Neurologist: this symptom should alert the patient - it is a harbinger of a stroke

Hundreds of thousands of people die every year from the consequences of atherosclerosis, which affects the vessels of the brain. A key link in the occurrence and development of this disease is dysfunction of the vascular endothelium. "The endothelium not only forms a barrier between blood and vascular smooth muscle, but also produces a number of vasoactive substances that regulate local processes of hemostasis, proliferation, migration of blood cells into the vascular wall and vascular tone. Endothelial dysfunction is an imbalance between the factors that ensure these processes," - explains Olga Doronina, Candidate of Medical Sciences, Associate Professor, Neurologist, Head of the Clinic for the Treatment of Neurological Diseases.

According to the neurologist, cerebral aneurysms often occur without symptoms. As the walls of this formation increase, they become significantly thinner, which can lead to its rupture and the development of a hemorrhagic stroke. "According to studies, the risk of aneurysm rupture ranges from 0.05 to 1% per year. Moreover, 1/3 of patients die before the start of assistance, 1/3 remain in a coma, 1/3 recover. The risk of re-rupture of the same aneurysms is 20% if not operated within 2 weeks, and 50% within 6 months," notes the neurologist.

She believes that the surgical treatment of hemorrhagic stroke is not well developed. Indications and results depend on the location and size of the hemorrhage, the clinical picture and the causes that caused it. Clipping of an unruptured intracranial aneurysm accidentally detected during MRI can prevent its rupture, the specialist emphasized.

Olga Doronina draws attention to the fact that 40% of patients have a headache 2-3 weeks before acute subarachnoid hemorrhage - a separate type of hemorrhagic stroke. "The causes of spontaneous intracranial hemorrhage can be: arterial hypertension; the use of anticoagulants, antiplatelet agents and thrombolytics, drug use, primary and metastatic brain tumors, hemorrhagic impregnation of the infarct zone in ischemic stroke," Olga Doronina said.

There are invariable risk factors for stroke - hereditary, associated with lifestyle, resulting from any pathological process or the result of life processes. "The presence of family cases of acute disorders of cerebral circulation is a proven fact of the risk of developing a stroke. The role of cardiogenic risk factors is increasing, especially in young people, such as: anomalies in the development of the heart, aneurysm of the atrial septum, etc. There is also a connection between taking oral contraceptives, especially in combination with smoking, and the development of ischemic stroke in young women, "explains the physician.

However, some of the risk factors for stroke can be successfully modified. "Lifestyle changes can prevent not only the risk of stroke, but also many other diseases and pathologies. This is weight loss, a diet enriched with vegetables, fruits and low fat, limiting salt to 5 g / day, regular dynamic physical exercise for at least 30 minutes a day, stop drinking alcohol and quit smoking (reducing the risk of stroke and heart attack by half), avoiding passive smoking," the neurologist noted.

The specialist emphasized that giving up cigarettes plays a special role in preventing the risk of stroke. However, according to WHO, only 30% of patients quit smoking permanently within the first 10 attempts. Those who remain are advised to at least reduce the harm from nicotine consumption by switching to alternative sources of nicotine delivery that pose less of a health hazard. "Tobacco smoke significantly affects the change in blood microcirculation. It contains particulate matter, the ingestion of which leads to oxidative stress, endothelial dysfunction, increased thrombus formation, platelet activation, inflammation, cell proliferation. Nicotine contained in tobacco smoke does not become the main cause of diseases associated with smoking, although not harmless and addictive. First of all, carbon monoxide has a toxic effect on the cardiovascular system. Carbon monoxide binds strongly to blood hemoglobin and prevents the normal supply of oxygen to organs and tissues, resulting in cerebral ischemia," the doctor said.

The work of the brain and heart directly depends on their continuous supply of oxygen. Carbon monoxide makes the heart work harder in two ways: the work of the heart is increased in order to make up for the lack of peripheral oxygen supply, while the supply of oxygen to itself is reduced due to carbon monoxide. Thus, carbon monoxide can cause not only acute disorders of cerebral circulation, but also myocardial infarction.