In 85 percent of all cases, a vascular occlusion is responsible for a stroke. The remaining 15 percent are caused by a hemorrhagic (bleeding) stroke, also known as a cerebral hemorrhage. In this case, a burst vessel is the trigger.
The cause of cerebral ischemia is usually a thrombosis or embolism:
In thrombosis, a so-called thrombus (blood clot) forms in the brain, which blocks the vessel. This is usually caused by deposits in the vessel due to arteriosclerosis (hardening of the arteries). The tissue in the brain no longer receives sufficient oxygen, and if the condition persists, the associated nerves and tissue die. The result is limited functionality.
Superficial venous thrombosis on the left leg @ hriana / AdobeStock
In an embolism (vascular occlusion), there is a blood clot that is located outside the brain. For example, in the heart. From there, the thrombus reaches the brain via the bloodstream and causes a blood vessel to become blocked. Blockages in the brain are caused by arteries that become thinner the closer they are to the brain.
Supplying the brain with blood is vital. Two pairs of arteries regulate the blood supply. Both meet at the base of the brain to form a ring-shaped circle of arteries, the so-called circle of Willis (named after the physician Thomas Willis).
If cerebral ischemia occurs below the circle of Willis, the other arteries can largely take over the blood supply.
However, if the occlusion occurs above the circle of Willis - in the cerebral arteries - then compensation is no longer possible. The result is permanent damage.
Just ten seconds without sufficient blood supply leads to unconsciousness. After about two to three minutes, nerve cells die and the brain tissue is damaged.
Illustration Willis circle @ joshya / AdobeStock
The symptoms associated with reduced blood flow to the brain vary greatly and can often occur in parallel. The symptoms vary, as different areas can be affected.
There are also differences in terms of duration. Symptoms can persist continuously or disappear again.
The most common symptoms are
- Disorders of the speech center
- Motor impairments
- One-sided numbness
- Comprehension disorders
- Dizziness
- Impaired vision
- Severe headaches
If you notice such symptoms in yourself or someone else, you must call the emergency services immediately.
The first port of call is the so-called stroke unit of a hospital. Stroke units are specialized in the treatment of stroke patients. Their actions play a decisive role in ensuring that the patient survives and whether they suffer any consequential damage.
Saving lives and consequential damage depend heavily onprompt and correct diagnosis . The faster the doctors act, the better the chances of recovery.
The stroke unit clarifies how severe the restrictions in nerve function are. The specialists then check the extent of the damage.
The doctors take blood samples from the patient and examine the coagulation factor and blood sugar level.
In order for the patient to receive the right treatment, the doctors must determine the exact form of the stroke. Patients with cerebral ischemia receive different treatment than those who have a cerebral hemorrhage. People with cerebral hemorrhage often need surgery.
If doctors do not recognize cerebral ischemia quickly, the chances of recovery are extremely low. An ischemic stroke is always a medical emergency. Rapid action is crucial.
The main factors that favor a stroke are
- Smoking
- being overweight
- High blood pressure
- Diabetes mellitus
- Chronic lack of exercise
If you are a high-risk patient and suffer from memory problems, you should definitely consult a doctor.
Early detection of arteriosclerosis is easily treatable. A healthy lifestyle and medication significantly reduce the risk of stroke.
If the patient suffers a stroke, the first six hours are crucial for the chances of recovery. Drug therapy is often still possible within this time frame.
The most important procedure here is the so-called lysis (Greek: to dissolve). The doctor administers injections to dissolve the clot.
Another option is the stent retriever (grid). The stent retriever is an instrument that doctors use in stroke therapy. The specialists push the stent retriever through the inguinal artery to the blocked artery. The clot remains trapped in the mesh and can thus be removed.
Mechanical thrombectomy for the treatment of acute ischemic stroke @ songkram / AdobeStock
If these two methods are no longer effective, therapeutic interventions can help to improve the long-term consequences. Rehabilitative measures(physiotherapy, occupational therapy or speech therapy exercises) can minimize the extent of consequential damage.
Various specialists are responsible for the treatment of cerebral circulatory disorders:
The
neurologist specializes in brain and nerve diseases and is therefore primarily the doctor providing treatment. The
internist (internal medicine) contributes his expertise in the field of vascular diseases. The
cardiologist is responsible for heart disease and the connection between a clot in the heart and a stroke.
Cerebral ischemia is the most common form of stroke. It is caused by an acute reduction in blood flow to the brain. The symptoms that occur depend on where exactly the doctor localizes the circulatory disorder. A stroke is a medical emergency and must be treated promptly in a stroke unit. The chances of healing and recovery depend primarily on the rapid start of treatment and the severity of the incident.
