels, it can also have a better ability to compensate.

6) Diet: Drinking winter melon soup can prevent hot stroke.

According to the statistics of the health department, from June to August each year is a period of high incidence of stroke. The higher the temperature, the greater the danger, so it is also called "hot stroke". It is recommended that middle-aged and elderly people who like to cook soup usually can cook some Jieshu soup in the hot summer to clear the heat and relieve heat.

Take one fresh lotus leaf, 500 grams of winter melon, and a little salt. Wash the fresh lotus leaves, peel the fresh winter melon, add five bowls of water to the soup, and a little salt. After the soup is finished, eat the winter melon and drink the soup. And it has the effect of clearing away heat and relieving summer heat, and quenching thirst.

In addition, middle-aged and elderly people should also regularly measure stroke risk factors such as blood pressure, blood sugar, blood lipids, and take precautions if they are abnormal.

Causes of ischemic stroke cerebral thrombosis

Mainly arteriosclerosis and hypertension. Thrombosis often occurs due to heart failure, myocardial infarction, arrhythmia, shock, syncope, dehydration, postpartum hemorrhage, fatigue, and sleep, which cause blood pressure to decrease, slow blood flow, increased blood viscosity, or abnormally increased blood coagulation. Other causes of cerebral thrombosis include various infectious diseases of the brain, leptospirosis, head trauma, and erythrocytosis. The cause of cerebral embolism is that patients with heart disease, such as rheumatic heart disease, chronic atrial fibrillation, wall thrombus caused by myocardial infarction, and bacterial endocarditis neoplasms can be shed into emboli. Lung or pelvic infections, venous thrombosis of the lower limbs, and certain parasitic diseases can also cause cerebral embolism. Others are also found in thoracic surgery, pneumothorax, pneumothorax, or decompression sickness, embolism of long bones or adipose tissue, and embolization of cancer cells such as lung cancer.

The main diagnosis of cerebral thrombosis is elderly patients with arteriosclerosis and hypertension. Hemiplegia and unconsciousness gradually appear within 1-2 days. The main diagnosis of cerebral embolism is a person with a history of heart disease, lung infections, fractures, etc. who suddenly develops hemiplegia and disturbance of consciousness. In recent years, the diagnosis of ischemic stroke can rely on CT examination. Pathologically, cerebral tissue provided by the diseased blood vessels after cerebral thrombosis infarcts, local edema, and congestion of surrounding tissues. After several hours to several days, the lesion area swells. , Ischemic necrosis and softening, sometimes also for hemorrhagic infarction, necrotic tissue gradually liquefies to form a cystic cavity, and finally yellow atrophic scars can remain. The pathological changes of cerebral embolism are roughly the same as those of cerebral thrombosis.

The treatment of ischemic stroke in modern medicine can be intravenous infusion of low-molecular dextran to dilute the blood, reduce blood viscosity and blood cell accumulation, increase blood flow speed, be beneficial to microcirculation, and use of vasodilator drugs and anticoagulation therapy.

This disease belongs to the category of "stroke" in Chinese medicine. This disease is generally lighter than hemorrhagic stroke, so there are more meridians in stroke, fewer intestines and organs, and it is more rare to get off the card.

Ischemic stroke hirudin and ischemic stroke

Acute ischemic stroke is one of the common diseases in clinical neurology. It is also a common complication of hypertension, heart disease, and diabetes. It accounts for about 70% of all strokes and has a high disability rate. The purpose of the treatment of acute ischemic stroke is to reduce the disability rate and improve the quality of life of patients. Ultra-early (3h) thrombolytic therapy can save ischemic penumbra nerve cells. However, most patients have missed the time of thrombolysis when they were admitted to the hospital. Therefore, such patients should be treated with active anticoagulation. The purpose of anticoagulation is to interfere with the coagulation process, improve the hypercoagulable state in the surrounding area of the ischemic lesion, reduce the re-thrombosis and further obstruction in the lumen, improve the collateral circulation, rescue the nerve cells in the ischemic penumbra zone, and reduce nerve function defects. The anticoagulant effect of low-molecular-weight heparin calcium depends on the presence of AM- in the plasma, which inhibits the action of thrombin and blocks the coagulation process. Its treatment of acute ischemic cerebrovascular disease has obvious effects, can improve the prognosis, reduce the disability rate and mortality.

The anticoagulant effect of hirudin is different from heparin. It is by far the strongest specific thrombin inhibitor. It binds to thrombin in an equimolar ratio and can bind to thrombin that is free in plasma and fibrin in clots. Binding, thereby blocking the coagulation process and preventing thrombus extension. Its effect does not depend on endogenous anticoagulant factors. Recombinant hirudin is only 63-tyrosine is not sulfated, its effect is lower than natural hirudin. Studies have shown that it can inhibit the formation of thrombin due to ischemia, prevent secondary microthrombosis, increase blood flow around the ischemic area, and save endangered nerve cells. It can still improve neurological deficits in the fourth week, and its mechanism remains to be studied. The role of thrombin in cerebral edema of cerebral hemorrhage is known. Hirudin can significantly inhibit this process and reduce cerebral edema. Other studies have shown that hirudin is safe and reliable in the treatment of acute ischemic stroke without increasing the bleeding rate. ^[1]