What are the symptoms of cerebral embolism?

Written by Liu Yan Hao
Neurology
Updated on September 03, 2024
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Brain embolism usually begins suddenly and develops rapidly, often reaching a peak in a very short time. This can cause patients to quickly become comatose or experience weakness in limbs on one side of the body, with some presenting with complete paralysis or speech impairments. These symptoms occur because a major blood vessel in the brain is blocked abruptly, leading to ischemia and tissue necrosis in the supplied area. Common sources of the emboli include plaques in the cervical arteries, where soft plaques can dislodge and form emboli that block cerebral vessels with the bloodstream. Alternatively, patients with atrial fibrillation may suffer from embolism when thrombi attached to the inner walls of the heart dislodge and block cerebral vessels through circulation. Brain embolism is generally a severe condition with a rapid onset.

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Written by Liu Yan Hao
Neurology
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Can people with cerebral embolism run?

Patients with cerebral embolism can jog moderately, but walking is highly recommended. This is because the common source of the embolus in cerebral embolism patients is a mural thrombus in the heart. The common causes of mural thrombus formation include arrhythmia and atrial fibrillation. Therefore, patients with cerebral embolism, who may also have coronary artery disease, atrial fibrillation, or cardiac mural thrombus, are not well-suited for running, which is a relatively intense form of exercise. They can jog moderately, but the distance and duration should not be too long. The most recommended form of exercise is walking. Walking is the best form of exercise to prevent worsening the condition after running, and it could also exacerbate coronary artery disease conditions.

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Written by Zhang Hui
Neurology
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Is cerebral embolism the same as cerebral infarction?

Brain embolism is a form of cerebral infarction, so essentially, it is also a type of cerebral infarction. Cerebral infarction encompasses a wider range, including cerebral thrombosis, lacunar infarction, watershed infarction, and others. Brain embolism primarily refers to abnormal substances entering the bloodstream, which then enter the arteries of the brain, causing obstruction in these arteries and leading to ischemia and hypoxia of the brain tissue, thus presenting clinical symptoms of cerebral infarction. The onset of the condition in patients is quite severe, rapidly leading to paralysis of limbs and disorders of speech function. In cases of extensive brain embolism, patients may even experience coma and death as serious complications. Most patients with brain embolism have a history of atrial fibrillation. Atrial fibrillation can lead to the formation of mural thrombi, and when these thrombi dislodge, they can cause brain embolism.

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Written by Zhang Hui
Neurology
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Guidelines for Thrombolytic Therapy for Cerebral Embolism

Cerebral embolism is a particularly dangerous type of ischemic cerebrovascular disease. Patients present with a very abrupt onset, typically with a history of atrial fibrillation. Acute onset rapidly leads to limb paralysis, and may also cause disturbances in consciousness and seizures, among other clinical manifestations. Current guidelines for thrombolytic treatment of cerebral embolism do not address extensive cerebral embolism, as thrombolysis in extensive cerebral embolism carries a certain risk of bleeding and is not generally advocated in clinical practice. Mainly, arterial thrombectomy treatment can be administered within an eight-hour window, which can provide significant therapeutic effects for some patients. Additionally, if the cerebral embolism is considered small and the patient's consciousness is relatively intact, intravenous thrombolytic treatment can be given. The time window for intravenous thrombolysis is generally within four and a half hours, so it is crucial to get to a hospital as quickly as possible in the event of a suspected cerebral embolism.

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Written by Zhang Hui
Neurology
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Causes of cerebral embolism

Any abnormal substance entering the cerebral arteries causing ischemia, hypoxia, and necrosis of brain tissue is called cerebral embolism. The causes of cerebral embolism mainly include the following types: The first type is cardiogenic cerebral embolism, which is caused by heart diseases. For example, the most common atrial fibrillation is the most common cause of cerebral embolism. Atrial fibrillation can lead to the formation of some mural thrombi. These thrombi form, detach, and enter the cerebral arteries causing embolism. Additionally, myocardial infarction is also an important cause, and patients with myocardial infarction can also form some abnormal thrombi in the heart. Second, other causes, such as air embolism. In patients with fractures, a large amount of fatty tissue enters the cerebral arteries, which can also cause cerebral arterial embolism. Moreover, some venous thrombi from the lower limbs can also form cerebral embolism. During childbirth, the entry of amniotic fluid into the brain can also cause cerebral embolism.

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Written by Zhang Hui
Neurology
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Can cerebral embolism be treated with thrombolysis?

For patients with cerebral embolism, if the onset is not particularly severe and the area of the embolism is not very large, for example, if the patient's consciousness is still clear, then thrombolysis can still be feasible. It is now also relatively advocated because the risk of cerebral hemorrhage is relatively small in such cases. However, if the area of the cerebral embolism is large, especially if the patient has fallen into a coma or other consciousness disorders, and shows conjugate gaze palsy, then the risk of thrombolysis is very high, and there is a very likely risk of conversion to cerebral hemorrhage. In such cases, thrombolysis is not recommended, and arterial thrombectomy can be performed instead, which can greatly save the patient's life and improve the quality of life. Besides thrombolysis and thrombectomy, anticoagulant therapy should also be administered after the condition stabilizes, as most cases of cerebral embolism are caused by atrial fibrillation, and anticoagulant therapy can prevent future attacks.