中風是指供應給腦部的血液受阻礙或嚴重減少,令腦部缺少氧氣及營養而造成。在幾分鐘內,腦細胞便會開始死亡。中風會令人們身體上、精神上及心理上有所影響。中風的後果差異可以很大,取決於血塊大小和出現病變的位置。如果受損的腦部區域是管轄某種功能,該功能有可能出現障礙,例如語言能力或身體活動能力等。
供應給腦部的血液受阻可以因為缺血(缺乏血液供應)或出血。局部缺血引起的血管阻塞或通過血栓形成或動脈栓塞,或由腦灌注不足。出血性中風是由腦血管的出血引起的,是直接到腦薄壁組織或進入蛛網膜下腔周圍的腦組織。因此,腦部受影響區域不能正常工作,這可能會導致一邊身體會出現一個或多個身體部位不能自主活動、不能理解或控制講話,或一側的視力出現障礙。
中風的危險因素包括高齡、高血壓、有中風病史或短暫性腦缺血發作(TIA)、糖尿病、膽固醇過高、抽煙、心室顫動。高血壓是中風最重要的危險因素。
中風可帶來一些身體缺陷,包括肌肉無力、麻木、壓瘡、肺炎、尿失禁、失用(不能履行學到的動作),日常活動困難、食慾減退、言語喪失、視力減退及疼痛。如果是嚴重中風,或在某些特別位置,如腦幹,有可能會導致昏迷或死亡。
中風可能會直接損害腦部控制情緒的部份或因中風而感到沮喪和受限而導致情緒問題。中風後情緒問題,包括焦慮、驚恐、情感平淡(無法表達情緒)、躁狂症及精神病。30至50%的中風倖存者患中風後抑鬱症,特徵是嗜睡、煩躁不安、睡眠障礙、自我形象低落等。抑鬱症會減低動力及令病情惡化,但可以用抗抑鬱藥治療。
情緒不穩是中風的另一個後遺症,患者除了情緒高低起伏大外,更有可能不適當地表達情感,譬如大笑或無緣故哭泣。雖然情感表達通常是根據患者的實際情緒,但情緒不穩的情況更嚴重的話,可能會導致患者沒有考慮因由或情感,出現「又哭又笑」的病徵(Pathological laughing and crying, PLC)。有些患者會表現出相反的情感,例如當開心的時候會哭泣。大約20%的中風患者會有情緒不穩出現。
中風可能導致認知障礙問題,包括感知障礙、失語、癡呆、注意力和記憶力。中風患者可能不知道他或她自己的殘疾,名為疾病失認症。而偏側空間忽略症的患者,只能參與其中一側的事物,例如請他讀報紙上的標題,他只讀右半而忽略了左半;請他數一數站在他病床前的人有幾名,他只數了站在右邊和前面的,而忽略了左邊的人。高達10%的中風患者會有癲癇發作,最常見於中風後的一周,中風的嚴重性會增加癲癇發作的可能性。
治療
缺血性中風偶爾用溶栓治療(「溶栓剋星」),而某些出血性中風需施神經外科手術。以治療方式令喪失的功能恢復的可稱中風康復,最理想的是以相關的治療恢復中風位置所影響的身體機能,如言語治療、物理治療和職業治療等。要預防復發的或需服用抗血小板藥物、亞士匹靈和潘生丁,以控制及降低高血壓,並使用他汀類藥物控制血脂。
因為活性氧(自由基)在人體氧化,而為了去除有害物質,抑制細胞凋亡。能傳達到神經的物質已被證實是有效,能減少因缺血引起的組織損傷,表現出神經保護作用。
中風
中風是因為供應到腦部的血液受阻或不足而形成腦功能喪失
National Institutes of Health Stroke Scale (NIHSS)
Score Stroke Severity
0 No Stroke Symptoms
1-4 Minor Stroke
5-15 Moderate Stroke
16-20 Moderate to Severe Stroke
21-42 Severe Stroke
1) Level of Consciousness
Alert; keenly responsive. (0 points)
Not alert, but arousable with minimal stimulation (1 point)
Not alert, requires repeated stimulation to attend or is obtunded and requires strong or painful stimulation to make movements (not stereotyped). (2 points)
Coma. Responds only with reflex motor or autonomic effects, or totally unresponsive. (3 points)
2) Patient Knows Month and Own Age
Answers both correctly (0 points)
Answers one correctly (1 point)
Both incorrect (2 points)
3) Patient Opens and Close Eyes on Command
Obeys both correctly (0 points)
Obeys one correctly (1 point)
Both incorrect (2 points)
4) Best Gaze (only horizontal eye movement)
Assesses ability for patient to track a pen or finger from side to side only using his or her eyes.
