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 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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What is a cerebral infarction?

Cerebral infarction is essentially a manifestation of ischemic necrosis of nerve cells. However, in clinical practice, there are many factors that can cause cerebral infarction. It is essential to treat the underlying causes to effectively prevent the further occurrence and progression of cerebral infarction. One characteristic of nerve cells is that once necrosis occurs, they cannot regenerate. Consequently, all patients who suffer from cerebral infarction may have some residual neurological deficits. Mild symptoms include headaches and dizziness, while severe cases may experience numbness and weakness in the limbs, speech impairments, and even more severe conditions such as a vegetative state or death. Therefore, in the case of cerebral infarction, it is crucial to focus on prevention early on to reduce the extent of necrosis. This can effectively ensure one's safety and reduce the occurrence of various complications and sequelae.

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Written by Gao Yi Shen
Neurosurgery
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What should I do if a cerebral infarction causes vomiting?

Patients with cerebral infarction who experience vomiting must undergo timely relevant examinations. Cerebral infarction typically presents with symptoms such as dizziness, headache, and nausea. The presence of vomiting often accompanies the development of intracranial hypertension. At this time, it is crucial to administer an appropriate mannitol diuresis therapy to reduce intracranial pressure. Prompt use of metoclopramide injection or granisetron injection is also highly necessary, as these can effectively alleviate the symptoms of vomiting. However, it is essential to complete the appropriate examinations to clarify the changes in the intracranial condition. Vomiting caused by cerebellar infarction is relatively normal, but if nausea and vomiting occur elsewhere, it is crucial to determine the specific cause, and sometimes surgical treatment may be necessary. (Please use medications under the guidance of a professional physician; do not self-medicate.)

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Written by Gao Yi Shen
Neurosurgery
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Can a cerebral infarction be treated?

Stroke is treatable, but it must also be judged based on the situation. The meaning of "treatable" here is that various treatment plans can be used to reduce the further occurrence of cerebral infarction and the situation of recurrence. However, the nerve cells that have already suffered ischemic necrosis cannot be restored to exactly the same condition as before. This means that the best scenario is recovery to the point of being able to take care of oneself, but it is absolutely impossible to return to the state of freedom before the illness, such as running and jumping. Currently, there are many treatment methods, including medication and surgical treatment. Each of these is a mode of treatment, and each case's differences determine different treatment plans. Decisions must be made according to the situation.

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Written by Hao Li Bin
Neurosurgery
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How is a cerebral infarction treated?

The treatment principles for cerebral infarction include thrombolysis, anticoagulation, volume expansion, lowering blood pressure, and brain protection. The main goal is to improve the blood circulation in the ischemic area of the brain as soon as possible and promote the recovery of neurological functions. During the acute phase, patients should rest in bed as much as possible, enhance care for skin, oral cavity, respiratory tract, and excretion, and maintain electrolyte balance. If a patient still cannot eat 48 to 72 hours after onset, nasogastric feeding with liquid nutrition should be provided to ensure nutritional supply. The priority should be given to the patient's daily care, diet, and the management of other comorbidities. Since some patients with cerebral infarction cannot take care of themselves during the acute phase and may even have difficulty swallowing, without adequate nutrition, metabolic issues can arise quickly. In such cases, even the best medications can fail to achieve positive outcomes. Since cerebral thrombosis is the most common type of cerebral infarction characterized by high incidence, high mortality, high recurrence rate, and high disability rate, patients may experience mild hemiplegia or severe scenarios leading to loss of life. Therefore, lifelong medication is necessary to prevent recurrence, achieve secondary prevention, and ultimately reduce the recurrence of cerebral infarction.