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Microstroke - symptoms and first signs, causes, consequences, treatment and prevention. Microstroke: symptoms, causes of development, treatment and rehabilitation period

Article publication date: 06/23/2017

Article updated date: 12/21/2018

From this article you will learn: what a microstroke is, how it differs from one, how to prevent it, identify the first signs in time and begin the necessary treatment.

Microstroke is a fairly conventional term that refers to an acute cerebrovascular accident in which areas of the brain experience oxygen starvation and die or become necrotic. The principle of any stroke or cerebrovascular accident is simple - a blockage occurs or that nourishes the brain tissue, brain cells die, and the person loses those functions for which the dead part of the brain was responsible (speech, hearing, vision, controlled muscle movement).

The main difference between a microstroke can be seen from the term itself - “micro”, or small. With this type of cerebrovascular accident, small arteries that supply brain tissue are affected, which is why a significantly smaller volume of brain tissue dies compared to a major stroke.

The consequences of such microscopic lesions are much less; a person can almost completely restore the lost function of speech, hearing or movement, but this requires excellent body reserves and persistent work on oneself.

The main insidiousness of micro-strokes lies in the blurred clinical picture - the first signs of a micro-stroke appear later and more slowly, so the start of diagnostic and therapeutic measures is significantly delayed. And the later specialized treatment for cerebrovascular accidents is started, the worse the results and prognosis.

Typically, a neurologist is involved in the diagnosis and treatment of any stroke. However, the first doctor to whom a patient with a microstroke turns can be a doctor of any specialty, depending on the nature of the patient’s complaints - headaches, visual impairment, interruptions in heart function, and so on.

Causes of microstroke

As we have already mentioned, the main cause of any type of stroke is some kind of obstruction to the flow of blood that carries nutrients and oxygen to brain cells. Conventionally, the reasons for such obstacles can be divided into three groups:

Vasospasm. This picture is most often observed in people with constantly high blood pressure - arterial hypertension. However, a stroke can also occur in a completely healthy person with constantly normal blood pressure due to stress, taking certain medications, dehydration, shock, and so on. A sharp stroke in such patients can cause both a microstroke and other types of cerebrovascular accidents.
Blockage of blood vessels. Violation of the lumen of the vessel impedes the flow of blood - oxygen starvation of the tissue occurs. Blockage of a vessel can occur with atherosclerotic or cholesterol plaque, thrombus, gas bubble, or, less commonly, bacterial screening, metastasis or foreign body.
Rupture of the supply vessel. Strokes formed in this way are called hemorrhagic. The blood spilled from the vessel not only does not reach its “destination”, but also permeates the surrounding tissues, aggravating the damage. The cause of a rupture of a vessel can be a surge in pressure, vascular atherosclerosis, head injury, disruption of the venous outflow from the head - for example, an attempt at strangulation.

Risk groups for developing the disease

Modern medicine has clearly identified patients whose health status and lifestyle significantly increase the risk of developing cerebrovascular accidents:

People with diseases of the cardiovascular system, especially heart rhythm disturbances and arterial hypertension.
Vascular atherosclerosis is the deposition of cholesterol salts on the inner lining of blood vessels - the formation of plaques.
Hereditary and acquired blood clotting disorders - antiphospholipid syndrome, polycythemia, Leiden factor defect, and so on.
Obesity and eating large amounts of fatty and sweet foods.
Diabetes.
Smoking and drinking alcohol in large doses.
Taking combined oral contraceptives by women.
The period of menopause in women, especially against the background of severe menopausal syndrome.
Strokes and heart attacks in the past.
Hereditary predisposition and family history.
Sedentary lifestyle – especially for bedridden patients.
Chronic fatigue, stress, emotional distress.

Symptoms of a microstroke

In this section, we will try to describe in as much detail as possible the first signs of a microstroke, so that the reader can assume the development of the disease in himself or others.

I would like to immediately note that in a microstroke, the symptoms directly depend on the location of the lesion and the caliber of the affected vessel feeding it. Simply put, the smaller the vessel, the less reliable the first symptoms of the disease.

Severe headache. Such a headache occurs or intensifies quite sharply, is not relieved by regular pills and does not go away after sleep or rest.
Numbness of the face, limbs, tongue. When a stroke occurs, it is often noticeable that the corner of the patient's mouth droops, the lip droops, and the eye closes.
Impaired functions of sensitive analyzers - hearing, smell and vision. The patient may complain of flashing "circles" or "floaters", blurred structures, white and dark spots, tinnitus, distortion or loss of smell.
Speech disorders – the patient becomes tongue-tied and speech becomes unclear. Unfortunately, such patients are often classified as “drunkards,” so help begins to be provided to them much later.
Numbness or complete failure of the arms or legs. Micro-strokes are more characterized by numbness of the fingers and hands, muscle weakness, unsteadiness and unsteadiness of gait.
To the listed typical symptoms, general complaints may be added: anxiety, sweating, palpitations, shortness of breath, dizziness, feelings of panic and fear.