Normal (0 points)
Partial gaze palsy (1 point)
Forced deviation (2 points)
5) Visual Field testing
With the first eye covered, place a random number of fingers in each quadrant and ask the patient how many fingers are being presented. Repeat this testing for the opposite eye.
No visual field loss (0 points)
Partial hemianopia (1 point)
Complete hemianopia (2 points)
Bilateral hemianopia (blind including cortical blindness) (3 points)
6) Facial Paresis
While inspecting the symmetry of each facial expression the examiner should ask patient to show teeth or raise eyebrows and close eye.
Normal symmetrical movement (0 points)
Minor paralysis (1 point)
Partial paralysis (total or near total paralysis of lower face) (2 points)
Complete paralysis of one or both sides (3 points)
7) Motor Function of Right Arm
With palm facing downwards, have the patient extend one arm 90 degrees out in front if the patient is sitting, and 45 degrees out in front if the patient is lying down. As soon as the patient's arm is in position the investigator should begin verbally counting down from 10 while simultaneously counting down on his or her fingers in full view of the patient.
Normal (0 points)
Drift (1 point)
Some effort against gravity (2 points)
No effort against gravity (3 points)
No movement (4 points)
Untestable* (0 points)
8) Motor Function of Left Arm
Normal (0 points)
Drift (1 point)
Some effort against gravity (2 points)
No effort against gravity (3 points)
No movement (4 points)
Untestable* (0 points)
9) Motor Function of Right Leg
With the patient in the supine position, one leg is placed 30 degrees above horizontal. As soon as the patient's leg is in position the investigator should begin verbally counting down from 5 while simultaneously counting down on his or her fingers in full view of the patient.
Normal (0 points)
Drift (1 point)
Some effort against gravity (2 points)
No effort against gravity (3 points)
No movement (4 points)
Untestable* (0 points)
10) Motor Function of Left Leg
Normal (0 points)
Drift (1 point)
Some effort against gravity (2 points)
No effort against gravity (3 points)
No movement (4 points)
Untestable* (0 points)
11) Limb Ataxia
The patient should be instructed to first touch his or her finger to the examiner's finger then move that finger back to his or her nose, repeat this movement 3-4 times for each hand. Next the patient should be instructed to move his or her heel up and down the shin of his or her opposite leg.
None (0 points)
One limb (1 point)
Two Limbs (2 points)
12) Sensory by Pinprick
Normal (0 points)
Mild to moderate decrease in sensation (1 point)
Severe to total sensory loss (2 points)
13) Language
The patient should be asked to explain the scenario depicted in the first figure. Next, he or she should read the list of sentences and name each of the objects depicted in the next figure.
No aphasia (0 points)
Mild - Moderate aphasia (1 point)
Severe aphasia (2 points)
No speech production (3 points)
14) Dysarthria
None (0 points)
Mild - Moderate slurring (1 point)
Severe (2 points)
Intubated or other physical impediment to testing (0 points)
15) Extinction and Inattention
This is performed by having the patient close his or her eyes and asking him or her to identify the side on which they are being touched by the examiner. To test extinction in vision, the examiner should hold up one finger in front of each of the patient's eyes and ask the patient to determine which finger is wiggling or if both are wiggling.
Normal (0 points)
Inattention or extinction to bilateral simultaneous stimulation in one of the sensory modalities (1 point)
Severe hemi-inattention or hemi-inattention to more than one modality (2 points)
腦血管及腦細胞復原
BotaMedi腦中風復康計劃
自由基在人體內會產生氧化作用,身體需要清除自由基,達至抑制抗氧化劑的死亡。實驗證明,當抗氧化劑能抑制活躍神經傳遞物質的話,能夠減少組織因為局部性缺血而造成的傷害。所以,強效抗氧化劑能起到保護神經的作用。
BotaMedi醫療中心內,利用及控制能夠穿血腦屏障(BBB),擁有回復細胞健康功能的Botamedi海洋多酚份量,為受損腦細胞及腦血管健康研發和提供復康方法。
服用BotaMedi海洋多酚
-
能滲透到血腦屏障 (BBB)
-
無副作用
-
強效消炎
-
抗氧化力
-
增強血液循環
-
增強新陳代謝
-
保護細胞
-
活化細胞
除此之外,由於中樞神經系統病症引起的運動神經元退化及肌肉僵硬而造成的活動阻礙,配合能令回復細胞健康的乳膏按摩,有效地改善因為腦中風後遺症引起的各種症狀。