How not to miss a "silent" stroke

iStock

At the same time, few people know that often the first stroke is "silent", that is, it goes unnoticed. If you do not take action, soon such people may break out in real trouble. How to protect yourself, "RG" - Our experts told the Week - a neurologist at the Doctis telemedicine center Dmitry Markov and a general practitioner and cardiologist at the Nearmedic clinic Polina Shelukha.

Due to the lack of symptoms, people suffer a silent stroke on their legs without even knowing it, because it can be detected with 100% certainty only with the help of an MRI of the brain. Nevertheless, a silent stroke triggers processes that lead to impaired brain function up to the onset of dementia. In addition, it often becomes a harbinger of a full-scale vascular catastrophe - a stroke or heart attack.

Why are there no symptoms?

“Its invisibility is explained by the small size of the focus of necrosis from a few millimeters to two centimeters,” Dmitry Markov explains. “Such foci are called lacunar, they are located in the deep parts of the cerebral hemispheres. , balance, muscle strength are not disturbed, and the person remains unaware that he suffered an acute cerebrovascular accident.If a functionally important part of the brain is affected, then this almost always leads to the development of a severe stroke, for example, with complete immobility of the arm and leg in the opposite direction. hearth half of the body, impaired speech, etc."

How to define a silent stroke?

He has no clear external manifestations, Dr. Markov notes. But when conducting a CT scan or MRI, the picture shows signs of infarction (necrosis) of one or more parts of the brain. Lacunar foci can be detected both on the day when the stroke occurred, and years later.

High blood pressure, dizziness and headache - all these symptoms indicate problems with the vessels and the central nervous system, but are not clear signs of a stroke. But if they are joined by numbness, muscle weakness on one side of the body, facial asymmetry and impaired speech, this may indicate a real stroke. To avoid this, prevention and regular examinations are needed.

Photo: Infographics "RG" / Leonid Kuleshov / Alexander Belyaev What are the reasons?

“Most often, the cause of a silent stroke is diseases of the small arteries of the brain - microangiopathy, when the diameter of the vessels narrows, making it difficult for normal blood flow and delivery of necessary substances, primarily oxygen, to the brain cells. Under a microscope, the walls of such vessels look thickened, loose and fragile, their the rupture leads to the formation of microbleeds," explains neurologist Markov.

"Unfortunately, with an asymptomatic course of a stroke, patients do not have the so-called red flags - clearly expressed symptoms that would be a signal for an immediate visit to a doctor. Therefore, one must keep in mind: if there is a burdened heredity for cardiovascular diseases or a person once in life, he noted high blood pressure, interruptions in the work of the heart, dizziness, then this is a reason to be examined in order to prevent the development of such serious diseases as cerebrovascular accident, "advises Polina Shelukha.

When blood vessels weaken (risk factors)

- Heredity.

- Hypertension without treatment.

In this case, a plaque of protein forms on the walls of the vessels. This is one of the reasons for the weakening of the walls of blood vessels and impaired microcirculation.

- Diabetes.

Against the background of an increased concentration of glucose in the blood, there is a gradual accumulation of cholesterol and calcium in the walls of the arteries - their obstruction develops, the blood supply to tissues, including the brain, is disturbed.

- High concentration of uric acid in the blood.

Blood viscosity increases and non-thrombotic blockage of the small arteries of the brain occurs, leading to damage to the area of ​​\u200b\u200bthe brain that they supply.

"The most common direct cause of ischemic damage in silent stroke is a hypertensive crisis. It can also be caused by thrombosis, inflammation or vasospasm - narrowing of small arteries," says Dr. Markov.

What to do?

“You need to be examined to find the cause of the stroke and take action,” says Polina Shelukha. “Otherwise, in the future, the stroke may recur with much more serious consequences, possibly even death, depending on the extent of brain damage.” and areas of occurrence of circulatory disorders.

Important Do not stop taking pills

“All patients after a cardiovascular event require certain medications,” says Polina Shelukha. “Some of them are prescribed courses to improve blood circulation, for example, drugs from the nootropic group, others need to be taken on an ongoing basis and for life.”

Very often, when the condition improves and stabilizes, patients stop taking the drugs on their own or simply forget to take the pills regularly. Moreover, some believe that they have fully recovered, arguing that they are feeling great, and stop being careful, return to their usual way of life: they again disrupt the sleep-wake cycle and even relieve stress with alcohol. Such an alignment will inevitably lead a person to the starting point and put an end to all the previously done path to well-being. You need to understand: drugs do not cure the disease completely, they help maintain the body in a stable state, prevent the development of complications. But it is possible to hope for an improvement in the quality and an increase in life expectancy only if therapy is followed.

“Of all strokes, a “silent” stroke, if not ignored and fully treated, is the most favorable in terms of prognosis,” Dmitry Markov reassures. do not ignore the recommendations of doctors. Well, and, of course, a healthy lifestyle will benefit - the person himself should take care of himself.

Rossiyskaya gazeta - Week - Federal issue: No. 237 (8885)