These symptoms may be present in equal measure, or one may stand out. In any case, a headache that cannot be relieved with conventional medications, numbness and failure of the limbs or tongue, especially against the background of high blood pressure, is a reason to immediately visit a neurologist.

It is important to understand some of the complexity in defining concepts. These symptoms can be called a microstroke if such neurological symptoms persist for a day or more. Anything that occurs within 24 hours is considered an acute transient cerebrovascular accident, or TIA - transient ischemic attack. In fact, the line between all these concepts is very thin and is based rather on long-term consequences - that is, whether certain neurological symptoms will persist after 24 hours or not.

Diagnostics

The “gold standard” for any cerebrovascular accident is magnetic resonance imaging, or MRI, of the brain. In the image, you can examine in detail all the structures of the brain and see the smallest - down to fractions of a millimeter - lesions. Using MRI, you can also monitor the dynamics of regression or “resorption” of pathological foci.

But MRI is a rare, inaccessible and extremely expensive research method, and performing it for emergency indications for any patient with a headache is extremely difficult and impractical. That is why there are a number of indicative tests, the results of which can be used to assess the need for this research method for a particular patient:

Examination by a neurologist with specific neurological tests to assess the patient’s stability, the condition of his muscles, reflexes, and pupils.
Measuring blood pressure and cholesterol levels - the higher these indicators, the higher the risk of stroke.
Determination of blood clotting - in the presence of certain tendencies to increase coagulation - hypercoagulation - there is a higher risk of blood clots in the vessels of the brain.

Initial diagnosis of stroke at home

I would like to pay special attention to pre-medical diagnosis of ischemic brain lesions. The first signs of a micro-stroke do not always appear in a medical facility; more often it happens at work, on the street or with family. It is important to know what indicative tests can be performed before contacting a doctor.

Smile. If you ask the patient to smile, the asymmetry of the mouth will be noticeable - one corner will be lower.
Speech - it is worth asking the patient to say a few simple phrases - for example, a proverb or a saying. Speech will be slower and unclear.
Movement. You need to ask the patient to raise his arms or legs. If there are cerebral circulation disorders, one of the limbs will lag behind or not obey the owner at all.

These tests, despite their apparent simplicity, are very effective and have saved the lives and health of many people.

Treatment methods

Ideally, the reason for starting therapy is the very first signs of cerebral circulatory disorders, but this happens very rarely. If there are vague symptoms of a microstroke, treatment is rarely started earlier than a day from its onset.

The main drugs for the treatment of cerebrovascular disorders are:

Thrombolytics - this group of drugs hits the heart of blood clots - dissolves the blood clot and restores blood flow in the vessel (streptokinase, urokinase, alteplase and others). But the effect of thrombolytic therapy can be obtained only within 72 hours from the onset of thrombosis, but such drugs will kill the patient. It is important to clearly know what type of stroke you are dealing with.
Anticoagulants are a group of drugs aimed at preventing blood clotting and the formation of blood clots - heparin and its low-molecular analogues (fragmin, fraxiparin and others).
Disaggregants are agents that prevent the “clumping” of blood cells: aspirin, clopidogrel, dipyridamole, and so on.
Diuretics, especially mannitol, selectively remove swelling from brain tissue, preventing more severe complications - wedging of swollen brain tissue into the foramen magnum.
Antihypertensive drugs - use both “essential” drugs and constant, specially selected therapy during the recovery period.
Neuroprotectors are a wide group of drugs and vitamins to support brain cells during the recovery stage - antioxidant complex, B vitamins, magnesium, nootropics, and so on.

Types of drugs, their combinations and course of treatment are prescribed only by a doctor.

At the recovery stage, rehabilitation measures are extremely important - physical therapy, water procedures, physiotherapy, classes with a speech therapist and rehabilitation specialist, therapeutic diets, sanatorium-resort treatment. The more persistent and hardworking the patient is, the sooner lost brain functions will return to him and speech, hearing, vision, and muscle strength will be restored.

It is very important to undergo the treatment prescribed by your doctor, take blood pressure medications, and antiplatelet agents. It is necessary to follow a diet, give up alcohol and smoking, exercise, get enough sleep and walk a lot.

Prognosis for the disease

The consequences of a microstroke depend on the age of the patient, his initial condition, the diameter of the affected vessel and the volume of dead brain tissue, as well as on the speed of initiation of treatment and the quality of rehabilitation.

A microstroke most often implies a complete restoration of the health and quality of life of patients, but significantly increases the risk of a recurrence of an episode of circulatory disorders in the future. According to statistics, in approximately 60% of cases after a mini-stroke, a repeat ischemic attack occurs within a year.

That is why the key to health and quality of life is strict measures to prevent the disease, since each subsequent episode becomes more and more severe.

