Can the blood vessels in a cerebral infarction be unblocked?

Written by Gao Yi Shen
Neurosurgery
Updated on September 03, 2024
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Whether the blood vessels in a cerebral infarction can be reopened is closely related to time. If it is within the hyperacute phase, which means within six hours from the onset of clinical symptoms to hospital admission, the majority of cases can undergo thrombolysis intravenously, or arterial thrombectomy to reopen the blood vessels. However, if the time exceeds this window, reopening is no longer feasible, and forced reopening at this stage can easily lead to the detachment of distal thrombi or cause reperfusion injury, which is more detrimental to the patient's condition. Therefore, it is impossible to reopen the blood vessels during the chronic phase or non-hyperacute phase. If treatment of this vascular occlusion is desired, vascular anastomosis can be considered, though the specific type of anastomosis surgery depends on the patient's specific condition at the time. Thus, the possibility of reopening a blood vessel in a cerebral infarction certainly depends on timing.

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Written by Gao Yi Shen
Neurosurgery
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Premonitory symptoms of cerebral infarction recurrence

The symptoms preceding the recurrence of a cerebral infarction mainly involve observing the symptoms presented during the initial incidence of the stroke. In many cases, the recurrent symptoms are very similar to those initially experienced. For example, if dizziness was a symptom during the previous episode, then dizziness could also be a precursor symptom in a recurrence, with similar nature and intensity of dizziness as before. Additionally, if previous symptoms included limb numbness, weakness, or speech impairment, similar signs might precede a recurrence. Clinically, it is imperative to address these issues before an actual recurrence occurs, such as actively pursuing antiplatelet aggregation therapy, lipid-lowering, and stabilizing plaques, and resorting to surgical treatment if necessary, to better reduce the chances of stroke recurrence.

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Written by Chen Yu Fei
Neurosurgery
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What tests are done for a cerebral infarction?

For patients with cerebral infarction, it is recommended to take the patient to a local hospital for timely treatment during the acute phase. A cranial CT scan or MRI should be performed to help assess the current situation. Cranial MRI plays an important auxiliary diagnostic role in identifying the specific location, extent, and severity of the cerebral infarction. It is advised to perform a cranial MRI during the acute phase for a clear diagnosis, and then decide the next step of the treatment plan based on the situation. Within the surgical window, thrombolytic therapy can be applied to achieve dissolution of the clot. If the optimal timing for thrombolysis has been missed, it is recommended that the patient be hospitalized to receive treatment, including intravenous drips, brain-nourishing drugs, nerve nutrition, and medications that invigorate blood circulation and remove blood stasis, to help improve the state of ischemia and hypoxia in the brain tissue.

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Written by Gao Yi Shen
Neurosurgery
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Methods of Cerebral Infarction

There are many methods for treating cerebral infarction, but it is essential to make judgments based on the situation, as each patient's condition is different and requires different treatment approaches. For patients with acute cerebral infarction, treatments such as emergency thrombolysis or thrombectomy can be undertaken. For chronic cerebral infarction, initially, medical treatment is applied, including managing blood pressure, lowering blood lipids, stabilizing blood sugar levels, quitting smoking and alcohol, etc. Subsequently, this includes the oral administration of antiplatelet aggregation medications, which can effectively reduce the recurrence of cerebral infarction. Finally, corresponding surgical treatments are considered, including endarterectomy, superficial temporal artery to middle cerebral artery anastomosis, and appropriate stent implantation surgeries, depending on the specific characteristics. (Specific medications should be administered under the guidance of a physician.)

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Written by Chen Yu Fei
Neurosurgery
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Symptoms of cerebral infarction

For patients with cerebral infarction, during the acute phase, they typically exhibit clear symptoms of headache, dizziness, nausea, and vomiting. Patients may experience slurred speech, difficulty speaking, and obvious articulation disorders. Additionally, some patients may develop facial nerve paralysis, deviation of the mouth to one side, drooling, and often exhibit clinical signs such as a shallower nasolabial fold and disappearance of forehead wrinkles. Furthermore, some patients may also experience dysphagia, manifested by coughing when drinking water, and may be accompanied by aphasia or motor dysfunction, primarily presenting as motor aphasia, mixed aphasia, anomic aphasia, and resulting unilateral limb paralysis.

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Precursors to cerebral infarction

For patients with cerebral infarction, before the onset of the illness, they often lack specific prodromal symptoms. Some patients may experience mild headaches, dizziness, nausea, and a clear feeling of discomfort. Additionally, some patients might experience numbness in the legs and involuntary twitching of facial muscles before the onset. Subsequently, some patients may also start to have drooping of the corner of the mouth to one side, drooling, slurred speech, and distinct articulation disorders. When these clinical presentations occur, it is necessary to be vigilant and seek timely medical attention at a local hospital. A cranial CT or MRI should be performed to confirm the diagnosis.