Stroke, microstroke - Causes, symptoms and treatment. MF.

Stroke symptoms
Stroke
Ischemic stroke
Hemorrhagic stroke
First aid, recovery, rehabilitation, patient care
Stroke consequences
Prevention of recurrent stroke

Stroke ( synonym for acute cerebrovascular accident) is the brain area death associated withtermination of his blood supply.

Causes of a stroke

If the cause of cessation of blood supply is arterial occlusion by an atherosclerotic plaque and / or thrombus, is said to be an ischemic stroke of .

If the cause is an artery rupture and a hemorrhage suggest hemorrhagic stroke .The most frequent causes of hemorrhagic stroke are the rupture of the expanded involvement of the artery( congenital abnormality of the vessel called an aneurysm) or rupture of the artery against a background of high blood pressure.

When brain cells of a particular region of the brain die, the functions for which this part of the brain is responsible are violated or completely lost. Usually stroke occurs in one half of the brain and there is a loss of function on the opposite half of the human body( due to the crossing of the neural pathways from the brain to the human body).For example, when the right side of the brain is damaged, there is a decrease in strength and sensitivity in the left half of the body. In addition, it must be remembered that a person has mental functions, speech is answered by the left half of the brain. If the stroke occurred in the left half, this leads to a gross violation of patient speech( slurred speech or its complete absence) and understanding of the speech of others.

The brain consists of several parts: on top of the cortex, which is responsible for thinking, feelings, speech, muscle movements of a person. The subcortical part of the brain is responsible for the basic functions: breathing, heart work, maintaining blood pressure, etc. In addition, in the posterior regions of the brain is the cerebellum, which is responsible for the coordination of movements. Depending on the affected area, these or other functions are violated. Most often affects the cortex of the brain.

Symptoms of a stroke:

• Movement disorders of , especially in the extremities. Decrease in strength or complete cessation of movements in the arms or legs
• Sensitive disorders of : decrease or loss of perception of pain, temperature, etc.usually the most noticeable in the extremities of the
• Visual impairment of the .For example, one eye may fall out( left or right) of one eye
• Speech disorders : Incomplete, fuzzy speech, complete inability to speak or understand speech
• Standing disorders : standing patient is swinging and can fall
• Consciousness disorder : from drowsiness to completeloss of consciousness.
• Less important symptoms, often seen in other diseases, are: headache( can be with migraine), dizziness( often with ear disease), muscle cramps( epilepsy).

If a person suddenly has the above symptoms, you must suspect the development of a stroke and urgently consult a doctor.

If you are near a person who suspects the development of a stroke, it is necessary to put it comfortably and urgently call an ambulance. Give the patient what medicine is not needed. If the patient is unconscious, you can not leave him lying on his back! A person without consciousness is reduced muscle strength and tongue can close the dying throat and a person will die from suffocation. A person without consciousness should always keep on his side so that saliva can drain out of his mouth and the tongue can not impede breathing.

Approximately in three cases out of four, the symptoms of a stroke are not clearly expressed and take place during the day. This is a transient impairment of cerebral circulation( another name is a transient ischemic attack).The name " microstroke " is not currently used by doctors.

Such short-term transient strokes or microinsults serve as a warning. The risk of developing large strokes with severe consequences after them is very high, so the appointment of a planned treatment to prevent the development of a second stroke is required.

Stroke treatment

It is not dependent on the nature of a stroke that emergency hospitalization is shown in a hospital, in severe condition, surveillance in a resuscitation unit. The refusal to hospitalize a patient with a stroke due to old age( usually over the age of 70-80 years) is a gross mistake. In this situation, the persistence of the patient's relatives is necessary.

Treatment of stroke depends on the nature of the brain damage( type of stroke): hemorrhage or ischemia( closure of the vessel).

Computer tomography of the brain( CT of the brain) or magnetic resonance imaging of the brain( MRI of the brain) is used to confirm the diagnosis, determine the nature of the stroke. These are the most informative methods that allow you to put an accurate diagnosis and determine the prognosis of the disease.

Hemorrhagic stroke( bleeding) of usually proceeds more severely than ischemic stroke. If a hemorrhage requires consultation of a neurosurgeon and the decision of a possible neurosurgical operation to remove a bloody area( hematoma) or clamping a bleeding vessel. Neurosurgical operations are often necessary, but involve a high risk for the patient.