Acute cerebrovascular accident can occur in the form of a transient ischemic attack, microstroke or stroke. A stroke is said to occur when neurological symptoms persist for more than a day. In the presence of a transient cerebrovascular accident, as with a microstroke, signs of disorders of body functions disappear on their own within 24 hours. After them, there are no morphological changes in the substance of the brain. As a result of a microstroke, foci of necrosis of the brain substance are formed. How to determine whether there was a mini-stroke? Doctors at the Yusupov Hospital Neurology Clinic use innovative methods for diagnosing diseases of the central nervous system. They make it possible to determine changes in the brain and pathology of cerebral vessels after an acute period of microstroke.

The Yusupov Hospital has created comfortable conditions for treating patients:

air-conditioned rooms;
individual dietary nutrition;
attentive attitude of staff to the needs of people in need of care.

Patients are consulted by cardiologists, endocrinologists, and ophthalmologists. Complex cases are discussed at the Expert Council with the participation of candidates and doctors of medical sciences, who are leading experts in the field of diseases of the nervous system. The rehabilitation clinic employs a team of highly qualified specialists. Rehabilitation specialists use innovative methods for restoring impaired functions and preventing recurrent cerebrovascular accidents. Thanks to the coordinated work of all staff and the use of individual treatment regimens with modern medications, the number of relapses of microstroke in patients who underwent treatment and rehabilitation at the Yusupov Hospital significantly decreased.

Diagnosis of microstroke

If a patient enters a neurology clinic in an acute period of cerebrovascular accident, doctors find many neurological symptoms that are minimally expressed during a microstroke. These include:

headache;
nausea and vomiting;
instability and unsteadiness of gait;
lack of coordination;
motor and visual disorders;
impaired sensitivity of one half of the body.

One day after the onset of the disease, neurological symptoms are not detected during a microstroke. How to check if there was a mini-stroke? Neurologists reconstruct the clinical picture of acute cerebrovascular accident based on a patient interview. Subsequently, the following diagnostic studies are carried out:

inspection;
examination of the biomechanics of the cervical spine (muscle tone, range of motion, position of the vertebrae at rest and in motion);
X-ray of the cervical spine with functional tests;
examination of the vessels of the neck and brain - Doppler ultrasound;
magnetic resonance and computed tomography;
angiography of cerebral vessels
computed angiography of neck and brain vessels
General and biochemical blood test and coagulogram.

For all studies, doctors at the Yusupov Hospital use modern equipment from leading companies in the world. Analyzes are performed using high-quality reagents to obtain accurate results.

Differential diagnosis of ischemic stroke and microstroke

How to recognize a stroke or micro-stroke in a person? Both diseases develop as a result of spasm or thrombosis of the cerebral artery. Symptoms depend on which vessel is affected - large or small. When blood flow through large cerebral arteries is disrupted, general and local disorders of neurological functions develop. Common symptoms of a stroke are:

sudden sharp headache;
nausea and vomiting;
disturbance of consciousness;
speech disorder;
numbness of half the body.

Local manifestations of a stroke depend on which artery is affected by the blood flow. With a microstroke, there are almost never any general manifestations of vascular pathology of the brain. Patients are bothered by a moderate headache, stability and coordination of movements are impaired. They lose the ability to look at objects with both eyes for a while. All local symptoms of a microstroke can last from several hours to a day and go away on their own. If signs of cerebrovascular accident persist for more than 24 hours, this means that the patient has developed a stroke.

After an ischemic stroke, impairment of motor, visual, speech function and sensitivity persists. Patients who have suffered a mini-stroke do not notice any changes and often do not attach importance to the symptoms that existed. But in them, as after a stroke, foci of necrosis of the brain substance form. With repeated microstrokes, more and more of the brain is replaced by connective tissue. As a result, patients experience impaired brain activity and develop memory and concentration disorders.

Alcohol and micro-stroke

Alcohol is a leading risk factor for the development of mini-stroke. In patients who abuse alcohol and have suffered an acute cerebrovascular accident at the age of under 60 years, a repeated cerebral crisis most often develops a couple of weeks after the first microstroke. Regular consumption of alcohol in uncontrolled quantities increases the risk of developing cardiovascular diseases (atherosclerosis, thinning of the walls of blood vessels, the development of blood clots, heart disease), in which the likelihood of a cerebral crisis increases many times over.

Alcohol increases blood pressure and blood glucose levels, and arterial hypertension and diabetes mellitus are the main factors in the development of micro-stroke. In patients who abuse alcoholic beverages, body weight increases, clotting is impaired, cholesterol levels in the blood increase and the formation of atherosclerotic plaques accelerates. It is difficult to notice the first symptoms of a microstroke against the background of alcohol intoxication. Patients in a state of alcohol intoxication are admitted to the neurology clinic only when they develop severe neurological symptoms. In this case, neurologists most often diagnose ischemic or hemorrhagic stroke.

Alcohol affects not only the cerebral vessels, but also the areas of the medulla responsible for various functions and systems of the body, and reduces vascular tone. The risk of developing cerebrovascular diseases in people who drink is 4-5 times higher. The first symptoms of a micro-stroke usually appear either under the influence of large doses of alcohol, or during the first or second day after taking it. In 2/3 of people, acute cerebrovascular accident occurs on the second day, with increased pressure in the blood vessels.

