Depending on how long circulatory disorders in the brain last and how severe these disorders are,show different signs and symptoms in the context of a stroke. There are fluid transitions between transient, transient symptoms and persistent neurological deficits.
In principle, one differentiates between several stages in relation to a stroke:
- TIA (transient ischemic attack): Here, the circulatory disorder in the brain is only a short time, complaints such as visual disturbances, speech disorders, numbness or dizziness occur only briefly and disappear after seconds to minutes again. This is similar to a temporary pain attack ( angina pectoris ) in coronary heart disease, ie the narrowing of coronary arteries. Like there, such temporary complaints are signs of a disturbed circulation situation – which can lead to a heart attack here in a stroke, in the heart .
- PRIN (prolonged reversible ischemic neurologic deficit): Here, the intensity and duration of the complaints are stronger; Failures can last for hours or even days, but then completely regress. The transition to a “big” stroke is fluid.
- Insult: Manifest stroke. Scar tissue forms in the area of the destroyed brain substance. Neurological damage often persists for the rest of life.
Stroke: recognize signs
Function and structure of the brain are very complex; Accordingly, a wide variety of complaint combinations are possible. Symptoms or deficits as signs of a stroke give the doctor hints to the affected vessel or brain area.
The supplying and dissipating nerve fibers, which make the connection between the brain and the rest of the body, intersect in the lower part of the brain, the brainstem. Therefore, in the cerebrum, symptoms appear in the opposite half of the body: In the case of a stroke in the left hemisphere, the right half of the body is affected, and vice versa. If there is a stroke in the area of the brainstem, both halves of the body can be affected, since many fibers are also close to each other for both halves of the body and control centers and can thus be affected equally.
Typical symptoms of a stroke
Below is a selection of typical symptoms of a stroke:
- Vascular occlusion of the middle cerebral artery (arteria cerebri media), which supplies part of the cerebrum (about 80 percent of vascular strokes): sensory disorders and paralysis on the opposite side of the body, which are most pronounced on the fingers and face; sometimes also vision loss in the opposite half of the face
- Vascular occlusion of the posterior cerebral artery (Arteria cerebri posterior), which also supplies a part of the cerebrum (about 10 percent of vascular strokes): loss of vision in the opposite field of vision, consciousness and emotional disorders on the opposite side of the body
- Vascular occlusion of the anterior cerebral artery (Arteria cerebri anterior), which also supplies part of the cerebrum (approximately 5 percent of vascular strokes): Semi-sided palsy on opposite side, which affects the leg more than the arm
- Vascular occlusion of one or more of the numerous brain stem vessels (20-50 percent of all vascular strokes): impaired vision, disorders of the musculoskeletal system, emotional disorders, back pain, twitching of the eyeballs, insecurity when walking, speech disorders and in severe cases also consciousness clouding
The diagnosis of stroke usually results from the typical picture of newly occurring neurological deficits. If the symptoms are only slightly pronounced, such as slight emotional disorders of one hand or sudden visual disturbances, other syndromes are included in the diagnosis.
Evidence of a circulatory disorder in the brain can be provided by computed tomography or magnetic resonance imaging (MRI). Thus, the type of damage and the affected area of the brain can be determined more precisely – not insignificantly also for the therapy or treatment. Additional diagnostic information may include ultrasound examination, cerebral circulation imaging, injection of contrast agents, examination of the heart for potential embolic sources, and blood testing for potential coagulation disorders.