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Incredible brain repair: What is the secret to recovery after stroke?
Stroke, also known as ischemic stroke, is a pathological process that leads to necrosis of brain tissue, usually caused by interruption of blood flow supply. Depending on the severity of the disease, stroke is the leading cause of disability and the second leading cause of death in middle- and high-income countries. Due to interruption of blood supply and restricted oxygen supply, brain tissue undergoes a process of liquefaction and necrosis. For the understanding and treatment of stroke, the medical community continues to explore and develop different classification and assessment methods.
Types of stroke can be divided into four main categories based on symptoms: total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), lacunar infarction (LACI), and posterior circulation infarction (POCI). These four patterns predict the extent of stroke, affected brain areas, cause and prognosis.
Stroke identification
A variety of tests are available for initial screening of patients who may be experiencing symptoms of stroke. Of these tests, the Cincinnati Hospital Stroke Scale (CPSS) and the Faciobrachial Speech Test (FAST) are the more common tools, which respectively detect symptoms such as facial droop, arm drift, and voice changes. In recent years, the intervention of AI technology has also provided new possibilities for stroke diagnosis.
Symptoms and risk factors
Symptoms of ischemic stroke are often related to loss of nervous system function. Common symptoms include unilateral weakness, facial paralysis, and speech difficulties. These symptoms often appear without warning. At the same time, many risk factors are the same as arteriosclerosis, such as high blood pressure, diabetes and obesity, which increase the risk of stroke to a certain extent. Notably, the risk of stroke doubles every decade as you age.
In some cases, uncontrollable risk factors (such as age, family history and race) also play a role in the likelihood of stroke, especially in people over 55.
Pathophysiology
Necrosis of brain tissue is usually caused by prolonged interruption of blood supply, possibly due to thrombosis, embolism, or systemic hypoperfusion. When the supply of blood flow drops significantly, brain neurons will begin to enter a state of hypoxia, and a series of chemical reactions will occur, eventually leading to cell death. This is called the ischemic cascade.
Diagnosis and Treatment
For the diagnosis of stroke, a CT scan or MRI is a key tool. CT scans are relatively cheap and available in most hospitals, while MRIs can more accurately show brain damage. In terms of treatment, in the past decade, treatment options similar to myocardial infarction have been gradually introduced into the treatment of cerebral infarction. If the patient can receive targeted therapy within 3 hours after the attack, the chance of recovery is relatively higher.
According to research, timely use of rtPA can reduce the disability rate of stroke patients by 30% three months later.
For acute cerebral ischemia, techniques for performing thrombectomy or using thrombolytic therapy are also improving and showing positive results. Not only that, subsequent rehabilitation processes such as physical therapy and speech therapy are crucial for patients to restore function.
These medical advances provide a deeper understanding of stroke and recovery. But in the face of the incredible repair ability of the brain, can everyone find a road to recovery that suits them after a stroke?
