What should be done if the area of cerebral infarction is large?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on March 17, 2025
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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 Tang Bo
Neurology
1min 18sec home-news-image

Do you need to take medication for a long time for cerebral infarction?

Brain infarction generally requires long-term medication, and the specific medications to be taken can vary from person to person. Moreover, the choice of medication should be determined by a doctor based on the patient's condition and past risk factors. Brain infarction is a disease caused by multiple factors, with common causes including hypertension. In the case of hypertension, the choice of antihypertensive medication and the duration of treatment should be based on the patient's blood pressure to maintain it within a normal range. There is also a possibility that the condition is due to diabetes, as some diabetic patients are also prone to brain infarction. Such patients may need to use long-term antidiabetic drugs or insulin to control blood sugar. Additionally, antiplatelet medications might be necessary for brain infarction, but whether to use them should also be determined by the doctor based on the patient's specific circumstances. Since medications can have side effects, a comprehensive decision must be made on what drugs to use. (Note: The use of medications should be carried out under the guidance of a professional doctor.)

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Written by Tang Bo
Neurology
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CT manifestations of cerebral infarction

Brain infarction has different manifestations on CT scans at different stages. Generally, within 24 hours, the CT scan may not show any imaging of the cerebral infarction lesion. However, some patients, especially those with thrombosis in the middle cerebral artery, might exhibit a high density sign in the middle cerebral artery. In cases of large-scale cerebral infarction, some sulci on the side affected by the infarction may appear shallower, indicating possible brain swelling. Generally, within 24 hours, a CT scan can reveal a low-density image, which appears relatively darker. This condition is typically considered a brain infarction, and as time progresses, this dark, or low-density image, tends to become even darker. In some patients during the acute phase, although the infarction may not be apparent, a CT scan is performed to rule out bleeding, as CT is very sensitive to bleeding.

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Written by Wang Li Bing
Intensive Care Medicine Department
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How should aspirin be taken for cerebral infarction?

Aspirin should be taken for cerebral infarction. It can be used not only during the acute phase of cerebral infarction but also for secondary prevention treatment. If a patient suffers a cerebral infarction, thrombolytic interventional surgery can be conducted during the acute phase window. If the patient has missed the time for surgery, then choosing antiplatelet drugs like aspirin and clopidogrel, along with atorvastatin for lipid regulation and stabilizing plaques, is advisable. A follow-up CT should be done dynamically, and changes in the patient's consciousness and pupils should be monitored.

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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.

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Written by Tang Bo
Neurology
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Can moxibustion be used for lacunar infarction (a type of stroke)?

Lacunar stroke is when small blood vessels in the deep parts of our brain's hemispheres or brainstem, under the long-term influence of high blood pressure, diabetes, or other risk factors, cause the supplying arteries to undergo ischemic necrosis. The affected areas typically have a diameter of less than 1.5 to 2 centimeters, leading to an acute syndrome of neurological function impairment. Treatment of this disease first depends on the patient's age and risk factors to decide whether to use medication. Also, the prognosis is generally good; there is no need for moxibustion, as moxibustion has neither benefits nor harms for lacunar stroke.