Ischemic stroke does not require neurosurgical treatment. Early hospitalization, regardless of the age of the patient( !), Observation in the hospital, careful care of the patient and symptomatic therapy determine the outcome of the disease. Already in the first days of the disease, with a stable course, the activation of the patient with exercise therapy is shown.

It must be remembered that there are no effective drugs for stroke treatment. Medications are prescribed to prevent pantary strokes and to combat complications of the disease. Careful observation of the patient and symptomatic therapy to maintain optimal blood pressure, combat complications, and prescribing drugs to prevent stroke recurrence is the basis of treatment!

Treatment after stroke includes

• course of vascular therapy,

• use of drugs that improve brain metabolism,

• oxygen therapy,

• restorative treatment or rehabilitation( physiotherapy, physiotherapy, massage).

In case of a stroke, immediately call for an emergency medical service! If you do not provide immediate help, this will lead to the death of the patient! In the treatment after a stroke and rehabilitation, some of the consequences of a stroke can be alleviated, while others are completely eliminated. In many people, however, individual physical or neurological defects remain until the end of life.

After a stroke

Symptoms after a stroke depend on which area of ​​the brain they are affected. Accordingly, functions that are controlled by this area are violated. Possible after a stroke loss of muscle control over any part of the body or great weakness and paralysis of one side of the body. The ability to speak and understand speech can be impaired. People affected by stroke often show confusion, helplessness, emotional instability.

What to do immediately after a stroke: first aid

If you have symptoms of acute cerebrovascular accident, you should immediately call an emergency to start treatment as early as possible.

In the first hours of the disease it is impossible to predict its further course: whether the symptoms regress for 24 hours, or for a month, or for a year. TIA and minor stroke, of course more favorable, but still do not give cause for joy and relief. These types of disorders of cerebral circulation are the "first call", followed by a more terrible outcome. That is why it is necessary not only to begin treatment early, but also after restoration of lost functions, to begin secondary prevention of a stroke.

Why hospitalization is necessary immediately after a stroke

If a doctor has diagnosed a stroke, then do not give up the proposed hospitalization, as patients often do. Often, refusal is motivated by the need to stay at home because of family problems that require the active participation of the sick person. Sometimes people show a lack of trust in inpatient treatment, asking questions to the doctor: "What will they do there?"There are other reasons. This behavior is erroneous.

In the first day, a patient with a stroke should be hospitalized for examination and treatment. During the first 3 days it is recommended to perform ultrasound examinations that will show the state of the vessels responsible for cerebral circulation. These include duplex scanning of the main arteries of the head( DS), transcranial dopplerography( TCDG).Heart examination: ECG, echocardiography and hemorheological study of blood( hematocrit, viscosity, fibrinogen, platelet aggregation, erythrocytes, etc.)

An accurate diagnosis that reflects the localization and nature of the stroke( ischemic or hemorrhagic) is established in the course of computed tomography of the headbrain or magnetic resonance imaging. If necessary, cerebral angiography, Holier monitoring of ECG, 24-hour blood pressure monitoring and other methods that take into account the individual characteristics of the patient may be included in the examination plan.

As a result of a comprehensive clinical, instrumental and laboratory examination, it is possible to disclose the main cause and mechanisms of stroke in a particular patient. This is necessary to know in order to conduct the correct treatment, which takes into account the subtype of stroke. Researchers of the Research Institute of Neurology of the Russian Academy of Medical Sciences have identified five subtypes of ischemic stroke and their diagnostic criteria, which determines the treatment option in each case. We do not go into professional difficulties here, it's the task of special medical literature. Our task is to teach people who respect their health, properly assess the acute situation and correctly manage the chance to survive.

Nutrition immediately after a stroke.

Stroke is a serious illness requiring a lot of energy from the patient. But often the patients are weakened and can not eat normally or their swallowing is disturbed. In these cases, therapeutic nutrition with special protein mixtures is required: nutrison, berlamin modular, etc. These mixtures can be introduced through a special tube installed through the nose into the stomach( nasogastric tube) if the patient does not swallow, or is given as a basic food or added to anotherfood. On the packaging of the drug should be indicated: for feeding through the mouth or nasogastric tube. In drugstores there is a drug nitride for 200 ml, 5 different flavors. Enough to fully supply the patient with food slowly drink( it is better to suck through the attached tube, this contributes to better absorption of nutrition) 3-4 pack of nutritional protein per day.

Gradually, as far as possible in the process of rehabilitation, the patient is transferred to normal food.

Recovery after a stroke

The recovery period after a stroke occurs begins on the first day( usually a few days) of the disease.

