Causes of cerebral infarction

Written by Gao Yi Shen
Neurosurgery
Updated on November 15, 2024
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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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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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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.

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Stroke treatment methods

For patients who suffer a stroke, it is crucial to immediately transport them to the nearest local hospital. At the emergency room of the local hospital, a cranial CT scan or MRI should be conducted to confirm the presence of a stroke, as well as to determine its exact range and severity. If there is an acute indication for surgery, thrombolytic therapy is recommended. If the optimal time window for thrombolysis has passed, it is advisable to use medications that invigorate the brain, improve blood flow to remove stasis, nourish the nerves, and enhance microcirculation in the brain tissue. This can effectively help improve the conditions of ischemia and hypoxia in the brain nerves. Furthermore, further treatment should be adjusted based on the patient’s condition. During treatment, attention should be paid to the prevention and treatment of various complications or comorbidities, such as pulmonary infections, urinary tract infections, hypoproteinemia, deep vein thrombosis, etc.

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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.