Is lacunar infarction dangerous?

Written by Tang Bo
Neurology
Updated on September 05, 2024
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Lacunar stroke is caused by pathological changes in some small blood vessels inside our skull, due to long-term hypertension or other factors, such as diabetes or immune factors, leading to the occlusion of the vessel lumen and the formation of small infarct lesions. Therefore, when these lesions appear, there may be symptoms, or there may be no symptoms; however, regardless of the situation, the prognosis is generally good. It is also necessary to assess the blood vessels to see if there are any major vascular abnormalities. If major vascular abnormalities are present, it could still be dangerous. If the abnormalities are confined to small vessels, the prognosis is generally good.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What should be done if the area of cerebral infarction is large?

If a large cerebral infarction occurs, brain edema often peaks within two to three days, and the mortality rate is extremely high. If medical attention is sought within six hours of onset, thrombolytic therapy can be considered. If emergency thrombolysis is exceeded, then only conservative drug treatment is available. For example, mannitol dehydration to reduce intracranial pressure, nourish neurons, protect brain cells, provide nutritional support, etc. After a stroke, it is essential to monitor changes in the patient's consciousness and pupils, dynamically assess the patient’s Glasgow Coma Score, and be aware of various potential complications. Family members should be well-informed about the patient's condition, etc. (Specific medications should be administered under the guidance of a doctor.)

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Written by Liu Yan Hao
Neurology
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Symptoms of cerebral infarction

Patients with cerebral infarction may exhibit paralysis of one side of the body and aphasia. If the patient has a brainstem infarction, symptoms may include unclear speech, difficulty swallowing, and coughing while eating. In cases of cerebellar infarction, there may not be symptoms of hemiplegia; the main symptom is usually dizziness. Additionally, large-scale cerebral infarctions can lead to disturbances in consciousness, manifesting as coma. Typically, cerebral infarctions do not affect consciousness unless they are extensive, which may also lead to coma. Moreover, patients with cerebral infarction often experience symptoms while resting quietly, commonly waking up in the morning to find themselves unable to speak or with paralysis on one side of the body, although their consciousness remains clear. These are typical manifestations of cerebral infarction.

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Written by Chen Ya
Geriatrics
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How should a stroke and a cold be handled?

It is recommended to actively address a cold in cases of cerebral infarction, as most people with cerebral infarction who also have motor disabilities are predominantly bedridden, making them prone to aspiration pneumonia. If a cold is not managed well and develops into pneumonia, it can further aggravate the condition, potentially worsening the perceived motor disabilities if timely functional rehabilitation is not administered, leading to further progression of the illness.

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Written by Xie Wen
Neurology
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Stroke rehabilitation exercise

In the early stages of a stroke, for bedridden patients, passive limb exercises can be conducted at the bedside. This includes joint loosening exercises and passive flexing of knee and elbow joints to prevent joint contractures. When not exercising, proper limb positioning is needed; sandbags can be placed on the inside of the upper limbs to avoid internal rotation, and the legs should be placed in stiff cloth shoes or T-bar shoes to prevent external rotation. Once the patient enters the recovery phase, they can gradually begin standing and walking exercises, while also receiving treatments such as medications, hyperbaric oxygen therapy, and acupuncture. (The use of medications should be under the guidance of a professional doctor.)

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Written by Chen Ya
Geriatrics
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Is a cerebral infarction a stroke?

Brain infarction is a type of stroke, and in traditional Chinese medicine (TCM), stroke is categorized as an illness, differentiated as external and internal wind. External wind, as discussed in "Treatise on Cold Pathogenic Diseases," occurs due to external evil invasions, also referred to as the Gui Zhi soup proof. Internal wind belongs to diseases caused by internal injuries, also termed brain stroke or sudden stroke. Commonly, stroke refers to the type caused by internal injuries involving disorders such as the chaos of qi and blood, obstruction of cerebral vessels, or blood overflow in the brain. It is a cerebral neurological disease identified mainly by sudden fainting, hemiplegia, numb limbs, difficult speech, facial distortion, and unilateral numbness. This condition is characterized by a sudden onset, rapid changes, and is akin to the pathogen of wind favoring rapid and multiple changes. The type of stroke discussed here is akin to a brain stroke. Brain infarction refers to the obstruction in a brain artery caused by various emboli such as intracardiac mural thrombi, atherosclerotic plaques, tumor cells, fibrocartilage, or air traveling with the bloodstream. When collateral circulation fails to compensate, it leads to ischemic necrosis of the brain tissue in the supplied area, causing focal neurological deficits. Cerebral hemorrhage, on the other hand, refers to bleeding within the brain tissue not caused by trauma but due to the rupture of intracerebral vessels. Both cerebral hemorrhage and brain infarction often result in varying degrees of motor deficits, cognitive impairments, and speech and swallowing difficulties, collectively referred to in stroke cases. Hence, brain infarction is considered a type of stroke.