Cerebral infarction

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Written by Xie Wen
Neurology
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Stroke rehabilitation exercise

In the early stages of a stroke, for bedridden patients, passive limb exercises can be conducted at the bedside. This includes joint loosening exercises and passive flexing of knee and elbow joints to prevent joint contractures. When not exercising, proper limb positioning is needed; sandbags can be placed on the inside of the upper limbs to avoid internal rotation, and the legs should be placed in stiff cloth shoes or T-bar shoes to prevent external rotation. Once the patient enters the recovery phase, they can gradually begin standing and walking exercises, while also receiving treatments such as medications, hyperbaric oxygen therapy, and acupuncture. (The use of medications should be under the guidance of a professional doctor.)

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Written by Zhang Hui
Neurology
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Imaging manifestations of cerebral infarction

For patients with cerebral infarction, in addition to collecting medical history and clarifying symptoms and signs, imaging examinations are also very important for the diagnosis and differential diagnosis of cerebral infarction. They are indispensable tools in clinical examinations. Cerebral infarction primarily requires cranial CT and MRI scans. On cranial CT, cerebral infarction lesions mainly appear as low-density areas and are easily distinguishable from cerebral hemorrhage. The lesions may cause swelling and have a certain mass effect. In cranial MRI, the appearance of cerebral infarction is primarily seen in diffusion-weighted imaging as a distinctly high signal, making it very easy to identify the responsible lesions. In T2-weighted images, the high signal is also clearly visible and easier to differentiate.

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Written by Tang Bo
Neurology
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Can moxibustion be used for lacunar infarction (a type of stroke)?

Lacunar stroke is when small blood vessels in the deep parts of our brain's hemispheres or brainstem, under the long-term influence of high blood pressure, diabetes, or other risk factors, cause the supplying arteries to undergo ischemic necrosis. The affected areas typically have a diameter of less than 1.5 to 2 centimeters, leading to an acute syndrome of neurological function impairment. Treatment of this disease first depends on the patient's age and risk factors to decide whether to use medication. Also, the prognosis is generally good; there is no need for moxibustion, as moxibustion has neither benefits nor harms for lacunar stroke.

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Written by Liu Yan Hao
Neurology
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Is a brain embolism the same as a cerebral infarction?

Cerebral embolism is a type of cerebral infarction, but not completely identical to cerebral infarction. Cerebral embolism occurs when an embolus from another part of the body outside the brain detaches and blocks a cerebral blood vessel. Cerebral embolism generally has a sudden onset, with a rapid development of symptoms, reaching a peak in a very short time, potentially causing severe conditions such as coma and paralysis of limbs within a short period. Common sources of emboli include arterial plaques in the neck vessels, particularly soft arterial plaques that are prone to detachment, forming an embolus that can obstruct cerebral vessels. Another common source of emboli is the detachment of mural thrombi from the inner walls of the heart, typically seen in patients with atrial fibrillation, where thrombi tend to form on the heart's inner walls and can detach to block cerebral vessels. Treatment includes the use of antiplatelet or blood-activating and stasis-dissolving drugs, as well as medications to stabilize plaques. It is vital to actively treat the primary disease, such as using anti-arrhythmic drugs for patients with atrial fibrillation.

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Written by Tang Bo
Neurology
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CT manifestations of cerebral infarction

Brain infarction has different manifestations on CT scans at different stages. Generally, within 24 hours, the CT scan may not show any imaging of the cerebral infarction lesion. However, some patients, especially those with thrombosis in the middle cerebral artery, might exhibit a high density sign in the middle cerebral artery. In cases of large-scale cerebral infarction, some sulci on the side affected by the infarction may appear shallower, indicating possible brain swelling. Generally, within 24 hours, a CT scan can reveal a low-density image, which appears relatively darker. This condition is typically considered a brain infarction, and as time progresses, this dark, or low-density image, tends to become even darker. In some patients during the acute phase, although the infarction may not be apparent, a CT scan is performed to rule out bleeding, as CT is very sensitive to bleeding.

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Written by Zhang Hui
Neurology
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Register in the neurology department for cerebral infarction.