The most important components of the early recovery period is exercise therapy. It is especially important to deal with the affected limbs. If the arm or leg does not move, passive flexion of the limb in the joints is necessary, early onset of easy massage( stroking).

In the more remote recovery period( 1-2 weeks from the onset of the illness), the patient needs self-service training. Obligatory visual and auditory loads are necessary: ​​music, conversations with relatives, watching TV, walking outdoors in a seated chair. The more active therapeutic exercise, therapeutic massage, especially the affected limbs, continues. It is very important to prevent immobilization of the affected extremities in the joints( the so-called contracture): the hanging of the foot, flexing the hand, etc.

Patients who have suffered a stroke may have urinary incontinence, stools, or vice versa, difficulty in urinating, stool retention. It is necessary to carefully monitor this. In addition, it is necessary to explain to the patient that changes are temporary and teach correct behavior( wearing diapers, enemas, etc.).

For rehabilitation to be effective, the patient's desire to participate in rehabilitation is necessary. The patient should have sufficient mental capacity to follow, at least, simple commands, and also be able to memorize rehabilitation exercises. The patient also suffering from ischemic heart disease( angina, postinfarction cardiosclerosis, arrhythmia) neurological rehabilitation program should be carried out in conjunction with the cardiac.

Frequency in a hospital twice a day every day. Houses daily. The probability of improving motor functions in the paralyzed limbs is maximal in the first 6 months. Improvement of speech can last up to 2 years. Movement in the hand is usually restored worse than in the leg. The absence of any movements in the hand within 4 weeks after ONMK is a poor prognostic sign for the restoration of motor function. According to statistics, in 50% of patients who underwent ischemic ONMK it is possible to achieve good effects from carrying out the reabilitation. For patients suffering from hemorrhagic stroke this figure is lower. About a third of the patients who survived the ONMK and survivors throughout the year remain dependent on outside help. This proportion remains stable for 5 years after a stroke.

If a stroke occurs, early hospitalization and the beginning of treatment, as well as the continued rehabilitation of the patient, are the guarantee of the most favorable outcome of the disease.

Rehabilitation after a stroke

Rehabilitation after a stroke is one of the most important tasks of modern medicine. The main principles of rehabilitation after a stroke are early timely onset, systematic and duration of rehabilitation treatment.

Disorder of cerebral circulation leads to the formation of a pathological focus in the brain. The core of the focus is the dead nerve cells, and the cells near it are in a state of reduced activity or complete inhibition. Timely medical measures can restore their activity.

To begin rehabilitation is necessary in the first month after a stroke, that is, during the period of the patient's stay in the hospital. Very much depends on the patient's psychological mood. Optimism, the desire to achieve the goal, an active attitude to life helps to defeat the disease. After discharge from the hospital, the rehabilitation process should be continued. Coordinates the work of specialists to restore the patient after a stroke, a neurologist or a rehabilitation doctor.

Recovery after a stroke includes drug support, active non-drug treatment( according to indications depending on the type of disorders: physiotherapy, exercise therapy, massage, psychotherapy) and teaching the patient to have lost or lost due to stroke skills.

Motor and speech disorders due to stroke are better able to be restored in the first months.

In patients who undergo a microstroke, all functions are usually restored within a month. But a micro-insult is just a warning that the blood supply system of the brain in this person is far from the best. That is, the stroke can at any time be repeated and lead to more destructive consequences. What to do?

There is a unique modern approach to rehabilitation: to combat the root cause of strokes - changes in the composition of blood at the cellular and molecular level. This approach is unique: physicians change their own blood through various physical, chemical and biological manipulations. Returned to the body, it becomes a medicine, devoid of side effects and extremely effective. A real miracle of new techniques have become for those who suffer from atherosclerosis, coronary heart disease, cerebrovascular atherosclerosis, kidneys, lower extremities or hypertensive disease.

The patient's own blood plasma, properly prepared by surgeons, dissolves cholesterol plaques. Then the harmful substances are again removed from the blood - and so until a lasting result is achieved. After the course of treatment, the lumen of the vessels and their elasticity are restored, the risk of a heart attack or stroke is reduced, blood pressure is normalized."Rejuvenation" of vessels naturally leads to the restoration of all body functions. Normalized lipid metabolism and hormonal background, improve the appearance of the skin, complexion, hair and nails. Painless procedures( from 2 to 10 depending on the severity of the disease and the methods chosen by the physicians) are conducted on an outpatient basis, every two days, and take no more than three hours.

