Life after a stroke. Step by step - to the old me

A stroke is a sudden disruption of cerebral circulation. Just a few years ago, this disease threatened, as a rule, only older people, but in recent years, the accelerated pace of life, a stressful environment and a deteriorating environmental situation have led to the fact that stroke is increasingly affecting young people. Ischemic stroke is considered an extremely dangerous pathology, since one of its consequences is disability and death. Specialists at the Neurology Clinic of the Yusupov Hospital provide timely, high-level medical care, which minimizes the risk of complications.

Symptoms of left-sided ischemic stroke

In accordance with the localization of the brain catastrophe in a particular part of the brain, a stroke can be right-hemisphere or left-hemisphere. The disease develops according to the principle of “reverse symmetry”: with a right hemisphere stroke, paralysis of the left side of the body develops, with a left hemisphere stroke, on the contrary, paralysis of the right side.

The hemispheres of the brain are responsible for different functions. The left is for language and thinking abilities, the right is for creative and emotional. In view of this, with a left hemisphere stroke, the patient experiences a speech disorder, which is manifested by slurred speech, difficulties with the coherent expression of one’s thoughts, and with understanding what is heard. With a right hemisphere stroke, these symptoms are usually absent, and therefore this form of stroke is much more difficult to recognize.

The majority of cases (up to 60%) occur in right hemisphere stroke. To diagnose it, it is necessary to take into account that this type of stroke affects the appearance of the left side of the face and the condition of the body. A left-sided stroke is manifested by disruption of the facial muscles on the left side: drooping of the corner of the mouth and the outer corner of the eye. Partial or complete paralysis of the left side of the body occurs. The function of internal organs located on the left side of the body may be impaired.

In addition, left-sided stroke is manifested by other symptoms:

• paralysis of the left eye;
• hearing impairment;
• impaired perception of the left side of the body: the limbs become disobedient, it is difficult to assess the distance from the limbs to objects or the size of the limb;
• the appearance of inexplicable aggression, inappropriate behavior, depression;
• inability to perceive colors.

When a part of the brain located in the central part is damaged, as a rule, complete immobility of the limbs occurs. When the lesion is localized in the parietal region, the patient has difficulty perceiving heat, cold, and pain.

After confirming the diagnosis, it is important to provide first aid to the patient competently and promptly. The specialists at the Yusupov Hospital have extensive experience in treating strokes; thanks to their practical skills, it is possible to minimize the severe consequences of this disease.

Home care for patients after a stroke

No matter how severe the stroke may be, with proper treatment and the patient’s active participation in rehabilitation procedures, most of the body’s functions are restored.

The patient needs a full range of procedures for rehabilitation, including therapeutic exercises and massage.

Turn a bedridden patient every two hours to prevent the formation of bedsores. Properly position the patient's paralyzed arm and leg:

In the supine position:

1. To prevent the development of stiffness in the shoulder joint and the appearance of pain in it:

• Place a stool next to the bed, on the paralyzed side, and place a large pillow on it so that the corner of the pillow is under the patient’s shoulder joint.
• Extend your client's arm at the elbow. Place it palm up, straighten your fingers, apply a splint and bandage it to your arm. The longueta should reach the middle of the forearm.
• Move the patient's arm to the side 90° (maintaining a palm-up position) and place it on a pillow so that the shoulder joint and the entire arm are at the same level horizontally.
• Place a roller between your arm and chest so as to fix your arm in the correct position; if necessary, place a 0.5 kg bag of sand on the roller.

2. Bend the patient’s paralyzed leg at the knee 15-20°. Place a cushion under your knee.

3. Place your foot in the middle position between flexion and extension and secure it with a stand.

In the “healthy side” position:

• Bend the patient’s paralyzed arm at the shoulder and elbow joints and place a pillow under it;
• bend the paralyzed leg at the hip, knee and ankle joints and place a pillow under it.

In the “lying on the paralyzed side” position:

• tilt the patient's head down slightly;
• Stretch the patient’s paralyzed arm forward at a right angle to the body and turn it palm up;
• place the patient’s healthy arm to one side or move it back (but not forward!);
• slightly bend the patient’s paralyzed leg at the knee joint, but straighten it at the hip;
• Bend your healthy leg at the hip and knee joints and place a pillow under it.

To maintain mobility of the joints in the paralyzed arm and leg, perform “passive exercises” with the patient: first take the patient’s hand and carefully make certain movements, and then make movements with the patient’s paralyzed leg.

Perform a set of therapeutic exercises with your ward every 4 hours.

Make sure that the movements are smooth and do not cause pain.

Make sure that the patient does breathing exercises. Breathing affects muscle tone.

Keep in mind that the behavior of patients with right-sided paralysis differs from the behavior of patients with left-sided paralysis.

Restoring motor activity after a stroke.

Exiting bed rest should be done gradually and only in consultation with a doctor.

First, they teach the patient to sit down, then do exercises for the legs, then stand up, and only then walk.

If the person in your care cannot sit up independently:

1. Help him sit up first.

2. Then he needs to learn to sit in bed.

3. Provide the bed with special devices so that the patient can sit up without your help.

4. Teach the patient to lower his legs from the bed and transfer to a nearby chair or wheelchair.

5. Gradually teach the patient:

1) stand;

2) transfer the weight of the body from one side of the body to the other;

3) take steps on the spot;

4) to learn to walk, purchase a walker.

6. When teaching walking, stay close to the patient on the affected side..

Helping patients eat after a stroke.

The physician should assess the patient's ability to swallow and chew and prescribe an appropriate diet.

It is easier for a patient with impaired chewing and swallowing functions to swallow soft food than liquid food.