Alcohol after a mini-stroke can trigger repeated attacks. First, blood pressure increases, then vascular tone decreases, edema and hemorrhage develop in the brain.

How to detect a microstroke at home

There are no symptoms that are unique to a ministroke. Sometimes an attack begins with a speech disorder - it becomes slurred, the person cannot utter a coherent phrase. Some people notice a feeling of numbness in the limbs on one side of the body; they cannot hold even a light object in their hands or get their feet into shoes. Sometimes you can notice facial asymmetry.

These symptoms may go away on their own after a couple of hours. But if they occur, you should ensure that the patient remains still, raise his head a little and turn him on his side. He needs to be calmed down and convinced to go to the hospital.

Call the phone and neurologists at the Yusupov Hospital will immediately prescribe treatment aimed at restoring blood circulation to the brain and protecting neurons after establishing an accurate diagnosis. They will determine the cause of the disease and eliminate it. After inpatient treatment, you will be offered an effective rehabilitation program.

Bibliography

ICD-10 (International Classification of Diseases)
Yusupov Hospital
Clinical neurology with the basics of medical and social expertise. St. Petersburg: Medline-Media LLC, 2006.
Shirokov, E. A. Stroke, heart attack, sudden death. Theory of vascular accidents / E.A. Shirokov. - M.: Quorum, 2010. - 244 p.
Vilensky, B.S. Stroke: prevention, diagnosis and treatment / B.S. Vilensky. - Moscow: Higher School, 1999. - 336 p.

A microstroke is a brain injury that occurs not only in older people, but also in young people. There is no such concept in official medicine. In another way, it can be called “transient disturbance of cerebral blood flow (TCI).”

As a result of the so-called microstroke, small (point) damage to the structure of the brain occurs. Since these injuries are very small, the disturbances characteristic of a stroke do not persist. The fact of pinpoint hemorrhage in the brain can only be established as a result of a pathological examination.

What kind of disease is this, how it manifests itself in adults, the first signs and methods of treatment are further in the article.

What is a microstroke?

A microstroke is necrosis of brain tissue due to a blood clot or a sharp narrowing (ischemic) of a small vessel. Due to impaired blood supply, point lesions develop in the brain tissue. Since the pathological process affects very small areas of the structure, the disorders characteristic of a “classical” stroke do not occur.

A microstroke cannot be treated as a small stroke. This concept in medicine exists under the diagnosis of transient disorder of cerebral blood flow (TCI), which means problems with brain functions of vascular origin that arose suddenly and are accompanied by general cerebral or focal neurological symptoms (like a stroke), but go away independently or under the influence of treatment during the first 24 hours.

The mechanism of a microstroke is as follows:

There is a sharp increase in pressure in the vessels of one of the parts of the brain, or the vessel is blocked by a blood clot.
Normal blood circulation is disrupted, the cells of the affected area begin to experience a deficiency of oxygen and nutrients.
This condition can last about six hours, if during this period blood circulation is restored to its previous volume, brain tissue can also be restored.
If the pathological condition lasts longer, cells die, necrosis develops, and the area affected by the stroke becomes larger.

Causes

The list of phenomena that cause a micro-stroke is quite “standard” and applies to many diseases of the cardiovascular system:

binge eating;
obesity;
alcohol abuse;
sedentary work and constant physical inactivity;
frequent overwork, stress;
smoking;
excessive physical activity;
bad ecology;
previous heart surgery (for example, valve replacement);
excessive amounts of animal fats in the daily diet;
constant cold climatic conditions (provoke an increase in blood pressure);
a sharp change in the usual climatic and weather conditions.

Some diseases also provoke a microstroke:

Uncompensated diabetes mellitus (with glucose fluctuations);
Atherosclerosis in the progression stage (reduces the diameter of the lumen of blood vessels);
Impairment of cerebral blood flow passing to the heart;
Lesions of the heart valves of an infectious or rheumatic nature (contribute to their destruction);
Congenital heart defects;
– a reason that complicates its diagnosis;
Arteritis (inflammatory process affecting the internal walls of blood vessels);
Thrombosis;
Arrhythmias - when the heartbeat is disturbed, microthrombi appear that clog the blood vessels of the brain (arrhythmia reduces blood pressure and impairs cerebral blood flow);
Oncological problems;
Hypertensive diseases with their vivid symptoms overshadow all signs of a microstroke;
Apnea (stopping breathing during sleep for 10 seconds or more).

Risk factors

Risk factors include people with:

constant nervous stress in professions that require increased attention;
atherosclerotic damage to the vessels of the brain, carotid and vertebral arteries;
heart diseases, especially those accompanied by valve defects;
hypertension and symptomatic hypertension;
allergic vasculitis of an autoimmune nature;
pronounced hernia in the cervical spine with compression of blood vessels;
germinating tumor, hematogenous small metastases;
skull injuries, concussion;
congenital vascular pathology.

