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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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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Written by Gao Yi Shen
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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 Li Qiang
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The difference between lacunar infarction and cerebral infarction

Lacunar stroke is a type of cerebral infarction and is considered the mildest form within strokes. Generally, the area affected by a lacunar infarction is very small, so if it is a single incident or there are not many lacunar strokes, it usually does not cause any symptoms. Many middle-aged and elderly people over the age of fifty or sixty who undergo routine CT scans during physical examinations exhibit signs of lacunar stroke on their CT images, yet most of them do not present any clinical symptoms. Therefore, lacunar stroke may only affect brain function and result in symptoms such as speech difficulties, slow reactions, weakened muscle strength in the limbs, or lack of coordination when there are numerous occurrences. Cerebral infarction can include strokes that affect larger areas of the brain, which are much more severe than lacunar strokes. These larger strokes are sufficient to cause clinical symptoms, which may include hemiplegia, drooping of the corner of the mouth and drooling, abnormal limb movements, and even fatal events in cases of extensive cerebral infarction. Thus, lacunar stroke, being a type of cerebral infarction, represents the mildest form of stroke.

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Neurosurgery
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Causes of cerebral infarction

There are many causes of cerebral infarction, but the most common in clinical practice is the narrowing or occlusion of the carotid artery. Since the brain is supplied by four blood vessels, any issues with any of these vessels can potentially lead to a cerebral infarction. Conditions commonly known as the "three highs"—high blood pressure, high blood sugar, and high cholesterol—can easily lead to narrowing or even blockage of the blood vessels. Thus, these factors are fundamentally the cause. Additionally, smoking and drinking can also lead to vascular narrowing and cause cerebral infarction. In some special cases, autoimmune diseases can cause inflammation inside the vessels, leading to narrowing. Other causes include arterial tears due to trauma, which can lead to ischemia and infarction, or abnormal blood supply due to arrhythmias causing cerebral infarction.

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What department should I go to for a cerebral infarction?

When a patient suffers a stroke, it is advised to promptly visit a local hospital and consult a neurologist to assess the condition. Often, when an acute stroke occurs, treatment can be administered through thrombolysis. If the window for thrombolytic therapy is missed, conservative pharmacological treatment is recommended. Clinically, it is generally recommended to treat patients with medications that enhance brain function, promote blood circulation to remove blood stasis, and nourish the nerves. Patients’ vital signs should be closely monitored, and dynamic reassessment through head CT or MRI should be conducted to observe changes in the patient's condition. In cases of extensive stroke, it may be necessary to transfer the patient to neurosurgery for decompressive craniectomy surgery.