Guidelines for Thrombolytic Therapy for Cerebral Embolism

Written by Zhang Hui
Neurology
Updated on September 20, 2024
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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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What department should I go to for a cerebral embolism?

Brain embolism is a disease in the field of neurology, and one can consult a department of neurology for it. Patients with brain embolism often have a rapid onset, generally with a history of atrial fibrillation. Some thrombi attached to the heart dislodge into the cerebral arteries, causing brain embolism. Symptoms can rapidly develop, including limb paralysis and speech disorders. If the affected area in the brain is large, it may even lead to consciousness disorders and epileptic seizures. For the treatment of brain embolism, interventional thrombectomy can be performed, but there is a strict limitation on the timing window. It should be noted that patients with brain embolism have a high probability of transforming into cerebral hemorrhage, and caution must be exercised during treatment.

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

Patients with cerebral embolism can appropriately eat some mutton, but not too much, as the main dietary approach is a low-salt diet. Additionally, foods high in fat should not be consumed excessively, because a common cause of cerebral embolism is the hardening of blood vessels in the neck, carotid artery plaques, especially when soft plaques break off and form emboli that block cerebral vessels through the bloodstream. Thus, consuming these high-fat foods excessively can exacerbate hyperlipidemia, worsen arterial sclerosis, and increase arterial plaque, potentially leading to the recurrence and aggravation of cerebral embolism. Therefore, patients with cerebral embolism can appropriately consume some mutton, as its fat content is not too high, but it should not be consumed in excess. Eating it in moderation is acceptable.

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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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Which department should I go to for a cerebral embolism?

For most hospitals, registration for cerebral embolism requires a visit to the Department of Neurology, which is the most specialized department for treating cerebral embolism. Cerebral embolism generally has corresponding causes, with the most common being heart diseases. For example, conditions such as old myocardial infarction or atrial fibrillation can easily form mural thrombi. These thrombi can detach, enter the cranial arteries through circulation, and cause cerebral embolism, leading to severe clinical consequences. The onset of the disease is very aggressive, quickly reaching a peak and resulting in limb paralysis or even consciousness disorders, requiring emergency treatment. If it is within the thrombolytic time window, intravenous thrombolytic therapy can be administered after assessment. However, one must be cautious of the risk of hemorrhagic transformation during thrombolysis for cerebral embolism. If within a certain timeframe, arterial thrombectomy can also be performed, and many in the Department of Neurology are capable of conducting such surgeries.

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Written by Liu Yan Hao
Neurology
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What are the symptoms of cerebral embolism?

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.