Ischemic stroke - a disease that has been known since ancient times as apoplectic stroke. This name came up once Hippocrates, and only in the 19th century, it was found that the cause apoplectic stroke is cerebrovascular accident.

Causes of ischemic stroke

Ischemic stroke - an acute ischemic attack due to insufficient income (or complete cessation of receipt) of arterial blood to the brain tissue.

The cause of ischemic stroke may be thrombi (blood clots, plugging the lumen of the vessel), embolism (broken away thrombi are formed in other parts of the circulatory system, often in the region of the heart valves), atherosclerotic plaques, sharp spasm of blood vessels, a sharp drop or rise in blood pressure, and etc.

The risk of ischemic stroke increased by atherosclerosis and coronary heart disease, hypertension, cardiac arrhythmias, sudden drop in blood pressure, osteochondrosis of the cervical spine, accompanied by compression of the blood vessels that carry blood to the brain.

When brain cells (neurons) do not receive oxygen and nutrients, they begin to die out, a zone of necrosis with loss of functions inherent in this portion of the brain. Depending on where it is a site necrosis, this may be a violation of movement (paralysis or paresis), sensitivity, speech, senses (vision, hearing, and so on).

Zone necrosis usually surrounded by injured neurons, which in the first hours and days and lose their function, but then, when properly administered adequate treatment of their function restored. Completely lost only the functions directly in the area of ​​necrosis.

Symptoms of ischemic stroke

Area of ​​necrosis in most intensively growing the first 1, 5-2 hours after the onset of stroke. It grows less rapidly over the next 4-5 hours. The threat of the necrotic zone is important for the first three days. Therefore, it is important to promptly hospitalization in a specialized intensive care unit, where everything will be done to stop the spread of stroke.

Mild manifestations of the disease are the main focal symptoms that occur immediately or gradually. When moderate to severe form of ischemic stroke, cerebral symptoms first appear, and then, on their background - patchy. Sometimes the development of ischemic stroke is preceded by bouts of transient ischemic attacks, accompanied by focal disorders that are fast enough.

By focal brain lesions are symptoms that are the consequence of a local (limited) nervous system. This movement disorders in the form of paralysis (complete immobilization) or paresis (partial immobilization). The most characteristic of ischemic stroke is hemiparesis - a violation of the movements in the left or right half of the body. Depending on the location of the affected area may occur unilateral visual impairment and hearing loss, skin sensitivity disorders, speech and other symptoms.

By the cerebral symptoms are those that develop with diffuse (spread) brain damage. These symptoms include headache, dizziness Dizziness - if the ground is slipping from under his feet , Cramps, nausea, vomiting, loss of consciousness, hallucinations.

Complications after ischemic stroke in most cases connected with cerebral disorders. When violations of breath may develop pneumonia, blood circulation - edema, including edema of the lungs and brain. There are also complications associated with focal disorders. So, may develop on the background of paralysis and paresis persistent contractures (information) relevant muscles.

Effects of ischemic stroke

Easy ischemic stroke, promptly and adequately treated, may not have any effect. But in most cases, the effects do occur. Usually they are the greater, the larger the area of ​​necrosis in the brain and its surrounding area of ​​injured neurons.

Typically, during the full scope of rehabilitation treatment these effects of stroke Stroke - consequences: recovery and treatment   significantly reduced by restoring the functions of injured neurons.

Pregnancy after ischemic stroke

Ischemic stroke in women of childbearing age is rare and most often develops in the hereditary predisposition. Risk factors for this are hypertension, seizures, sudden decrease in blood pressure, migraines I have a migraine. What to do? , Heart rhythm abnormalities, various diseases of the heart valves (eg, rheumatism), smoking, obesity, diabetes Diabetes - threatening and incurable disease .

Ischemic stroke occurs during pregnancy (usually during the third trimester), as well as after birth. This is facilitated by late toxicosis (gestosis), cardiovascular disease, age after age 40, a caesarean section.

If a woman of childbearing age suffered ischemic stroke, examined it carefully in order to identify genetic predisposition to thromboembolism (such as antiphospholipid syndrome - APS). Prevention of repeated ischemic stroke - is carrying out the treatment and possible elimination of the factors predisposing to stroke. After treatment, the woman can bear a child again. Repeated strokes in these women is rare.