Symptoms of microstroke in adults

With a microstroke, the symptoms are not always characterized by specificity. Many patients attribute them to changes in atmospheric pressure, weather changes, physical or psycho-emotional stress and chronic fatigue. The first signs of a microstroke are:

dizziness;
the appearance of “flies” before the eyes;
headache of varying intensity;
general weakness and malaise;
nausea.

The main symptoms include:

Numbness of the face and limbs;
Dizziness and sudden intense headache;
A sharp increase in blood pressure;
Loss of coordination of movements, problems when walking or maintaining balance;
Hypersensitivity to bright light and loud sounds.

There may also be additional symptoms:

General weakness—feeling stunned, tired, drowsy;
Possibly, but not necessarily, short-term loss of consciousness;
Short-term visual impairment;
Problems with speech, difficulty in pronunciation and understanding of speech.

A number of signs of a microstroke (asymmetry, visual impairment...) will depend on the affected area of the brain. If the left hemisphere is affected, the symptoms appear on the right side of the body. And vice versa.

Memory loss is one of the most obvious symptoms of a mini-stroke. It allows you to determine the severity of brain damage. If a person has a partial or hemorrhagic stroke, then memory recovery occurs within 5-6 hours.

How to recognize the first signs of a microstroke in a person?

In some cases a person may not even suspect that he had a mini-stroke, for example, ordinary dizziness, headache, numbness and tingling in the arm for several seconds, blurred vision, muscle weakness may be signs of a transient ischemic attack.

The symptoms of a stroke and a microstroke are quite similar, but an attack of a microstroke lasts from 5 minutes to a day and is more mildly expressed.

It is important to know what indicative tests can be performed before contacting a doctor.

Smile . If you ask the patient to smile, the asymmetry of the mouth will be noticeable - one corner will be lower.
Speech - it is worth asking the patient to say a few simple phrases - for example, a proverb or a saying. Speech will be slower and unclear.
Movement . You need to ask the patient to raise his arms or legs. If there are cerebral circulation disorders, one of the limbs will lag behind or not obey the owner at all.

Even if the patient exhibits only some of the symptoms of a ministroke listed above, it is necessary urgently call an ambulance. Proper treatment within the first 24 hours significantly increases the chance of full recovery.

First aid

The rapid improvement in the condition of a microstroke should not mislead those present.

Try to sit or lay in a comfortable position.
Find out your relatives' phone number and call them.
If possible, apply ice to your head.
Unfasten your tight collar, tie, belt, belt.
If vomiting, turn the victim's head to the side.
Be sure to call an ambulance.

Consequences

Very often, after transient cerebrovascular accidents, no noticeable consequences are observed. But some people experience the following consequences of a microstroke:

memory impairment,
decreased concentration,
absent-mindedness,
increased irritability,
tearfulness or, conversely, aggressiveness.

Diagnostics

After you have experienced all the symptoms of a microstroke presented above, you should go to see a doctor, who will send you for an examination to determine the condition of the heart and blood vessels. Such studies include:

Magnetic resonance diagnostics,
CT scan,
Angiography.
Dopplerography.
Echocardiogram.
Electrocardiogram (ECG).
Detailed blood test.

If symptoms of a microstroke appear, you must call a doctor: remember that these signs may also indicate a large-focal stroke or myocardial infarction. The main treatment will be aimed at the underlying disease. Sometimes a full examination is required (especially in young people) to find out what exactly caused the short-term circulatory disorder in the brain.

Treatment and recovery

Upon arrival of the victim at the hospital, the doctor prescribes a series of laboratory and x-ray tests to confirm the preliminary diagnosis. As a rule, a micro-stroke is detected on an MRI, where darkened areas of damaged brain tissue are clearly visible.

Medications

Further treatment regimen:

means for improving blood microcirculation and metabolic processes in blood vessels (angioprotectors): Nimopidin, Tanakan, Bilobil;
vasodilating medications: Instenon, Xanthinol nicotinate, Pentoxifylline;
drugs to improve metabolism: Mexicor, Actovegin;
agents to reduce the ability of red blood cells to form blood clots in blood vessels (antiplatelet agents): Ticlopidine, Aspirin, Dipyridamole;
medications to improve brain activity (nootropics): Cinnarizine, Vinpocetine, Cerebrolysin, Piracetam.
Vitamin supplements (kvadevit, dekamevit, corvitol) strengthen the body’s immune system and also help improve brain function. These drugs should be taken periodically, 1 volume, 2 - 3 times a day after meals, for 1 month, then you need to take a short break for 1 - 2 weeks, and resume taking them again.

It is necessary to treat a microstroke exclusively under the supervision of a medical specialist. Treatment at home consists of providing first aid until specialists arrive. The patient should be laid down, his head slightly raised, reassured, since panic only aggravates the course of the attack, and oxygen access should be ensured.

