1.What is cerebrovascular disease?
The general term for brain diseases caused by various diseases of vascular origin.
The causes of vascular origin are summarized into two main categories.
(1) Cardiovascular system or other system lesions, involving the brain vascular and circulatory functions, such as atherosclerosis, cardiogenic embolism, etc.
(2) Developmental abnormalities of the intracranial vessels themselves, such as congenital intracranial aneurysms and cerebral arteriovenous malformations.
According to the form of onset, it can be divided into two categories: acute and chronic.
(1) Acute cerebrovascular disease is a group of sudden onset cerebral blood circulation disorders, manifested as focal neurological deficits and impaired consciousness, also known as cerebrovascular accidents, strokes or strokes.
(2) Chronic cerebrovascular disease is the brain metabolism and functional decline due to insufficient blood supply to the brain, such as cerebral arteriosclerosis.
2.What is the incidence of cerebrovascular disease in China?
Cerebrovascular disease is a major common disease that causes death and disability, and it constitutes three major causes of human death together with heart disease and malignant tumor. According to the epidemiological survey in Beijing, the number of deaths from cerebrovascular disease ranks first in the total number of deaths and is increasing year by year; it was 137/100,000 people/year in the mid-1970s and 295.83/100,000 people/year in the early 1980s, which is higher than that of other countries in the world. The annual incidence rate in Beijing is 470 cases per 100,000 population. Men are slightly higher than women, and the morbidity and mortality rate increases gradually with age.
3.What kinds of cerebrovascular diseases are there and how to diagnose them?
Clinically, cerebrovascular diseases are divided into two major categories: one is vascular occlusion, called ischemic stroke, and the other is vascular rupture, called hemorrhagic stroke. The diagnosis of cerebrovascular disease should be based on medical history, symptoms, physical signs at the onset and CT and MR examinations, and cerebral angiography (DSA) is feasible if necessary.
(1) Ischemic stroke.
Transient ischemic attack A transient, reversible, localized disturbance of cerebral blood circulation, manifested by transient slurred speech, blurred vision, inability to move or numbness of the limbs, each attack lasts from a few minutes to an hour, with complete recovery within 24 hours. Recurrent episodes may occur with normal CT and MR examinations.
Cerebral infarction is caused by thrombosis or embolism, resulting in occlusion of cerebral blood vessels and local brain tissue necrosis, which is manifested by acute onset, sudden distortion of the mouth, hemiplegia, and slurred speech, with general mental clarity. The onset of the disease is older, with a higher incidence at quiet rest, and symptoms are often detected in the morning after waking up. The onset may also be gradual, with progressive worsening over a few hours or over a longer period of time.
(2) Hemorrhagic stroke.
Hypertensive cerebral hemorrhage Often develops during physical activity or emotional excitement. The attack is often accompanied by recurrent vomiting, headache, and elevated blood pressure. CT can detect the site and size of cerebral hemorrhage.
Subarachnoid hemorrhage has a rapid onset, often accompanied by severe headache, clear in mild cases, coma in severe cases, with cervical ankylosis, and CT can detect the distribution of hemorrhage in the brain pool. Since the disease is mostly caused by rupture of aneurysm, and the incidence and mortality rate of rebleeding are high, further cerebral angiography must be performed to detect the site, size and number of aneurysms for timely surgery.
Cerebrovascular malformation hemorrhage usually starts at a young age, 16-31 years old, with sudden headache, or in severe cases, coma, hemiparesis, aphasia, etc. Depending on the site of hemorrhage, CT can detect intracerebral hematoma or subarachnoid hemorrhage. Further cerebral angiography must be performed to clarify the site and size of the lesion.
4.How to deal with a stroke at home?
At home, once a loved one is found to have a distorted mouth, slurred speech, hemiplegia, or even unconsciousness, incontinence, especially in the elderly, a stroke should be considered. At this time, the patient should be immediately laid flat, untie the collar and loosen the trouser belt. If the patient is unconscious, the head should be tilted to the side and foreign objects (dentures) should be removed from the mouth. Avoid unnecessary or wrong practices, such as pinching, shaking the patient’s head, or violently pushing or pulling the patient, or attempting to wake him/her up. Call 120 as early as possible and take the patient to the hospital early. Be slow and gentle when moving the patient and keep breathing open.