A pinched nerve in the hip joint is often the result of acute trauma or crush (eg tumors). In most cases, such a violation can be eliminated, provided the cause of the lesion of the femoral nerve and early administration of adequate treatment.

Why might infringe upon the nerve of the hip

The hip joint is innervated by branches of the obturator, femoral and sciatic nerves. The infringement of any of these nerves can cause a number of characteristic symptoms. The cause of nerve entrapment in the hip joint can be:

• osteochondrosis; this disease first occurs decrease amortization ability of intervertebral discs, and then, as a result of prolonged trauma vertebral tissue grows their bone; All this may result in injury to the spinal cord extending from the spinal nerves, including those of the nerve fibers that innervate the hip joint;
• acute sports injury Sports injuries - whether a full recovery?   or sports (professional) overload, leading to hemorrhage in the muscles and nerve compression of the hip;
• retroperitoneal hematoma caused by various factors (eg, bleeding disorders in conjunction with the sessions of manual therapy Chiropractic: the main thing - to choose the competent expert , Damage to blood vessels during surgery, and so on) which may also compress the nerve;
• compression of the nerve benign or malignant tumors Malignant tumor: cells are mad ;
• damage to nerves during surgery, for example, acute appendicitis, in the urinary system, spine, and so forth;
• nerve compression aneurysms (sudden expansion plot) of large arteries, as well as abscesses in the region adjacent to the hip joint.

The symptoms of a pinched nerve hip

Pinched nerves in the hip joint can manifest itself in different ways, depending on the branch of a nerve had been violated, and at what level. If there is compression of the femoral nerve in the groin area, then there are a lot of pain in this area, extending to the anterior-surface of the femur and tibia. If the infringement is possible to remove the pain completely disappear. But with prolonged compression of the nerve appear sensitive and motor disorders: numbness of the skin, sensation of crawling ants on it, reduction in volume (atrophy) innervated muscles (quadriceps), which leads to movement disorders.

Movement disorders manifest themselves in frustration hip flexion in the hip joint and it is lifted the torso from a prone position and sitting.

If the infringement of the sciatic nerve Infringement of the sciatic nerve: why it happens   can develop piriformis syndrome. The reason for infringing a compression of the sciatic nerve piriformis muscle spasm. A manifestation of the syndrome piriformis muscle pains are burning character, sensory disturbances in the area of ​​the outer surface of the leg and foot. Pain aggravated by rotation inside the thigh and leg in flexion of the hip and knee joints. Exerting pressure on the region piriformis muscle (the buttocks) also increases the pain.

If the infringement occurred at the exit site of spinal roots, the pain in the lumbosacral region, extending to the hip, groin and went down on his thigh and shin. Characterized as parastezii - violation of skin sensitivity in the form of pins and needles sensation, tingling and burning sensations in the affected areas.

Diagnosis of a pinched nerve in the hip joint

To assign adequate treatment, you need to identify the cause of nerve entrapment. To do this, conduct a thorough clinical diagnosis based on neurological examination and analysis of the distribution of sensory and motor disorders.

To exclude compression of nerve tumor or hematoma require computed or magnetic resonance imaging (CT or MRI). To assess the state of the nerve in the inguinal ligament and hip possible by ultrasound (US). Confirm the defeat of a nerve can also electromyography (EMG).

Treatment for a pinched nerve in the hip joint

Treatment depends on the cause of the infringement. If a nerve is compressed tumor or hematoma, the main method of treatment - an operation. The operation is also needed for gross trauma and even rupture of the nerve. When minor injuries appointed conservative therapy with painkillers and anti-inflammatory drugs (NSAIDs, glucocorticoid hormones), drugs that restore normal blood circulation in the injured area (eg, aminophylline, pentoxifylline and other) tools to improve metabolism (vitamins B, Micro and macro elements and so on).

When muscle paresis prescribe a course of physiotherapy and massage to maintain range of motion in the joints and muscles of the affected activation, altered muscle electrostimulation courses and the use of funds, improve neuromuscular transmission (neostigmine, ipidacrine etc.).

A pinched nerve in the hip joint, in most cases can be completely cured with timely appointment of adequate therapy.

Galina Romanenko