If you are drooling from the paralyzed side of your mouth, make sure your face is dry and clean. Lubricate the skin near your mouth with a protective cream.

Always serve food to your client from the side, on the uninjured side, and place it on the side of the mouth that is not affected.

After eating, make sure that there is no food left in the patient's mouth.

Monitoring the patient.

Watch your skin and take all measures to prevent bedsores.

Such patients often have urinary and fecal incontinence; take proper care of the patient.

To restore a normal sleep cycle:

• lower the air temperature in the patient’s room at night;
• reduce the calorie content of food and its temperature (after a hot, hearty meal a person falls asleep);
• Organize your ward’s daytime so that he has something to do all the time.

Call a doctor if

• There was an increase in temperature and severe pain in the side. Bedridden patients have a high risk of pneumonia;
• swelling has appeared on the paralyzed side - this may be a sign of vein thrombosis.

Provide your client with emotional support. Reassure him that his family loves and appreciates him regardless of his condition.

Therapist (head) of the day care department Lyudmila Vyacheslavovna Narab

First aid for left-sided ischemic stroke

First of all, you should call and clearly explain to him what happened to the patient, list all the symptoms. After which, a team will come to you for transportation to the Yusupov Hospital, which will necessarily include a neurologist.

During the waiting period, it is necessary to provide first aid to the patient on your own. First aid for a stroke has basic rules that must be followed:

• the victim’s head should be raised 30 degrees, which can be achieved with the help of a low pillow, blanket, clothing, etc.;
• the patient must be provided with access to fresh air - it is necessary to open the windows and doors in the room;
• you need to loosen or remove all squeezing objects: belts, waistbands, collars, etc.;
• when vomiting, it is necessary to prevent the victim from choking on vomit by turning his head to the side, and then help him rinse his mouth;
• It is necessary to constantly monitor blood pressure, recording the results.

After transporting the patient to the hospital, the best neurologists at the Yusupov Hospital will conduct the necessary diagnostic tests and provide subsequent assistance - medicinal or surgical.

Treatment and rehabilitation after paralysis of the left side

The choice of treatment method depends on what type of stroke struck the patient: hemorrhagic or ischemic, the causes of which differ.

The occurrence of a hemorrhagic stroke is caused by excessive blood flow into the brain, under the pressure of which an artery ruptures, accompanied by cerebral hemorrhage. This disorder is associated with a critical increase in blood pressure.

The development of ischemic stroke, on the contrary, is caused by an insufficient amount of blood in certain parts of the brain, which most often occurs due to the presence of atherosclerotic plaques in the vessels or problems in the hemocoagulation system.

Hemorrhagic stroke requires immediate surgical intervention.

The treatment method for ischemic stroke is determined depending on the causes of the disease. Conservative therapy for ischemic strokes is carried out by taking thrombolytic drugs (no later than three hours after the onset of the first symptoms), low molecular weight dextrans and anticoagulants.

For hemorrhagic stroke, drug treatment consists of taking angiotensin-converting enzyme inhibitors and low molecular weight dextrans. However, the main treatment method for this pathology is surgery aimed at removing the hematoma.

The rehabilitation course for a patient with a stroke at the Yusupov Hospital involves a set of measures aimed at restoring lost body functions and consists of the following procedures:

• massage course;
• manual and speech therapy;
• physical therapy;
• physiotherapy;
• acupuncture;
• breathing exercises;
• hirudotherapy;
• dietary nutrition.

What you need to know

The disease entails severe complications. The main condition is rest and minimal activity, this in turn contributes to the development of bedsores, pneumonia, thrombosis, loss of sensitivity, and mental disorders. Therefore, care for the patient must be taken responsibly. A comprehensive rehabilitation program is required:

1. Drug treatment (drugs: nootropic, erythrocyte, platelet, vasoactive, angioprotective).
2. Vitamins . Taking vitamins plays an important role in restoring the body and restarting metabolism. For a speedy recovery, you need to establish a balanced diet, and if necessary, consult a nutritionist to reduce body weight.
3. Physiotherapy. One of the successful areas in the fight against the disease is physiotherapeutic procedures. Having diagnosed paralysis of the left side after a stroke, treatment with physiotherapy is simply necessary. With the help of modern equipment, it is possible to restore the functioning of nerve endings and make the remaining parts of the brain function. Achieve activity of the affected parts using artificially created impulses. The following physiotherapy procedures are effective:
   kinesitherapy;
4. magnetic stimulation;
5. physiotherapy;
6. micropolarization;
7. neuromyostimulation.
8. Psychological support.

Treatment of disorders is a long process; relatives need to be patient and strong. The center’s specialists successfully cope with the most complex diseases. Modern equipment, successful experience, participation in world scientific conferences, the use of innovative methods, and most importantly, a sincere interest in achieving results - all this allows us to return to a full life, including patients who have suffered complete paralysis after a stroke.

Consequences of left-sided ischemic stroke

A patient who has suffered a stroke in the right hemisphere has a distorted image of his body, he does not feel motor disturbances and, therefore, does not strive for recovery. Such indifference makes rehabilitation difficult and requires referral to qualified specialists.

At the Yusupov Hospital, highly qualified doctors will select and implement an effective rehabilitation program after left-sided ischemic stroke. The program includes activities aimed at restoring the motor system and psycho-emotional state of the patient. Rehabilitation is based on classical and latest recovery techniques. Patients undergo massage, mechanotherapy, electrical stimulation, kinesthetics, diet and herbal therapy.

The Neurology Clinic of the Yusupov Hospital combines the advanced achievements of rehabilitation medicine and a homely atmosphere, thanks to which patients feel the care and attention of medical personnel and receive the necessary assistance from highly qualified specialists.