Apoplsktichesky coma.

Clinic. Clinical implications and rendering assistance at acute disturbances of a cerebral circulation depend on character of a stroke. buy zyban 50mg
At a hemorrhagic stroke of a clod develops acutely. More often at height of an emotional or physical strain of the patient suddenly loses consciousness and falls. Integuments of the person purple-red, breath loud, rattling. Pulse strained. The mouth is half-opened. Often there is a vomiting. A cheek «» on the paralysis party. Eyeballs are rejected aside, up and quite often "float". Pupils are narrowed, are sometimes irregular. Their reaction to light is absent. The hemiparesis or a hemiplegia are possible. The muscle tone, as a rule, is lowered. and periosteal reflexes are lowered or do not cause. Appear pathological reflexes. Capsulate symptoms are sometimes observed. Function organs is upset. Pressure of liquor can be raised, in liquor the blood impurity is defined. Pulse strained. Arterial pressure is raised, it is more rare normal.
Rendering assistance. Prescribe hemostatics: Acidum aminocapronicum - 12-18 г in 400 ml of an aqueous solution of a glucose of 5 % or in an isotonic solution of sodium of Sodium chloridum intravenously driply with rate of 30 40 kap/mines within 10 days; Haemophobinum - inside on 1 table spoon 2-3 times a day.
The patient with the high arterial pressure strained by pulse, purple-red colouring of a face skin should be made an exsanguination (to take 100-300 ml of blood from an ulnar vein), on a head to put a bubble with ice, and it is even better - to impose a head sick of bubbles with ice and to hold them within several hours (in case of need - some days with breaks at 1-2 o'clock); to put Sinapismuses on a back surface of a neck. Prescribe Vicasolum, calcium gluconat.
To lower arterial pressure, use Dibazolum, a papaverine; intravenously driply enter a lytic admixture of following structure: : 2,5 % - 2 ml, Dimedrol of 1 % - 2 ml, Promedolum of 2 % - 1 ml, Novocainum of 0,5 % - 50 ml, a glucose of 10 % - 30 ml. In order to avoid a collapse strictly supervise level of arterial pressure.
Prescribe agents: Glycerinum, Lasixum (Furosemidum), Novuritum or Mannitum. Furosemidum can be entered intramusculary, intravenously
2 ml of a solution of 1 % in day, in serious cases - to 2 times a day, enter (10-20 % the solution prepared on distilled water or an isotonic solution of sodium of Sodium chloridum from calculation of 1,0-1,5 g/kg of mass of a body).
At an ischemic stroke the apoplectic coma can gradually develop. Harbingers in the form of a malaise, giddinesses, a headache, paresthesia, transient delicacy in extremities, difficulties of speech are often observed, paresises or paralyses of extremities develop. The consciousness is lost gradually within several hours or days. The person of the patient acyanotic, pulse soft, arrhythmic, breath is not changed or speeded a little up. buy levitra 100mg online
Rendering assistance. The patient should be laid so that the head was hardly above a trunk. Prescribe an Euphyllinum of 2,4 % of a solution of 5-10 ml intravenously to 10 ml of 40 % of a solution of a glucose or 1 ml of 24 % of a solution intramusculary, a papaverine of 1-2 % of a solution of 1-2 ml, Nospanum of a solution of 2-4 ml of 2 % or Nicospanum on 2 ml intravenously or intramusculary, Cordiaminum of 1 ml subcutaneously. At a high prothrombin ratio (norm of 70-90 %) apply anticoagulants direct (heparin) and indirect (Dicumarinum, Pelentanum, Phenilinum, etc.) Actions, Streptoliasum () - intravenously 100 000-250 000 which dissolve in 50 ml of an isotonic solution of sodium of Sodium chloridum or 5 % a solution of a glucose and enter fermental preparations with rate of 15-30 kap/minutes Use Fibrinolysinum (dissolve in an isotonic solution of sodium of Sodium chloridum from calculation 100-160 a preparation in 1 ml). To Fibrinolysinum solution add a heparin from calculation 10 000 on everyone 20 000 Fibrinolysinum and the admixture is entered into a vein with initial rate by of 10-15 kap/minutes Fibrinolysinum Daily dose duration of introduction 3-4 ч (5000-8000 Ed/ch) is peer 20000-40000