Ischemic cerebrovascular disease is mainly divided into two types:
Acute ischemic cerebrovascular disease.
Acute ischemic cerebrovascular disease is relatively common, with sudden onset and rapid progression of symptoms, often involving unilateral neurological dysfunction. It typically affects the upper limb first and then extends to the same side. The condition continues to worsen over a few hours or days, causing headaches or fever. The progression of the disease is variable, with periods of severity and relief, and some may experience persistent worsening.
Transient ischemic attack.
A transient ischemic attack (TIA) occurs suddenly, lasting 2-30 minutes or even longer (rarely exceeding 1-2 hours), then subsides without leaving persistent neurological disorders. Throughout the attack, consciousness is preserved. If it lasts for several hours, even without causing permanent neurological damage, a brain CT scan performed afterwards may reveal the lesion site.
The second type is hemorrhagic cerebrovascular disease.
Brain hemorrhage occurs suddenly, often accompanied by headache, followed by persistent symptoms such as weakness, paralysis, numbness, loss of vision, and consciousness disorders. Nausea, vomiting, seizures, and loss of consciousness often occur within a few minutes. Doctors often do not need to perform any tests to make a diagnosis of brain hemorrhage.
Clinically, the symptoms of hemorrhagic cerebrovascular diseases can be mainly divided into two types:
One is intracerebral hemorrhage.
Intracerebral hemorrhage begins with sudden headache, followed by neurological disorders. Small intracerebral hemorrhages can cause focal neurological disorders, and their clinical manifestations are similar to those of ischemic strokes. Large intracerebral hemorrhages can lead to hemiplegia and functional disorders of the cerebellum or brainstem, manifesting as eye deviation towards the side of the bleeding site, or paralysis of the muscles controlling eye movement, pinpoint pupils, and patients may experience coma, nausea, vomiting, incoherent speech, and seizures.
In more than half of the cases with large intracerebral hemorrhages, death occurs within a few days. In survivors, as the bleeding is gradually absorbed, consciousness recovery and gradual improvement of neurological disorders are observed. After recovery, patients may remain with neurological dysfunction, such as difficulty in speaking.
The second type is subarachnoid hemorrhage.
Patients with subarachnoid hemorrhage may experience acute severe headaches, and the headache may be the only symptom. The temperature may rise in the first 5-10 days. Patients may experience varying degrees of neurological disorders, or changes in consciousness, sluggishness, or dementia.
When blood mixes with cerebrospinal fluid, it stimulates the meninges, causing increased intracranial pressure, which leads to headaches, vomiting, dizziness, and changes in pulse and respiratory rates. Patients may also occasionally experience seizures and neck stiffness.
