The historical name for this condition is apoplexy. This is what the Roman surgeon Galen called a hemorrhagic stroke, denoting the main external signs of the disease - a sudden loss of consciousness, after which the person changed forever. Today, doctors know for sure that a vessel ruptures in the cranial cavity, blood flows out, after which up to 70% of patients die. However, the development of neuroimaging technologies, as well as the capabilities of neurosurgery, lead to the fact that the number of deaths from stroke is decreasing, and in some cases, rehabilitation sufficient for a good life is possible.
Why do blood vessels rupture?
The main cause is arterial hypertension, especially if untreated or during breaks in taking antihypertensive drugs. The vessels physically cannot withstand the pressure that blood exerts on their walls. A vessel breaks through at the site of thinning or damage, this happens in the presence of an atherosclerotic plaque, congenital aneurysms, head injuries, the use of certain medications that prevent blood clotting, tumors and encephalitis. Another important cause of rupture is arteriovenous malformations, when small arterial and venous vessels do not end in capillaries, but are intertwined into one large ball. Such congenital pathology can be detected during a preventive examination. If a person knows about it, he behaves more carefully and avoids unnecessary risks.
Nature has protected the brain as much as possible from damage, providing it with a mass of protective and backup systems. At a young age they work, but in the second half of life they don’t always work. Therefore, it is advisable that people at risk undergo an annual examination by a neurologist.
At CELT you can get advice from a neurologist.
- Initial consultation – 4,000
- Repeated consultation – 2,500
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The following people are at high risk of developing hemorrhagic stroke:
- hypertensive patients, they need to take medications daily;
- overweight people - the body grows approximately 1 kilometer of blood vessels per 1 kg of excess weight;
- people with high levels of cholesterol, namely low-density lipoproteins, which form atherosclerotic plaques on the vascular wall;
- people who eat insufficient amounts of protein and do not have the “building material” for complete tissue repair;
- those under chronic stress, often suffering from physical or emotional stress;
- alcohol abusers and smokers;
- those suffering from diabetes or heart disease;
- suffering from chronic infections that destroy the vascular wall - lupus erythematosus, vasculitis;
- people who constantly take medications to reduce blood viscosity;
- having direct relatives who died from cerebral hemorrhage.
How does a hemorrhagic stroke occur?
Vascular rupture can occur at any time of the day. This is usually preceded by physical or emotional stress. The person suddenly falls, sometimes with a loud cry, and loses consciousness.
Approximately 30% of patients have warning signs that develop within a few minutes to several days. On the eve of a rupture of blood vessels, there may be severe headaches - ones that the person has never experienced. There is a feeling of a rush and a sharp reddening of the face. Sometimes the sensations of numbness in the limbs, muscle weakness, and facial asymmetry appear.
The main symptoms of hemorrhagic stroke are:
| Contralateral hemiplegia | The nerve pathways intersect, so the paralysis is located on the side opposite to the hemorrhage. During a stroke, the left arm and leg stop moving in the right hemisphere, and the right ones in the left hemisphere. |
| Contralateral hemianesthesia | In paralyzed limbs, sensitivity disappears on the side opposite to the rupture. |
| Aphasia | Loss of speech occurs when the dominant (dominant) hemisphere is damaged. For right-handers - right, for left-handers - left. |
| Spatial hemiagnosia with damage to the non-dominant hemisphere | If a right-hander's left hemisphere is affected, and a left-hander's right hemisphere is affected, then the person behaves as if half of the real space does not exist for him. A person does not realize that he has two halves of the body, that food can be eaten from the entire plate, and not from half. Half of everything that is located around a person is not perceived by him. |
| Facial asymmetry | One half of the face does not receive innervation and cannot contract. One nasolabial fold is smoothed out, the smile becomes one-sided, the tongue deviates to one side, water and food flow out of the mouth. |
From the moment these symptoms appear, there is only 3 hours to help the person as much as possible. After 3 (sometimes 6) hours, irreversible changes will occur, then nothing can be corrected.