Thus, the timely and properly organized rehabilitation of patients after a stroke contributes to the restoration of their health, return to a full life and reduces the risk of relapse.

Care for a stroke at home.

First of all, it is necessary to organize correctly those places in the house that will become for some time the main areas of the patient's habitat.

The bed needs to be moved away from the wall - so that you can approach it from any direction. This will greatly facilitate the care of the patient. The head of the bed is better to lift, so that it would be easier for the patient to sit, leaning on the pillows. The mattress must be rigid and even. Blanket - or rather, its heaviness, which we, healthy people, do not notice - can contribute to the formation of pressure sores in a sick person who has to lie still. It is necessary to make a special frame made of cardboard and attach it to the bed so that the blanket lies on the frame.

The room should be warm - after all, a person lying motionless supercooled very quickly. However, several times a day the room needs to be ventilated.

The patient should be able to call you from another room or kitchen at any time. You can put a bell near the bed or agree on some other signal, which means that the patient needs your attention urgently.

If the patient can already get up on his own, it is necessary to take care that near the bed there is a comfortable armchair. It should be low( to make it more comfortable to get up), with a firm seat and fairly wide armrests. You can attach a homemade table to the chair - it will serve as a support for a paralyzed hand. In addition, such a table will be convenient for eating and various other activities - reading, restoring exercises.

At first, when the patient starts to move around the apartment, he, again unable to fully own his body, will surely fall. Therefore, it is necessary to carefully inspect the apartment and remove anything that could trigger a fall( mats, wires) and become a source of increased danger( heating appliances).

It is necessary to make the whole apartment well-lit.

After returning from the hospital home, the rehabilitation of the patient at first must be carried out under the supervision of a neurologist. Sometimes disorders caused by a stroke quickly pass, after a few months a person can start the previous work.

In other cases, the restoration of the disturbed functions is delayed. It is necessary to be prepared for the fact that therapeutic gymnastics and speech restoration classes will be conducted for a long time and necessarily systematically. Especially persistently it is necessary to be engaged in the first 2-3 months after the transferred or carried stroke. It is necessary to perform exercises, not to miss a day, gradually increasing the load.

Exercise exercises should be agreed with the attending physician. Significant assistance can be provided by specialized centers or rehabilitation departments. Programs for the phased rehabilitation of a person who has suffered a stroke have been developed, which can be used at home. Following her, you can help the patient gradually return to normal, active life.

The process of recovery after a stroke recalls how the infant develops in the first months and years of life: first he learns to coordinate limb movements, then turn over, sit down, get up, walk. At the same time, control over the excretory functions of the body increases. Social skills are developing: the speech develops, the person learns to eat, dress, wash, master the phone, door locks, electrical appliances and habitable space apartments.

Practically also the patient who has suffered a stroke learns to live again. And just like a small child, he needs support and love, the approval of his loved ones. If the patient is constantly affectionately spoken, if he feels that others are confident in his recovery, it adds strength, optimism to himself.

It should be remembered that despite the need for independent activity, without assistance, a person who has suffered a stroke can not recover.

Recommendations for the relatives of the patient.

If you are almost at the limit - rest! !!

This simple rule neglects many people, not allowing themselves to rest until fatigue literally does not knock them off their feet. Meanwhile, breaks for rest significantly increase efficiency in any kind of activity, and not only in such hard and physically, and psychologically labor, as caring for a motionless patient.

Feel free to seek help from other people.

Help is very different - a neighbor or girlfriend can sit with the patient while you rest or go to the store or pharmacy. Find ways to escape from painful thoughts and improve your mood. When the hard situation lasts for months, it's especially important to be happy with the little things of life. Give yourself small gifts, go to visit - it will help you hold out. Use traditional methods to relieve tension. Among them - walking tours, a variety of water procedures, sports, aromatherapy. Use the techniques of auto-suggestion and auto-training.

Make a healthy diet with the maximum content of vitamins, minerals and other useful nutrients. And most importantly: NEVER LOSE OPTIMISM!

Memo for a person who has suffered a stroke.

Even if you are paralyzed, you still do not need to lose hope. Remember: the main and most effective method of restoring the motor function is therapeutic gymnastics, especially restorative and breathing exercises are recommended.

Motor and speech disorders caused by a stroke are better resilient in the first months.

Physical activity stimulates the ability of nerve cells to "retrain" and to a certain extent take on the responsibilities of the deceased, compensate for their inactivity.

The basic rule of physical activity is the gradual increase in loads.

It is necessary to constantly monitor the blood pressure level.

