stroke in women

There are two main forms of cerebrovascular disease:

• acute disorders of cerebral blood supply (stroke);
• chronic disorders of cerebral blood supply.

Strokes are one of the most important problems both in medicine and in society. One person in 1000 dies due to a stroke, and many remain disabled for life. Only 20% of people after a stroke return to normal life.

What is a stroke

A stroke is an acute violation of the blood supply to the brain, resulting in cerebral disorders that do not go away on their own during the day or lead to death.

What you need to know about stroke

Types of Stroke

• Ischemic stroke – the cause is a blood clot that clogs the vessel. This leads to the cessation of blood supply to a certain area of ​​the brain and the gradual death of cells.
• Hemorrhagic stroke – associated with a rupture of a vessel or an aneurysm, which leads to a splash of blood, disruption of the blood supply to a certain area of ​​​​the brain and compression of surrounding tissues due to hematoma.

Signs of a stroke in women

We list the common symptoms of a stroke in women:

• severe weakness or numbness in the upper and / or lower extremities;
• problems with speech and / or impaired understanding of it;
• gait disturbance;
• fainting;
• severe headache for no apparent reason;
• facial numbness.

Since the brain has a complex blood supply system, the symptoms of a stroke will also vary depending on the affected artery:

• anterior cerebral artery – disorientation, behavior becomes inadequate, sensitivity in the limbs changes;
• middle cerebral artery – memory problems, impaired coordination;
• posterior cerebral artery – visual impairment, speech impairment, color recognition and written text.

Causes of stroke in women

The main causes of stroke in women are:

Rupture of a vessel due to an aneurysm. An aneurysm is a bulge in the wall of an artery due to its thinning or stretching. In this place, there is a change in blood flow, which can lead to the formation of a blood clot or rupture.

Thrombus formation, which can be called:

• the presence of an atherosclerotic plaque;
• increased blood viscosity;
• thrombophilia (blood clotting disorder) with atrial fibrillation, varicose veins of the lower extremities, etc.

There are also factors that can lead to the development of a stroke:

• increased arterial;
• family history and hereditary predisposition;
• heart disease (atrial fibrillation, heart failure, an increase in the mass of the myocardium of the left ventricle, coronary artery disease);
• atherosclerosis;
• taking oral contraceptives – increase blood viscosity;
• diabetes mellitus – constant hyperglycemia leads to changes in the vascular wall;
• smoking, excessive consumption of alcoholic beverages – increased blood viscosity and increased blood pressure;
• age over 50 years;
• obesity, lack of physical activity.

Treatment of stroke in women

Stroke is divided into acute period (from onset to 3 weeks) and recovery (from 2 weeks to 24 months). Treatment is selected individually by the doctor after instrumental and laboratory studies, depending on the stage and concomitant diseases.

Different groups of drugs are used to treat stroke in women:

• thrombolytic therapy – the destruction of a blood clot that has formed in a blood vessel;
• anticoagulants, antiaggregants – prevent thrombosis;
• neuroprotectors – protect brain cells from damage;
• nootropics – improve blood supply to the central nervous system and normalize metabolic processes in neurons;
• antihypoxants – correct energy metabolism in the brain;
• antioxidants – reduce lipid peroxidation;
• reparants – improve the processes of regeneration and repair of cells and tissues.

First aid for stroke in women

1. Call an ambulance.
2. Give the head an elevated position (30 degrees), using a pillow, bag, things.
3. Unfasten tight clothes, loosen a tie, belt.
4. Provide fresh air (open windows).
5. Measure blood pressure.
6. Tilt your head to the side when vomiting.
7. In the absence of breathing and blood supply, start chest compressions.

Diagnostics

To independently determine a stroke, you need to ask a person:

1. Smile – the smile will be crooked with a clear shift to one side;
2. Stick out the tongue – there will be a deviation of the tongue in one direction;
3. Lower your head (press your chin to the sternum) – this action will be accompanied by severe pain in the cervical region;
4. Squeeze both hands – it is important to assess the strength of compression, with a stroke, the affected side will be weak;
5. Raise your arms above your head and hold for 10 seconds – with a stroke, one hand will not “obey”;
6. Walk in a straight line – with an acute violation of cerebral blood supply, a person will not be able to do this on his own.

The main diagnostic methods for detecting stroke are CT and MRI.

• CT (computed tomography) is a diagnostic method that allows, through layer-by-layer scanning, to detect hemorrhages. CT angiography allows you to evaluate thrombosis or stenosis of cerebral vessels. It is the “gold standard” of diagnostics.
• MRI (magnetic resonance imaging) is a method for obtaining tomographic medical images. Compared to CT, it allows you to better see structural lesions, the development of edema.

Modern treatments

Therapy for stroke is divided into two types.

• General therapeutic measures that provide adequate ventilation (AIR), normalization of hemostasis (BLOOD) and adequate hemodynamic level (COR).
• Adequate ventilation involves the improvement of the upper respiratory tract, oxygen therapy and mechanical ventilation when indicated (decrease in the level of oxygen saturation in the blood).
• Normalization of hemostasis includes correction of the electrolyte composition of the blood.
• An adequate level of hemodynamics consists of correcting blood pressure and heart rate (it is necessary to maintain pressure at 140/90 mm Hg).

• Specific therapy depends on the type of stroke.

In ischemic stroke, an important step is thrombolysis (drug dissolution of a blood clot to restore blood flow). To achieve the greatest effectiveness, it is necessary to carry out therapy in the first 3-6 hours from the onset of the disease.

With a hemorrhagic stroke, it is important to restore the nutrition of the brain. If there are large aneurysms or hematomas, then surgical methods of treatment are used. They help reduce intracranial pressure.

All treatment is carried out in a hospital setting. Outpatient therapy for stroke in women is not possible.

Stroke prevention in women at home

There are 10 commandments for stroke prevention:

1. Blood pressure control (no more than 140/90 mm Hg).
2. Regular intake of prescribed drugs (especially blood thinners).
3. Regular monitoring of the heart and blood vessels using ECG and ultrasound of the vessels of the neck.
4. Control of glucose and cholesterol.
5. Enough daily physical activity.
6. Stop smoking.
7. Stop drinking alcoholic beverages.
8. No more than 5 grams (1 teaspoon) of salt per day.
9. Drink at least 2 liters of water per day.
10. Learn about hereditary predisposition to stroke and visit a neurologist.

Popular questions and answers

Together with an expert therapist Tatyana Pomerantseva we discussed important issues regarding stroke in women.

Sources:

1. Clinical recommendations “Stroke” 2016;
2. Clinical guidelines “Ischemic stroke and transient ischemic attack in adults” 2020;
3. Principles of diagnosis and treatment of patients with acute disorders of cerebral circulation – Guidelines, Moscow – 2000;
4. Cerebrovascular diseases. Headache. – textbook on private neurology – St. Petersburg, 2015.