An unruptured cerebral aneurysm may present with the following symptoms:
- Visual impairment of various types and degrees.
- Convulsions are not of an epileptic nature.
- The headache is unilateral, subacute in nature, with a predominant localization in the fundus of the eye, quite often the pain is throbbing.
- Transient ischemic attack. The most typical symptoms are dizziness, loss of consciousness, nausea, vomiting, temporary loss of orientation in time and space, memory loss, sensory disturbances with complete or partial loss of certain sensations, various paralysis, and speech impairment.
- Dysfunction of cranial nerves. When they are compressed, various neurological disorders can occur, such as paralysis of facial muscles, taste disturbance, inability to turn the head in the direction opposite to the damage, partial or complete drooping of the upper eyelid, hearing impairment with tinnitus, or even auditory hallucinations.
- Pain in the face.
Our doctors
Belikov Alexander Valerievich
Neurologist, Candidate of Medical Sciences
21 years of experience
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Novikova Larisa Vaganovna
Neuropathologist, Candidate of Medical Sciences, doctor of the highest category
Experience 39 years
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Pankov Alexander Rostislavovich
Neurologist
40 years of experience
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Types of strokes
Depending on which part of the brain the hemorrhage occurred, there are 4 types of stroke:
- Intracerebral or parenchymal, when the spilled blood saturates an area of the brain. In turn, they also have their division into:
- hemispheric, when an area of the hemispheres is affected;
- subcortical, located under the cortical (gray) matter of the brain;
- hemorrhage in the cerebellum, where the balance centers are located;
- hemorrhage in the brain stem, where the respiratory center and the area that is responsible for the functioning of the heart and maintaining the pressure in the vessels necessary to support life are located.
- Subarachnoid (bleeding into the space between the meninges).
- Ventricular (hemorrhage into the ventricle of the brain).
- Mixed: ventricular-parenchymal, subarachnoid-parenchymal, parenchymal-ventricular-subarachnoid and so on.
Survival depends not only on the location of the vessel rupture, but also on how much blood was released. Small hemorrhages are considered to be those in which from 1 to 20 ml are poured out, medium - from 20 to 50 ml, large - more than 50 ml. The greater the amount of blood shed, the more severe the consequences. A stroke is almost always accompanied by disturbances in cardiac activity, breathing and swallowing, oculomotor disturbances, and changes in the size of the pupils.
Modern treatment of cerebral aneurysm
If an aneurysm is detected, treatment should begin immediately, without waiting for tragic consequences. The price of surgery for a cerebral aneurysm may seem high, but this is the cost of high-quality medical services, the masterly work of the best surgeons, the use of the latest technologies and a stay in a modern hospital. We provide our patients with the best conditions available in Moscow today.
The most effective way to treat an aneurysm is surgery - therapeutic angiography of the brain, which involves catheterization and, if necessary, stenting of blood vessels. The final cost of surgery for a cerebral aneurysm will depend on the specific technique and details of the operation, which will be determined only after undergoing a diagnosis of a cerebral aneurysm. The operation may involve covering the desired section of the artery with special microspirals. This is an endovascular minimally invasive operation that does not require opening the skull. However, the specific technique is determined by the surgeon after a thorough analysis of the patient’s condition, indications, type and size of aneurysm and all related factors.
Additional Research
MRI of the brain
- Cost: 14,000 rub.
More details
The initial diagnosis is established after examination by a neurologist, but instrumental diagnostics are always required to clarify the boundaries of the lesion. The most informative method is computed tomography, which allows a good examination of the brain matter. MRI is used for the same purpose if there is time for it.
Angiography gives excellent results, this is a study of blood vessels with contrast. It identifies malformations, dissections (dissections) and other vascular pathology. The important thing is that this study can be conducted in healthy people at risk. This is the best prevention of stroke if research is supplemented with treatment.
Lumbar puncture is used for diagnostic and therapeutic purposes.
