Stroke

By Drs. Li-Ke Wu, Xiaojuan Wang, Bo Cheng, Susan Chu and Xiang Wang

Wu Medical Center, Bejing, China

No matter the morbidity rate or impotence, cerebrovascular disorder is on the top of all nervous system diseases found in adults. A stroke is brain abnormalities which are caused by the pathological process of the blood vessels. This disease is normally presented in acute attack in the middle-aged people and/or elderly, which may cause consciousness disorder and limb paralysis. Stroke is a major disease that can cause death and physical disability; the main cause of death for patients is when they present high blood pressure results.

According to a different property, the classification of strokes is a ischemic cerebral vascular disease and a hemorrhagic cerebrovascular disease. Ischemic cerebral vascular disease is more common, cerebral infarction occupies 59.2%-85%, cerebral hemorrhage is less than 20% in different countries, except Japan.

Ischemic cerebral vascular disease:

(1) Transient ischemic attack (TIA, small stroke) etiological factor is related to cerebral arteriosclerosis. This is a kind of functional disorder caused by the brain tissue transient, ischemia, and focal lesions.

(2) Cerebral thrombosis is a blood clot formed from the cerebral blood vessel local lesions, which is caused by atherosclerosis, arthritis, trauma, blood disease and other physical factors.

(3) Cerebral embolism may be caused by an embolus, from many kinds of diseases, or an obstruction of the blood vessels in the brain. Although, heart disease is the most common cause, next in importance are embolus from fractures, or post-traumatic fat in the blood, eggs or bacterial infection, pneumothorax air into the blood, and/or phlebophlogosis.

Hemorrhagic cerebrovascular disease

(1) Cerebral hemorrhage is a cerebral vascular rupture with bleeding; this is not including the traumatic cerebral hemorrhage. Cerebral hemorrhages are commonly caused by hypertension, cerebral arteriosclerosis, tumors, etc.

(2) Subarachnoid hemorrhage is caused by a vascular rupture on the surface of the brain and the base of the brain with bleeding; the blood flows straight into the cavum subarachnoidale. Common causes are an aneurysm, vascular malformations, hypertension, arteriosclerosis, blood diseases, etc.

Pathology of Stroke

The pathology of cerebral ischemia and ischemic infarction include two pathological and physiological processes:

1. Shortage of oxygen and glucose caused by secondary vascular occlusion.

2. Tissue capacity processes collapse, a series of endocrine and metabolic changes occur in the cells and the cells membrane decomposition.

Above pathology changes may cause a variety of symptoms, such as: stroke syndrome: abrupt non-convulsive, focal neurological deficits. The most serious type is when patients have hemiplegic paralysis, or even coma.

Neurovascular Syndrome: Different arterial occlusion and patients physical quality is caused by different symptoms, but there are still some typical symptoms: such as three partial syndromes and lacunar syndrome in pars geniculate artery stroke, etc.

Course and Prognosis of Stroke

Generally, when the later rehabilitation training begins the prognosis worsens. If patient begins to have rehabilitation training 2 weeks after stroke, then he will have poor hope of motor and language function recovery. Movement and language disorders will be a permanent disability for them if they last 5-6 months.

Advance in the Treatment of Stroke

Generally it is thought that stroke is preventable by paying attention to blood pressure levels, blood glucose levels, blood lipid levels, diet and body mass index can effectively prevent a stroke from occurring. For patients who have one cerebrovascular occlusion, they should pay attention to cerebral vascular occlusion in different blood vessels, which can occur again. For patients who have had sequel already, it was thought that there was no effective treatment to recover any functions, but they still can have rehabilitation training to keep muscle away from atrophy. With the development of science and technology, new treatments for patients who are suffering from stroke disability is now available, this kind of new treatment belongs to the field of regenerative medicine.

Wu Stem Cells Medical Center found that necrotic nerve cells cannot regenerate after they die, which is caused by extensive damage of ischemia and hypoxia, but reserve cells and the cells around the lesion can be activated and are useable, which is brought about by regulation of the neural stem cell transplantation.