Stroke

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What is a stroke?

This disease, in which, for one reason or another, the blood supply to a certain area of the brain is impaired. Accordingly, the brain does not receive nutrition and nerve cells located in the area with impaired blood circulation are damaged or die. And along with them, those functions of the body suffer, for which the affected area of the brain responds to the stroke.

What types of strokes do you treat?

Depending on the causes of the disease, specialists divide the stroke into two types:

Ischemic stroke. The most common form of stroke. Occurs due to blockage of blood vessels responsible for the blood supply to the brain, thrombus or blood clot. As a result, nerve cells cease to receive oxygen and nutrients and, if not to take special measures, die off.

Hemorrhagic stroke. The reason for this type of stroke is the rupture of the cerebral vessel. Blood in the brain begins to accumulate in the adjacent tissues, exerts pressure on the nervous tissue, thereby disrupting its vital functions.

What types of surgery are performed with strokes?

Neurosurgical operations can be performed both with ischemic and hemorrhagic strokes and can include both prevention of stroke development, when there are signs of narrowing of the main arteries of the head and neck, and eliminating the consequences of the stroke that occurred.

Before the operation, special studies are usually conducted:

• Duplex ultrasound scanning

• Computed tomography of the brain

• Angiography

They help to determine the level and severity of blood flow in the vessels of the neck and head, the speed of blood flow, the presence of plaques and some other parameters of the cerebral circulation.

With ischemic strokes, stents of the neck and head vessels are also performed. This is usually done to prevent further development of ischemic stroke in the presence of transient ischemic attacks. Also, surgical intervention in ischemic strokes can include selective thrombolysis: this intravascular intervention amounts to the fact that through one of the large arteries (often the femur) a thin catheter is conducted, which is brought directly to the site of blockage of the artery in the brain - thrombolytic (a substance that dissolves thrombus as the root cause of the development of ischemic stroke), administered locally and in small dosages. This often leads to the dissolution of the thrombus that clogs the vessel, the so-called "recanalization of the blood flow" occurs and the symptoms of stroke regress in the eyes.

With hemorrhagic stroke, the maximum possible removal of blood clots is

possible with minimal damage to the brain substance, a decrease in local and general intracranial pressure. With spontaneous subarachnoid hemorrhages caused by cerebral aneurysms, aneurysm clipping is performed, or intravascular intervention with coils (spirals).

What factors contribute to the onset of a stroke?

There is no single cause of acute ischemia. There are several predisposing factors:

• elderly age;

• genetic predisposition;

• persistent increase in pressure;

• diabetes;

• Smoking;

• transferred myocardial infarction;

• frequent stress;

• Low physical activity.

Under the influence of several factors, the prerequisites for the formation of a vascular spasm form, which leads to ischemia.

The causes of hemorrhagic stroke are:

• severe arterial hypertension;

• Vascular pathology;

• defects in connective tissue;

• Blood diseases;

• long-term use of anticoagulants;

• drug addiction.

These factors contribute to the development of bleeding and the formation of a hematoma in the substance of the brain. Hematoma squeezes the nerve centers and leads to the development of appropriate symptoms.

In the Dnieper in the Mechnikov hospital, the first in the whole Ukraine operation to close the aneurysm spiral was carried out.

What will you advise our readers?

I advise you to follow the readers for their blood pressure, to lead a healthy lifestyle, to take tablets, if the pressure is higher than 130 to 90, to measure the pressure.

In 2016, with the support of the chief doctor of the Mechnikov hospital, a new angiographic complex was purchased with modern software. This year, with the support of the administration, a new computer tomograph with the latest software has been purchased, which makes it possible to do computer angiography. Grigoruk Sergey Petrovich

Honored Doctor of Ukraine

Head of the Department of Vascular Neurosurgery Dnepropetrovsk regional

Clinical Hospital named after Mechnikov.

Dnipro, Dnepropetrovsk region Sq. Cathedral 14 phone +38 (056) 373-09-46

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