A microstroke or transient ischemic attack is a condition associated with impaired blood circulation in the brain.
Arises against the background of oxygen starvation of the brain, and differs from extensive ischemic stroke in that the blood supply to the organ is able to resume independently.
But even despite this, such a pathological deviation cannot be ignored, since its consequences can be extremely dangerous.
What it is?
Many patients interpret the term "microstroke" differently. Some believe that this is a pathology in which the death of the tissues of a separate, small part of the brain occurs. Others understand this concept as a short-term violation of the transport of oxygen by blood to a certain zone of the GM.
In household medical terminology, the term "microstroke" means a temporary, lasting less than a day, oxygen starvation of an individual brain area. In official terminology, such a violation is called a transient cerebral circulation, or PNMK. This condition is divided into 3 types, the most common of which is transient (transient, temporary) ischemic attack. As a rule, TIA is called a microstroke.
The concept of a transient ischemic attack is deciphered as follows:
- transient - temporary;
- ischemic - one that is accompanied by a lack of oxygen;
- attack - suddenly developed state.
In other words, a separate part of the brain does not receive the required amount of oxygen from several minutes to 24 hours. At the same time, the supply of oxygen does not stop completely, therefore, in small quantities, but it all nourishes the brain cells. Because of this, they do not die off completely, but a breakdown of their work occurs.
This is the main difference between a microstroke and a “real” stroke.
Causes and risk factors
A very common and extremely erroneous opinion is that people over 45 years old are preferably susceptible to microstroke, as well as “big” stroke. But in fact, all persons who have reached the age of 30 are at risk. This is especially true for weather-sensitive patients, as well as those who are exposed to frequent stresses, overwork, excessive physical exertion.
Also, risk factors for the development of a microstroke can be divided into pathological and individual. Briefly consider each group.
Micro stroke can develop in the background:
- Hypertensive heart disease. With persistent, difficult to lower blood pressure increases the risk of rupture of blood vessels or their degeneration.
- Atherosclerosis. In the cerebral (cerebral) form of ASB, lipid deposition occurs on the vascular wall of the brain. A cholesterol plaque is formed gradually, which blocks the lumen of the vessel.
- Heart failure. With such a disease, the activity of the entire cardiovascular system is disrupted. When the vascular element loses its ability to compensate for impaired cardiac activity, blood circulation deteriorates.
Unlike a stroke, TIA is accompanied by a lesion of a tiny brain area, so many patients do not even notice it.
Microstrokes are most affected:
- elderly people whose body actively loses elastic fibers, which leads to the inability of the vessels to fully perform their functions;
- patients who are overweight or obese;
- people who abuse junk food: fast foods, fried, smoked dishes, trans fats, flour products, sweets;
- chronic alcoholics;
- heavy smokers;
- diabetics: diabetes affects almost all metabolic processes, significantly disrupting their course, which affects the nervous, reproductive, cardiovascular and other systems;
- Persons leading a sedentary lifestyle: such people have an insufficiently trained heart, like the vasomotor center, so they cannot provide adequate nutrition for the brain;
- people exposed to constant stress, overwork, lack of sleep, etc.
The first signs of a microstroke
Sometimes the body signals a possible violation even some time before it occurs. The first signs of microstroke appear:
- increasing headache;
- numbness of the hand or a certain part of the face;
- visual disturbance;
- pronounced weakness;
- impaired thinking and reaction: a person can interrupt in half a word, or begin to respond inadequately to the interlocutor's speech;
- black dots, threads, flashes or spider webs;
- sharp lack of coordination of movements;
- paresthesia (feeling of tingling on the skin).
But it should be borne in mind that such signs do not appear in all patients.
The main symptoms of a microstroke directly depend on the localization of the lesion of the pathological process and the size of the affected vessel. In other words, the larger the vessel, the more intense the manifestation of the clinical picture of the disease. It is also worth noting that many patients blame the occurrence of certain ailments on pressure drops, weather changes, fatigue, etc.
But in most cases, patients suffer from:
- the appearance of "fly" before the eyes;
- cephalgia of varying severity;
- general weakness and indisposition;
- bouts of nausea.
In parallel with this, the appearance is possible:
- numbness of the face, hands, or feet;
- coordination disorders;
- balance disorders;
- shakiness and uncertainty of gait;
- sudden increase in blood pressure;
- light and sound hypersensitivity.
In some cases, patients with microstroke suffer from fainting, visual impairment, speech problems. All of this will depend on which part of the brain is affected. It is noteworthy that during hypoxia of the right hemisphere, disorders appear in the left side of the body, and vice versa.
For a microstroke, memory loss is characteristic. It is for this symptom that we can judge the severity of brain damage. With a "small" stroke, it is fully restored after 5 - 6 hours.
Specific, demarcating clinical manifestations of microstroke, characteristic only for men or exclusively for women, do not exist. But the representatives of the weaker sex are more susceptible to this disease due to increased emotionality and reduced stress resistance.
If the above symptoms occur, you should immediately call an ambulance. In parallel with this, the patient should be given proper care in order to relieve his condition a little before the arrival of the doctors. To do this:
- Place the patient on a hard surface. If a person is on the street, it must be transferred to a shady place.