Diagnosis of brain aneurysm
If you suspect a disease, make an appointment at the clinic for diagnosis of a cerebral aneurysm according to the international protocol and start treatment right now. We will arrange for you the assistance of neurosurgeons of the highest class.
Examination for cerebral aneurysms includes MRI, endovascular examination, angiography with contrast or CT angiography, an appointment with a neurosurgeon and preoperative preparation (laboratory tests, ECG, X-ray of the lungs).
What do you get when you seek treatment from us:
- quick and accurate understanding of your problem,
- carrying out all diagnostic measures as soon as possible,
- our consultant is always in touch with you,
- the right strategic decision from a council of top-class specialists, the decision is made not by one doctor, but by the heads of departments and clinics: leading specialists in your problem areas, a specialized surgeon if necessary, a diagnostician - an Israeli general practitioner,
- the best treatment option in the Russian Federation according to international standards, these are the most qualified doctors, and their work according to Western standards, guaranteeing the best result,
- solving all problems at all stages, that is, Dr. Aronov is always “with you”, for everything we will offer the best solution,
- peace of mind, clear steps in treatment - you get all the benefits of Israeli and European medicine in Russia, medical care from an Israeli doctor in Russia.
Features of treatment
Treatment of hemorrhagic stroke today is more in the purview of neurosurgeons than neurologists. The blood has already been shed, and the possibilities of medical assistance are limited. Removal of an intracerebral hematoma can save lives and maintain an acceptable level of health. Surgical removal is more successful the earlier it is performed. Optimally, the patient should be operated on on the first or, in extreme cases, on the second day after the incident.
The main intervention is aspiration (suction) of the hematoma and clipping of the aneurysm. It is only possible when the artery is in an accessible place. There is no way to help with an aneurysm deep in the medulla. In a typical case, the blood is aspirated, a clip is placed at the base of the aneurysm, and the aneurysm is isolated from the bloodstream.
Malformations are excised whenever possible. These are complex operations that require not only the skill of a specialist, but also first-class equipment.
Patient reviews
Mikhail Lvovich Vysotsky: I was observed and treated by Dr. Alexander Aronov at Medis for several years, for all sorts of little health issues, and at some point I was diagnosed with an aneurysm on an MRI. After consultations and “weighing” all the pros and cons, I went for an operation with Dr. Moisei Aronov, he is an endovascular surgeon, probably one of the best in Moscow. The neurosurgeon dealt with the situation and now I can continue to live in peace. Otherwise, it’s like walking around with a bomb in you. If someone has such a situation, you need to boldly go for surgery, but with one “but”, you need to go to the best specialist.
Anna Larina: Thanks to the timely operation performed by Dr. Krylov, my mother’s life was saved. The organization of everything was perfectly done.
How to help a stroke victim?
Recovery largely depends on how the people around the patient behave. First of all, you need to call an ambulance, and until it arrives, try not to move the person. You need to place a cushion or pillow under the shoulders and head, carefully turn the person on the right side, and place a basin or bag in case of vomiting. It is advisable to measure blood pressure. Anti-pressure pills should not be given before the ambulance arrives: there is a possibility of a sharp drop in blood pressure. Only specially trained medical personnel know the rules for lowering blood pressure when it rises above 150/100 mmHg. If respiratory depression occurs, you need to start resuscitation - chest compressions, mouth-to-mouth breathing.
The best prevention is timely treatment of hypertension, atherosclerosis, identification of malformations and aneurysms before they rupture.
Our neurologists see patients every day, and every patient at the clinic can find out their risk for developing a hemorrhagic stroke. Visit your doctor while you still have time.
Make an appointment through the application or by calling +7 +7 We work every day:
- Monday—Friday: 8.00—20.00
- Saturday: 8.00–18.00
- Sunday is a day off
The nearest metro and MCC stations to the clinic:
- Highway of Enthusiasts or Perovo
- Partisan
- Enthusiast Highway
Driving directions
