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.)

Other Voices

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Written by Zhang Hui
Neurology
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What is the cause of swollen feet after a stroke?

Patients with cerebral infarction presenting with swollen feet and lower limb edema should be aware of the following reasons. The first scenario is due to reduced activity in the limbs on the paralyzed side, which results in weaker muscle contraction. Consequently, a large amount of blood accumulates in the lower limb veins, causing poor circulation and naturally leading to swollen feet. Therefore, it is crucial for patients to begin early rehabilitation training, engage in muscle massage, and perform passive joint exercises, among other activities. The second scenario that requires close attention is the formation of venous thrombosis in the lower limbs on the paralyzed side after a cerebral infarction. This condition can easily lead to venous thrombosis, which significantly contributes to foot swelling. Furthermore, it increases the risk of pulmonary embolism. It is important to complete routine coagulation tests and d-dimer examinations, as well as comprehensive lower limb venous Doppler ultrasound assessments.

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Written by Tang Bo
Neurology
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Cerebral infarction X-ray manifestations

Brain infarction generally does not involve X-rays because X-rays primarily target bone issues, not brain tissue issues. If a brain infarction occurs, a cranial CT or MRI can be performed. In acute cases of sudden onset, a cranial CT is primarily used to exclude cerebral hemorrhage, as brain infarction typically does not show up in the acute phase. However, in cases of extensive brain infarction, changes might also appear on a CT during the acute phase. Additionally, after the acute phase, about 1 day or 24 hours later, brain infarctions generally appear as low-density shadows on a CT. On an MRI, in diffusion imaging, brain infarctions generally appear as high-density, high-signal areas, while they appear as low-signal areas in T1 imaging and high-signal areas in T2 imaging. It is also suggested to perform cranial magnetic resonance angiography to examine the status of the blood vessels.

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Written by Tang Bo
Neurology
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Lacunar Infarct Nursing Issues

Lacunar stroke is caused by the blockage of small blood vessels in our skull due to long-term risk factors such as hypertension, diabetes, or hyperlipidemia, leading to a stroke. Generally, the area of infarction is relatively small, typically less than 1.5 to 2 centimeters. Symptoms may or may not be present. In either case, the symptoms are usually mild and the prognosis is generally good. There are no special strict nursing requirements. If patients are active and can take care of themselves, they do not need special care. Furthermore, it is crucial to focus on secondary prevention, which is to prevent further occurrence of stroke, and to seek further treatment from a neurologist.

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Written by Zhang Hui
Neurology
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Imaging manifestations of cerebral infarction

For patients with cerebral infarction, in addition to collecting medical history and clarifying symptoms and signs, imaging examinations are also very important for the diagnosis and differential diagnosis of cerebral infarction. They are indispensable tools in clinical examinations. Cerebral infarction primarily requires cranial CT and MRI scans. On cranial CT, cerebral infarction lesions mainly appear as low-density areas and are easily distinguishable from cerebral hemorrhage. The lesions may cause swelling and have a certain mass effect. In cranial MRI, the appearance of cerebral infarction is primarily seen in diffusion-weighted imaging as a distinctly high signal, making it very easy to identify the responsible lesions. In T2-weighted images, the high signal is also clearly visible and easier to differentiate.

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Geriatrics
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Nursing Measures for Patients with Cerebral Infarction

The nursing measures for stroke patients vary according to different conditions. During the acute phase, the primary concern is life-threatening infections, while during the recovery and residual stages, the focus is on preventing various complications and risks. The care measures are categorized as follows: The first is dietary care. Relatives of stroke patients should be reminded that the diet should be light, low in fat, and high in fiber, following the principle of eating small meals frequently. The second is maintaining clear airways, preventing colds, especially tuberculosis, and ensuring that someone watches over the patient at all times. The third is the prevention of bedsores, assisting and maintaining regular patient turning and moderate activity. The fourth involves preventing burns, bruises, falls, and other injuries by creating a safe and comfortable environment for the patient, ensuring their safety and that there are no hazardous objects in the room. The fifth is preventing constipation which can be aided by abdominal massage and eating foods high in fiber. The sixth is preventing urinary tract infections, timely changing diapers for those patients who can urinate independently, or ensuring sterile techniques for those with catheters. The seventh is preventing falls from the bed, especially for those who are restless; installation of bed rails and other safety measures should be considered. The eighth concerns psychological care since many patients tend to become pessimistic and disappointed post-illness. Family members should be caring and provide comfort and encouragement to the patients. The ninth general care measure involves daily oral care with saline solution or brushing teeth every morning and evening, bathing the patient once or twice a week, and daily cleansing of the genital area.