Rehabilitation after a mini-stroke

A patient’s recovery after a mini-stroke is best done at home. The minimum comprehensive non-drug rehabilitation program consists of:

eliminating stressful situations;
quitting smoking and drinking alcohol;
diet therapy, nutrition correction, combating obesity;
herbal medicine;
physical therapy and massage, regular physical activity;
physiotherapeutic procedures, water and heat therapy, climatotherapy;
other non-traditional methods of treatment and rehabilitation (acupuncture, yoga, hirudotherapy, etc.).

After suffering a micro-stroke, patients are strictly prohibited from eating salty, fatty, spicy foods, which will only aggravate the general course of the disease. The diet of patients should be high-calorie, containing a large amount of vitamins (potassium and magnesium), necessary to normalize the functioning of the cardiovascular system.

Prognosis for recovery after a mini-stroke depends on its causes:

If it is on the surface (excess weight, stress), then eliminating provocateurs will be the best prevention of relapses and complications;
If the cause was a specific disease, a regimen for its treatment is developed.

Prevention

Methods for preventing microstroke at any age include:

Blood pressure control- the main thing among a number of preventive actions. The main cause of a micro-stroke is high blood pressure, or its sharp rise;
Rejection of bad habits helps to significantly reduce the risk of disease;
Proper nutrition that does not contribute to obesity is also among the preventive measures;
Constant moderate physical activity will help not only make the body strong and fit, but also maintain the health of the brain vessels;
Reducing factors that cause stress, and healthy sleep is another key to success in the prevention of micro-strokes.

A microstroke is a very dangerous disease that disrupts the functioning of the brain, causing unpleasant and life-making symptoms. The presented illness must be treated immediately so as not to expose your body to various complications.

The concept of “ministroke” can be heard from both patients and doctors, however, such a diagnosis does not officially exist. In neurology there is only a diagnosis of “stroke”. Most often, a microstroke is a transient disturbance of cerebral circulation, accompanied by all or some of the strokes, which disappear on their own within 24 hours. Sometimes disturbances last only a few minutes, and patients do not even suspect that they have suffered a short-term cerebrovascular accident. If neurological symptoms persist for more than a day or increase, the doctor diagnoses a stroke.

Causes of microstroke

The leading cause of cerebrovascular accidents is atherosclerosis.

Most often, microstrokes occur in people suffering. Blockage of small branches of the cerebral arteries by atherosclerotic plaques leads to pinpoint damage to the substance of the brain.

Very often, microstrokes develop against the background of some severe pathologies, as a result of which little attention is paid to the symptoms of short-term cerebrovascular accidents or they go completely unnoticed against the background of the vivid symptoms of the underlying disease. People suffering from hypertension, especially if they have hypertension, have a very high risk of developing hemorrhagic strokes and micro-strokes.

Treatment of microstroke

Treatment of transient ischemic attack may include antihypertensives, vasodilators, drugs that improve metabolism in brain tissue, antiplatelet agents, and others, depending on the cause of the disease.

The doctor may prescribe drugs that improve cerebral metabolism and brain activity, vasodilators, antihypertensive drugs, antiplatelet agents and other necessary medications.

Having suffered a short-term cerebrovascular accident is a reason to seriously think about the state of your health. It is necessary to change your lifestyle, give up bad habits, normalize your work and rest schedule, and if necessary, increase physical activity. It is also necessary to undergo medical examination in a timely manner (every 3 years) for the purpose of early detection and timely treatment of hypertension, coronary heart disease, arrhythmias, atherosclerosis and other pathologies of the cardiovascular system, diabetes mellitus and other diseases. Be healthy!

Which doctor should I contact?

If signs of transient ischemic attack appear, described in our article, you need to contact a neurologist. Additionally, you should consult a cardiologist, endocrinologist, or rheumatologist, since the cause of a mini-stroke may be related diseases. To prevent cerebrovascular accidents, it is necessary to reduce weight, which a nutritionist will help with. Finally, for medical examination you should contact a therapist at your place of residence.

Almost everyone knows what a stroke is and how dangerous this disease is, but among people you can find another term, the specific meaning of which no one really knows, this is a microstroke. This article will talk about what kind of pathology this is, how dangerous it is and how it differs from a stroke.

What does the name hide?

It is immediately necessary to clarify that in official medicine there is no such diagnosis as microstroke, nor can it be found in the International Classification of Diseases, 10th revision. This is an exclusively colloquial term used by patients and doctors to explain to a person what happened to him and to emphasize the seriousness of the situation.

A microstroke cannot be interpreted as a small stroke (a stroke is either present or not). This concept in medicine exists under the diagnosis of transient disorder of cerebral blood flow (TCI), which means problems with brain functions of vascular origin that arose suddenly and are accompanied by general cerebral or focal neurological symptoms (like a stroke), but go away independently or under the influence of treatment during the first 24 hours. Moreover, after a micro-stroke, no neurological symptoms remain, which is confirmed by additional data).

This is the most common type of clinical forms of acute cerebrovascular accident. Although this time (micro-stroke) the patient was lucky (there are no residual effects of the previous problem), even a single case of a micro-stroke is a kind of warning from the body for a person to urgently take measures to prevent acute cerebrovascular accidents, because next time everything may not end so lucky.

