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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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 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 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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Symptoms and manifestations of cerebral embolism

The so-called cerebral embolism primarily refers to the presence of abnormal substances in the arteries, which block the smaller arteries leading to arterial occlusion, causing severe cerebral ischemia and hypoxia, and resulting in the necrosis of brain tissue. It generally occurs in patients with atrial fibrillation, where atrial fibrillation can form larger emboli that detach from the heart and can easily cause cerebral embolism. The symptoms of the onset are very sudden and rapidly reach their peak. Patients may experience coma and consciousness disorders, fixed staring of the eyes, paralysis of limbs, numbness of limbs, and an inability to sense pain and temperature in the limbs. Additionally, some may experience epileptic seizures and urinary and fecal incontinence. Cerebral embolism is a very dangerous disease, and once these symptoms appear, it is crucial to seek hospital treatment as soon as possible.

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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.