Stroke is a very common disease in neurology. When registering at a hospital, you should definitely see a neurologist. Neurologists have rich experience in diagnosing and treating strokes. There are many causes of stroke, but the most common cause is atherosclerosis, and these patients usually have risk factors such as hypertension and diabetes. Acute onset of focal neurological deficits such as limb paralysis, numbness, and unclear speech are common clinical manifestations. In terms of treatment, antiplatelet medications and statins are typically used. Additionally, formal rehabilitation exercises are essential. (Specific medications should be administered under the guidance of a doctor, and self-medication should be avoided.)

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Written by Liu Yan Hao
Neurology
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Can a cerebral infarction be effectively treated?

Most cases of cerebral infarction can be treated effectively, except for some extensive cerebral infarctions, which may leave varying degrees of sequelae. During the acute phase of treatment for cerebral infarction, medications that promote blood circulation, improve circulation, prevent platelet aggregation, and anti-atherosclerosis drugs are used. If treatment can be administered within three hours of onset, intravenous thrombolysis can be performed, which may lead to a faster recovery if successful. Additionally, medications that eliminate free radicals are used during the acute phase to remove free radicals that damage brain cells. Other treatments involve the use of neurotrophic drugs to support the repair of damaged brain cells. After stabilizing the condition, active rehabilitation exercises are recommended, and most patients can be effectively treated.

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Written by Liu Yan Hao
Neurology
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Symptoms of cerebral infarction

Patients with cerebral infarction may exhibit paralysis of one side of the body and aphasia. If the patient has a brainstem infarction, symptoms may include unclear speech, difficulty swallowing, and coughing while eating. In cases of cerebellar infarction, there may not be symptoms of hemiplegia; the main symptom is usually dizziness. Additionally, large-scale cerebral infarctions can lead to disturbances in consciousness, manifesting as coma. Typically, cerebral infarctions do not affect consciousness unless they are extensive, which may also lead to coma. Moreover, patients with cerebral infarction often experience symptoms while resting quietly, commonly waking up in the morning to find themselves unable to speak or with paralysis on one side of the body, although their consciousness remains clear. These are typical manifestations of cerebral infarction.

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Written by Zhang Hui
Neurology
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What is the cause of swollen feet after a stroke?

Patients with cerebral infarction presenting with swollen feet and lower limb edema should be aware of the following reasons. The first scenario is due to reduced activity in the limbs on the paralyzed side, which results in weaker muscle contraction. Consequently, a large amount of blood accumulates in the lower limb veins, causing poor circulation and naturally leading to swollen feet. Therefore, it is crucial for patients to begin early rehabilitation training, engage in muscle massage, and perform passive joint exercises, among other activities. The second scenario that requires close attention is the formation of venous thrombosis in the lower limbs on the paralyzed side after a cerebral infarction. This condition can easily lead to venous thrombosis, which significantly contributes to foot swelling. Furthermore, it increases the risk of pulmonary embolism. It is important to complete routine coagulation tests and d-dimer examinations, as well as comprehensive lower limb venous Doppler ultrasound assessments.

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Written by Tang Bo
Neurology
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What foods should not be eaten in the case of a cerebral infarction?

Stroke refers to the necrosis of brain tissue, causing a series of neurological functional deficit symptoms. The dietary requirements for stroke must be determined comprehensively based on the patient's own condition and underlying diseases. For instance, common risk factors for stroke include hypertension, diabetes, hyperlipidemia, and elevated homocysteine levels, along with unhealthy habits such as smoking and drinking. If the patient has hypertension, a light diet should be emphasized. If they have hyperlipidemia, fatty foods should be avoided in favor of a low-fat diet. In cases of high homocysteine levels, it is advisable to consume foods rich in vitamins. Additionally, if the patient has diabetes, they must adhere to a diabetic and low-sugar diet. Therefore, what food can be consumed depends on the patient's underlying diseases and the symptoms of the stroke. If the patient has swallowing difficulties, care must be taken to avoid hard foods as this could lead to choking and potentially cause a lung infection. Thus, the patient's individual condition must be taken into account when deciding their diet.