If we look at medical statistics, 40% of patients who have suffered a microstroke develop an ischemic stroke over the next 3 years, and the more transient disturbances of cerebral blood flow there were, the higher the chances of a full-scale vascular catastrophe.

It is also necessary to emphasize that microstroke is a collective concept; it includes several types of transient disorders of cerebral blood flow:

transient;
cerebral hypertensive crisis;
acute hypertensive encephalopathy.

The pathogenesis of PNMK is based on acute stroke, which lasts several seconds or minutes (up to 3-4), after which normal blood flow is resumed and the death of brain neurons does not occur, unlike a true stroke, when a section of brain tissue succumbs to necrosis and irreversible changes. Accordingly, after the first symptoms of a microstroke appear, they quickly pass, and no neurological deficit remains, since the cells completely resume their function, which never happens with a stroke.

It also needs to be emphasized that PNMK is a dynamic diagnosis, that is, it is possible to accurately answer the question of whether the patient has had a stroke or not only after several days of careful observation in a hospital setting and a CT scan of the brain (whether there are foci of damage to the brain tissue or not ). Therefore, all patients with a suspected diagnosis of a microstroke should be hospitalized, and they should be given care as in the case of a stroke, so as not to waste precious time in the event of the development of an irreversible disorder of cerebral blood flow.

Causes and predisposing factors of microstroke

The causes and risk factors for a mini-stroke are no different from those for a real stroke. Most often this disease is caused by:

As you know, atherosclerosis is a systemic disease; if a person suffers from coronary heart disease, then he certainly has atherosclerotic plaques in the vessels of the brain;
and frequent;
diseases of the cardiac and vascular system (atrial fibrillation, congenital or acquired heart defects, heart surgery to replace valves, coronary artery disease, endocarditis and myocarditis, cardiac arrhythmias and blockades);
diabetes mellitus, especially type 2;
compression of the cerebral and extracranial arteries from the outside (tumor, osteophytes in cervical spondylosis, hernia of the cervical spine, arterial dissection, their aneurysms) or their spasm;
inflammatory damage to the arteries of the brain of an infectious or autoimmune nature (vasculitis);
congenital diseases of the vascular bed of the brain (various vascular malformations, fibromuscular dysplasia of the arteries);
Increase the risk of PNMK by taking oral contraceptives, seizures, smoking, diseases of the blood system, varicose veins of the lower extremities, age, and excess weight.

In the vast majority of cases, microstroke affects small arterial vessels that supply blood to a small area of the brain.

Knowledge of the causes and predisposing factors for the development of PNMC is necessary for everyone who plans to engage in primary or secondary prevention of vascular accidents in the body.

The first signs of a microstroke

The first signs and symptoms of a microstroke vary over a wide range, which depends on the diameter and location of the affected arterial vessel, as well as on the mechanism of development of the disorder (thromb, embolus, spasm, compression, disruption of autoregulation of cerebral circulation, etc.). In some cases, a person may not even suspect that he has had a mini-stroke, for example, ordinary dizziness, headache, numbness and tingling in the arm for several seconds, blurred vision, muscle weakness can be signs of a transient ischemic attack.

In other cases, disorders develop very quickly and do not go unnoticed, as they are pronounced and similar to the symptoms of a real stroke.

Warning signs:

sudden rubbing of any part of the body or limb, a feeling of “crawling goosebumps”;
severe muscle weakness in an arm or leg;
loss of sensitivity in a certain area of the skin;
severe headache and increased blood pressure, dizziness;
sudden visual impairment;
paralysis of a leg or arm;
drooping corner of the mouth, inability to smile;
speech disorder;
convulsions, vomiting, nausea, confusion.

If you notice at least one of the above-described symptoms in yourself or in the people around you, be sure to call an ambulance and provide first aid to the victim, because such signs may indicate both a stroke and PMI.

Symptoms of a microstroke

A characteristic feature of the clinical picture of a microstroke is the short-term presence of pathological symptoms with their further rapid regression. Also, the signs of PNMK vary depending on the type of disorder. Let's take a closer look at them.

Cerebral hypertensive crisis

This type of transient cerebrovascular accident occurs most often (2/3 of all patients with this diagnosis). The cause is hypertension, and the pathogenesis of symptoms is based on a breakdown in the autoregulation of cerebral circulation. There are two possible options here. The first is that, as a result of a sharp increase in pressure, the cerebral arteries dilate too much, which leads to hyperperfusion of brain tissue, venous congestion and cerebral edema. The second option develops with a gradual increase in pressure, when the arteries of the brain narrow in response to an increase in systemic pressure, which leads to hypoxia and oxygen starvation of neurons.

Signs are nonspecific. Patients complain of a sharp bursting or throbbing headache, dizziness, nausea and vomiting. As a rule, no focal symptoms are observed, but convulsions, mild impairment of consciousness, and meningismus syndrome may occur. When measuring pressure, it is increased to high numbers.