During the first year after a stroke, it is necessary to refrain from taking alcoholic beverages, smoking, drinking coffee and other tonic drinks.

Do not lose optimism, avoid stressful situations, fulfill all doctor's prescriptions.

Try to be as active as possible and do everything yourself that is within your power.

Complications and consequences of stroke

Treatment of a patient in an acute period of stroke is necessary in the conditions of a specialized neurological department, which allows, due to accurate diagnosis of the nature of stroke, intensive treatment and early rehabilitation, to reduce mortality and disability among patients.

Two main areas can be distinguished in the treatment of stroke patients:
• treatment of stroke consequences,
• prevention of recurrent stroke and other diseases of the cardiovascular system.

is one of the most frequent and severe consequences of a stroke. Recovery of lost motions is maximum within two to three months from the time of stroke, it lasts throughout the year and most significantly in the first six months. Restoration of the ability for independent movement is observed even in patients in whom a stroke leads to a complete absence of movements in the limbs on the one hand( hemiplegia).With adequate physiotherapy, most of these patients begin to stand independently and walk, at least 3-6 months after the disease, which is one of the main goals of rehabilitation with a severe degree of motor disorders.

Medical gymnastics should be conducted already in the first days after the stroke in the absence of contraindications to physical exertion( for example, myocardial infarction or cerebral artery aneurysm).Movement in the paralyzed limbs should be carried out for several( 10-20) minutes at least three times a day, special attention should be paid to the joints( humerus, elbow, hip and ankle) in which early and significant development of inflammation and mobility limitation is possible. Active movements in the paretic limbs must be trained immediately after their appearance, gradually increasing the load. In the absence of contraindications, patients should sit in bed only 2-3 days after the development of ischemic stroke and one to two weeks after the occurrence of an intracerebral hemorrhage. Then, if they are confidently sitting in bed, patients can sit in an armchair or on a chair and learn the standing, the use of a wheelchair. In the future, it is necessary to train patients walking, using first special devices, and then a stick. When carrying out physiotherapy, a gradual increase in physical activity is necessary. If the patient has a pathology from the heart( for example, arrhythmia or angina), then the rehabilitation program is consistent with the cardiologist.

To reduce pain in front of the gym, you can use locally anesthetic ointments or compresses with novocaine and dimexid, massage and reflexology.

If a patient after a stroke has speech disorders , logopaedic exercises are recommended. The patient should hear the speech of other people, the radio, the TV and have the opportunity to communicate with others. It is necessary to stimulate the patient to speak independently, even at a rough degree of its violation. Of great importance are reading aloud, writing, drawing and other activities that stimulate speech functions. The effectiveness of restoration of speech functions is largely determined by the patient's motivation and active participation in the rehabilitation process, so positive comments from the doctor and surrounding sick people about his success in the class are of great importance.

A decrease in the memory and intelligence of occurs in a significant proportion of patients after a stroke. To improve memory and intelligence in patients who have suffered a stroke, you can use drugs that increase metabolic processes and blood supply in the brain. Treatment is more often carried out by courses within one month 2-4 times a year. Piracetam is used internally at 1.2-4.8 g / day. Gliatilin is prescribed by mouth at 0.8-2.4 g / day. Nimodipine is prescribed by mouth 30-60 mg 3-4 times a day. Vinpocetine is administered orally 5 mg 3 times a day. Nicergoline is used orally 5 mg 3-4 times a day. Cinnarizine is administered orally 25 mg 3-4 times a day. Nicardipine is used orally 20 mg twice a day.

Depression of occurs in more than half of patients after a stroke. It greatly complicates the process of rehabilitation of the patient, complicates the care for him and his contact with surrounding people. Depression can be manifested by headaches and other neurological disorders, which are sometimes mistakenly regarded as the progression of cerebral vascular injury in a patient who has suffered a stroke. For the treatment of depressive syndrome, psychotherapy is used. It is advisable to tell the patient that many people who suffered a stroke were able to gradually restore their lost abilities, domestic skills and even return to their former professional activities.

Stroke prevention

Stroke is one of those diseases that are easier to prevent than cure. It can be prevented through the rational organization of the working and rest regime, proper nutrition, sleep regulation, normal psychological climate, limitation of sodium salt in the diet of , timely treatment of cardiovascular diseases: coronary heart disease, hypertension.

The best way to avoid a stroke is to prevent atherosclerosis and other cardiovascular diseases. It is important to monitor blood pressure and check for diabetes.

