脑干中风

定义

A brainstem 中风 happens when 血液供应 to the base of the brain is stopped. This can affect many functions in the body, such as heart rate, breathing, 和 blood pressure.

There are two main types: 缺血性 和 出血性. An 缺血性 中风 is the most 常见的类型.

Medical care is needed right away. Cells in the brain die if they are without oxygen for more than a few minutes. 这可能是致命的.

大脑

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原因

An 缺血性 中风 happens when blood flow is blocked. 这可能是由于:

• A clot from another part of the body that breaks off 和 gets trapped in a blood vessel supplying the brain
• A clot that forms in an artery that supplies blood to the brain
• A tear in an artery that supplies blood to the brain

A 出血性 中风 is caused by a burst blood vessel. Blood pools in the brain. This slows or stops the flow of blood 和 causes a buildup of pressure on the brain.

风险因素

This problem is more common in older adults 和 people with a family history of 中风.

Problems that affect blood vessel health 和 blood flow can raise the risk of 中风. 一些例子是:

• 的历史 transient 缺血性 attacks (TIA)
• Lack of physical activity
• 吸烟
• 酒精 使用障碍
• 肥胖 or 代谢 并发症状
• 2型糖尿病 或前驱糖尿病
• 高血压
• 高胆固醇
• Heart problems such as past heart attack, atrial fibrillation or enlarged heart
• Diseases of blood vessels such as carotid artery stenosis or 动脉粥样硬化
• 物质滥用 of 可卡因, amphetamines, or heroin

Daily habits can also play a role. 一些例子是:

• 吸烟 和特许经销商
• A diet that is high in saturated fat, trans fat, cholesterol, 和 sodium
• 不 being physically active
• Cocaine, amphetamines, or heroin use

症状

A person having a brainstem 中风 may have:

• 肌肉无力
• Hearing 和 vision problems
• 感觉的变化
• 平衡问题
• A feeling of spinning when they are still
• 呼吸的问题
• Problems chewing, swallowing, 和 speaking

诊断

A 中风 needs to be diagnosed fast. The doctor will ask about symptoms 和 health history. A physical exam will be done. The doctor will look for signs of nerve or brain problems.

Blood tests may be done to look for clotting problems.

Images may be taken of the brain. 这可以用:

• CT扫描
• 血管造影—to look at the heart 和 its 血液供应
• CT血管造影
• 核磁共振成像扫描
• Magnetic resonance angiography (MRA)
• 多普勒超声

Heart function will be checked. 这可以用:

• 心电图 (ECG)看一下 heart's electrical activity
• 超声心动图 去看心脏 肌肉运动

治疗

Emergency care will be needed. The heart 和 lungs may need support. A tube may also be placed to help with breathing. 其他选择包括:

药物

For an 缺血性 中风, medicine may be given to:

• Dissolve clots 和 prevent new ones from forming
• 薄血

For a 出血性 中风, medicine may be given to:

• Work against any blood-thinning drugs a person has been taking
• Reduce how the brain reacts to bleeding

手术

Options to treat an 缺血性 中风 are:

• Embolectomy—a tube is passed through blood to remove a clot or deliver medicine to break it up
• Vertebrobasilar 血管成形术 和 支架—a major artery to the brain is widened 和 a mesh tube is left in place to help keep it open

康复

Therapy may be needed to regain lost skills. 选项有:

• Physical therapy—to help with movement
• Occupational therapy—to help with daily tasks 和 self care
• Speech therapy—to improve swallowing 和 speech
• Psychological therapy—to provide support after the 中风

预防

The risk of 中风 can be lowered by:

• Managing long term health problems, such as high blood pressure 和 diabetes
• Keeping a healthy weight through diet 和 exercise
• Eating a diet that is low in fat 和 cholesterol 和 rich in whole grains, fruits, 和 vegetables
• 不 吸烟 或特许经销商
• 限制酒精

参考文献

• Hemorrhagic 中风s (bleeds). 美国中风 Association 网站. 可以在: http://www.中风.org/en/about-中风/types-of-中风/出血性-中风s-bleeds.
• Intracerebral hemorrhage. EBSCO DynaMed网站. 可用 在:http://www.力学.com/condition/intracerebral-hemorrhage.
• Ischemic 中风s (clots). 美国中风 Association 网站. 可以在: 美国中风 协会网站. 可以在: http://www.中风.org/en/about-中风/types-of-中风/缺血性-中风-clots.
• Lifestyle changes to prevent 中风. 美国中风 协会网站. 可以在: http://www.中风.org/-/media/Stroke-Files/Lets-Talk-About-Stroke/预防/Lifestyle-Changes-to-Prevent-Stroke.PDF格式.
• Long-term management of 中风. EBSCO DynaMed网站. 可用 在:http://www.力学.com/management/long-term-management-of-中风.
• Medelson SA, Prabhakaran S. Pace of progress in 中风 thrombolysis: are hospitals running to st和 still? Circ Cardiovasc Qual Outcomes. 2017; 10 (1): e003438.
• Neuroimaging for acute 中风. EBSCO DynaMed网站. 可以在: http://www.力学.com/evaluation/neuroimaging-for-acute-中风.
• Stroke (acute management). EBSCO DynaMed网站. 可用 在:http://www.力学.com/management/中风-acute-management-1.
• 蛛网膜下腔出血. EBSCO DynaMed网站. 可用 在:http://www.力学.com/condition/subarachnoid-hemorrhage.