- To prevent swelling of the brain, the patient's head should be slightly raised. If vomiting occurs, the head must be turned to the side so that the person does not choke on vomit.
- It is necessary to eliminate all the factors hampering respiratory movements: remove or loosen a tie, undo the belt and buttons, etc.
- Attach to the head a cold compress.
- Measure blood pressure. With hypertension, you can resort to the use of antihypertensive drugs. In this case, it is absolutely unacceptable to use antispasmodic drugs without the permission of physicians, even if the patient has a headache that is too severe.
Consequences of a microstroke
Usually a microstroke is not accompanied by severe complications. But some patients may well manifest negative effects of the transferred condition, which are expressed:
- memory impairment;
- distraction, inattention;
- increased irritability;
- depressive conditions;
- nervousness up to aggression.
But sometimes it happens that a few days after the TIA, a patient develops an extensive hemorrhagic or ischemic stroke. According to statistics, in 60% of cases transient attacks are repeated again after the initial attack. The consequences of such a process will already be more serious.
Transferred pathology should be a weighty basis for making serious adjustments in lifestyle. It is important to balance the time of work and rest, change the diet, perform moderate exercise. In parallel, it is necessary to undergo a comprehensive examination once every 12 to 24 months, in order, if necessary, to start treatment of IHD, arterial hypertension, atherosclerosis and other diseases that may lead to TIA.
How to treat a microstroke?
It is very good if the patient asks for help from a doctor immediately after the first warning signs appear. But, unfortunately, this rarely happens, since a person associates the deterioration of his well-being with any factors, but not with a microstroke.
For the treatment of this pathology, doctors prescribe:
- Thrombolytic drugs (Streptokinase, Urokinase, Alteplaza, etc.). They are necessary to dissolve the resulting blood clots, and restore blood flow in the affected vessel. But they begin to act only after 72 hours from the time of thrombosis. But with a hemorrhagic stroke, thrombolytics can kill a patient, so it is extremely important to know exactly what kind of violation you have to fight.
- Anticoagulants (heparin, its low molecular weight analogues). This group of drugs is aimed at preventing blood clots.
- Disaggregants - drugs that prevent the "gluing" of blood cells. This group includes Aspirin, Dipyridamole, etc.
- Diuretic drugs (in particular, Annitol). Diuretic drugs relieve cerebral edema, preventing the swelling of cells in the occipital foramen.
- Antihypertensive drugs. Used as a means of emergency treatment, but can also be prescribed for long-term use in order to maintain an optimal level of blood pressure and prevent attacks of hypertension.
- Neuroprotectors. This is a whole group of medicines and vitamins, the action of which is aimed at maintaining the functioning of the brain. In the rehabilitation period, antioxidant complexes, B vitamins, magnesium, nootropic drugs, etc. are prescribed.
The scheme of drug therapy for microstroke is developed strictly individually! Self-treatment in such a situation is unacceptable, because it can have dire consequences!
A microstroke, like a “big” stroke, requires not only treatment, but also mandatory recovery. The rehabilitation period begins immediately after all therapeutic measures have been completed, and the patient's condition has stabilized. Its continuation makes 3 - 4 months, and it is spent as in a hospital, and at home.
Recovery after a microstroke is:
- Treatment of the underlying disease with the normalization of blood pressure and blood circulation. In parallel with this, it is necessary to eliminate or minimize the manifestation of vascular lesions.
- Physiotherapy. It normalizes blood pressure, eliminates muscle hypertonus. Reflexology, massage, heat compresses and applications, etc. They do an excellent job with this task.
- Diet therapy. Proper nutrition is based on the rejection of salt, sugar, animal fats. Alcohol should be excluded completely.
- Normalization of weight. Extra pounds can not be dropped sharply - this should be done gradually.
- Restore optimal physical activity. For this, the patient is prescribed a course of exercise therapy.
It is very important to undergo a full course of treatment prescribed by a doctor and subsequent rehabilitation. It is important to give up bad habits, to establish a lifestyle, it is good to get enough sleep and to walk more in the fresh air.
To reduce the risk of microstroke, you need:
- To control blood pressure. One of the main reasons for the development of microstroke is arterial hypertension, or a sharp jump in blood pressure. Therefore, with frequent fluctuations in blood pressure, it is important to acquire a blood pressure monitor and daily blood pressure monitoring.
- Completely give up bad habits.
- Eat right, fractional. This will help avoid obesity, which can trigger a microstroke.
- Doing sports, doing exercises and not avoiding moderate physical labor.
- Get rid of the effects on the body of factors that provoke insomnia. The inability to fully sleep leads to stress for the whole body. As it accumulates, it can cause the development of a microstroke.
Thus, in order to avoid a microstroke and its possible complications, you just need to follow the rules described above. In fact, it is not difficult at all, because you do not need to make any radical adjustments in life.
It is especially important to listen to such recommendations for people of middle and old age. With biological aging of an organism, a person increases the risk of developing the pathology in question, since his vessels gradually "wear out" and lose their elasticity.
But young people should also be aware of such a pathology as a microstroke, since the modern rhythm of life makes them on the list of the main risk group. Being able to recognize the symptoms and the first signs of pathology, each of us can not only identify such a deviation in a timely manner, but also help another person if he has disturbing clinical manifestations.