If necessary - take medications that improve the microcirculation of cerebral vessels, as well as drugs that prevent the lack of oxygen( hypoxia) of the brain.

Prevention of recurrent stroke

One of the important areas of treatment for stroke patients is the prevention of recurrent stroke. The risk of recurrent stroke is increased in the presence of arterial hypertension, arrhythmia, the pathology of heart valves, congestive heart failure, diabetes mellitus.

Prevention of recurrent stroke should begin as soon as possible and last at least 4 years. Of great importance is the maintenance of a healthy lifestyle, which includes quitting smoking or reducing the number of cigarettes smoked, refusing to use drugs and alcohol abuse, adequate physical activity and reducing excess weight. It is advisable to reduce the consumption of foods containing large amounts of cholesterol( butter, eggs, fatty cottage cheese, etc.), and increase the amount of fresh fruits and vegetables in the diet. Women who have had a stroke should not use oral contraceptives.

Arterial hypertension is the most important correctable risk factor for stroke.

Patients who have suffered a stroke and who have hypertension can be recommended to reduce salt intake from food, as this can reduce blood pressure and, as a result, reduce the dose of antihypertensive drugs, which can cause undesirable side effects. If the patient is overweight, it is recommended to achieve and maintain an ideal body weight, which requires a reduction in the total caloric intake of food and regular exercise( gymnastics, walking), the intensity of which is individual.

For the prevention of recurrent stroke, patients who underwent ischemic stroke are recommended for 1-2 years or constantly receiving angioagregants: acetylsalicylic acid, dipyridamole, ticlopidine or clopidogrel. Acetylsalicylic acid is usually used in small doses( 80-300 mg / day).To reduce the irritant effect of the drug on the stomach, use is not dissolving in the stomach form of acetylsalicylic acid.
If a patient suffering from ischemic stroke shows hyperlipidemia( an increase in total cholesterol more than 6.5 mmol / l, triglycerides> 2 mmol / L and phospholipids> 3 mmol / L, a decrease in high-density lipoprotein levels of less than 0.9 mmol / l), a diet with low cholesterol is recommended to prevent the progression of atherosclerosis.

* Antidepressants prolong life after a stroke

February 2011 Treatment with antidepressants within 12 weeks after a stroke improves the condition of patients regardless of whether they suffer from depression.

Given the relationship between depression after stroke and mortality, the obvious question would be to reduce the appropriate treatment for antidepressants with mortality, "writes Ricardo E. Jorge and colleagues at the University of Iowa College of Medicine, USA.

During the recovery period after stroke, 104 patients were selected for a 12-week course of nortriptyline, fluoxetine or placebo. The groups were uniform in severity of stroke, deterioration of cognitive functions and received therapy. Out of 104 patients, 48.1% died within 9 years. Out of 53 patients who received antidepressants, 67.9% lived longer compared with 35.7% who received a placebo.

Treatment with antide-deceptants after stroke significantly increased the survival of both suffering and non-depressed patients. This may mean that the pathophysiological processes that determine an increased risk of mortality are associated with post-stroke depression, can be adjusted by antidepressants.

"Our data suggest that all patients who have experienced an acute stroke should undergo antidepressant treatment if it is likely that this can prolong their life," the authors conclude in the pages of The American journal of psychiatry.

* The new medicine will save from the consequences of a stroke

February 2011. The regulation of the processes of programmed cell death can be the key to creating a new effective tool for the treatment of stroke.

American scientists have successfully tested in mice a substance that has already found application in other fields of medicine. It turned out that its administration to animals reduces the neurological consequences of stroke by 91%.

As explained by the authors of the work from the University of Rochester and the Scripps Research Institute in California, much of the damage to the brain after a stroke occurs not in the first hours, when the cells remain without oxygen, and much later, when the damaged cell "decides" that for the good of the bodyshe needs to die. This process is called apoptosis.

Scientists have found that activated protein C, used, for example, in severe sepsis, can reduce programmed cell death. Through the cellular receptors, it reduces the content of the molecules of the p53-protein, which is at the center of death processes due to hypoxia. In addition, the content of substances interfering with this process is increased.

In experiments with laboratory mice, described in the pages of Nature Medicine, Berislav Zlokovic and John H. Griffin found that activated protein C retained up to 65 percent of those cells that usually die as a result of a stroke. In general, neurologic disorders after stroke were reduced by 91 percent.

Scientists hope that their discovery will help create a medicine that will be effective not only in the first hours of the stroke, but also help those patients who enter the hospital later.