Transient ischemic attack

Transient ischemic attack most often develops due to atherosclerotic vasoconstriction, blockage of blood vessels by emboli or thrombotic masses. The causes and mechanisms of development of this type of transient disturbance of cerebral blood flow are the same as. The difference is only in the time of blockage of the vessel and the consequences: with TIA it is a few seconds or 3-4 minutes, the symptoms when eliminating the blockage of the artery disappear without a trace, with an ischemic stroke the changes are irreversible, since the causative factor acts longer than the neurons are able to maintain vital activity without blood (4-6 minutes).

The clinical picture of TIA is dominated by focal neurological symptoms. You can observe numbness in certain parts of the body, paralysis and muscle weakness of one of the limbs, impaired vision, hearing, speech, facial asymmetry, convulsions, loss of sensitivity in certain areas of the skin. In some cases, general cerebral symptoms are also observed.

With TIA, these signs quickly disappear, unlike a stroke, in which they can even progress.

Acute hypertensive encephalopathy

This PNMK has the same mechanism of development as the first version of hypertensive cerebral crisis, but differs from it in the duration and degree of pathological changes in the brain tissue. If high blood pressure is not eliminated in time, it progresses, which leads to the release of the liquid part of the blood from the overcrowded vessels into the nervous tissue with the development of cerebral edema, which is a life-threatening condition. The symptoms are similar to cerebral hypertensive crisis, but are more pronounced.

If you do not provide timely assistance to the patient (quick and dosed reduction in blood pressure), then acute hypertension can lead to death.

First aid for microstroke

The scope of emergency pre-medical and medical care is no different for a micro-stroke and a real stroke, since it is almost impossible to distinguish between these conditions at the onset of the disease.

First aid:

be sure to call an ambulance;
you need to place the patient on a hard surface (in case resuscitation measures are needed) with the head end raised to prevent swelling of the brain tissue;
if a person is vomiting, then you need to turn his head to the side so that the vomit does not enter the respiratory tract and cause asphyxia;
you need to unfasten the victim’s collar and belt so that they do not squeeze the body, it is also necessary to provide access to fresh air;
if you have the opportunity to measure blood pressure, then be sure to do so - in case of a sharp increase in blood pressure, you can take a tablet of the antihypertensive drug that the doctor advised you in such cases; administering antihypertensive drugs parenterally on your own is prohibited - the decrease in pressure must be dosed, otherwise you risk only aggravating situation;
if the patient is in a state of clinical death, be sure to begin resuscitation measures and do not stop until the ambulance arrives.

Video instructions on first aid for a patient with suspected stroke:

First aid depends on the clinical situation and includes activities with the following goals:

dosed reduction in case of hypertensive crisis;
improvement of heart activity;
timely and adequate resumption of cerebral circulation;
correction of rheological properties of blood;
establishing microcirculation processes in brain tissue;
improvement of metabolic processes of nervous tissue;
prevention or relief of cerebral edema;
symptomatic therapy.

With a micro-stroke, the patient’s condition improves significantly against the background of the measures taken, but if this does not happen or progression of symptoms is observed, then most likely the person has had a stroke.

Principles of treatment

To quickly and dosedly reduce blood pressure, several groups of antihypertensive medications are used, which are administered parenterally:

Dibazol with papaverine is administered intramuscularly;
intravenous magnesium with saline and furosemide;
obzidan, anaprilin, aminophylline, aminazine, nifedinine, sodium nitropruside, etc. can also be prescribed depending on additional symptoms.

To normalize cardiac activity, corglycon, digoxin, and cordiamin are prescribed.

To improve cerebral circulation, vasoactive drugs are administered - aminophylline, cavinton, nicotinic acid, cinarizine, citicoline, actovegin.

To normalize blood rheology and improve microcirculation, aspirin, dipyridamole, sermion, pentoxifylline, anticoagulants - heparin and low molecular weight heparins (fraxiparin, enoxaparin) are used.

For neuroprotection, drugs are used - Ceraxon, Nootropil, Piracetam, Cerebrolysin, B vitamins.

For cerebral edema, manitol, furosemide, aminophylline, corticosteroid hormonal drugs, and antihistamines are prescribed.

For frequent TIAs, which are caused by atherosclerotic narrowing of extracranial arteries, surgical treatment in the department of vascular surgery is possible.

Video about micro-stroke:

Consequences and prevention of microstroke

As already mentioned, a microstroke has no immediate consequences unless cerebral edema occurs, which can lead to death. But TIA or another type of PNMK is a kind of last warning for the body. According to statistics, approximately 40% of patients develop extensive ischemic strokes during the first 3 years after TIA, and frequent hypertensive crises result in cerebral hemorrhages. Therefore, an important point in the prevention of fatal cardiovascular accidents is the active identification and treatment of conditions and diseases that lead to this.

Correction of risk factors for microstroke, lifestyle modification, healthy eating, maintaining normal body weight, and regular exercise are also important in prevention.

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