Imaging manifestations of cerebral infarction

Written by Zhang Hui
Neurology
Updated on March 06, 2025
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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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Written by Sheng Wang
Neurology
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How is lacunar stroke treated?

Lacunar infarction is a cerebrovascular disease. For lacunar infarctions caused by arteriosclerotic atherosclerosis, the main treatment is to prevent recurrence of infarction and dislodged plaques that cause blockages. Therefore, it is necessary to initiate treatments like aspirin, antiplatelet therapy, and atorvastatin to lower blood lipids and stabilize plaques. It is also important to control risk factors such as high blood pressure, diabetes, smoking, as well as conditions like hyperuricemia and hyperhomocysteinemia.

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Written by Wang Bo Min
Neurology
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Can lacunar infarction recur?

Lacunar stroke is a common disease in clinical practice, mainly caused by the blockage of capillaries in the brain, leading to the necrosis of some brain cells. Lacunar strokes often occur in middle-aged and elderly people over the age of 50. The main causes of lacunar stroke are hyperlipidemia and abnormal blood components, such as high blood sugar, high blood lipids, and high blood viscosity. At the same time, there is concurrent cerebral arteriosclerosis. The occurrence of lacunar stroke indicates that the degree of arterial sclerosis has reached a certain level, hence the recurrence rate of lacunar stroke in clinical practice is relatively high. Once a lacunar stroke occurs, it is recommended that patients take statins to lower blood lipids and medications like aspirin to prevent cerebral vascular blockage, to prevent further incidents.

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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 Wang Li Bing
Intensive Care Medicine Department
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What is a cerebral infarction?

Brain infarction is also relatively common in clinical practice, mainly seen in elderly people, generally accompanied by underlying diseases such as hypertension, hyperlipidemia, and diabetes. Brain infarction is primarily caused by the blockage of cerebral blood vessels, leading to necrosis of brain tissue due to ischemia and hypoxia. After a brain infarction occurs, patients should seek medical attention in a timely manner and be admitted to the department of neurology or neurosurgery for systematic drug treatment. If the infarction area is large or a brain herniation has formed, surgical intervention should be considered, such as decompressive craniectomy and lowering intracranial pressure.

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Written by Li Min
Neurology
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Can lacunar infarction be treated?

Lacunar stroke, also known as lacunar infarction, refers to a type of brain infarction where the diameter of the affected area ranges from 2 millimeters to 15 millimeters. It is treatable, typically caused by atherosclerosis of cerebral arteries leading to ischemia and hypoxia in small capillaries, and subsequently, localized tissue necrosis. These usually occur more frequently beneath the cortical layer of brain tissue, as this area has a dense distribution of small blood vessels and is thus more prone to lacunar infarcts. However, if a lacunar infarct occurs in critical areas such as the thalamus, brainstem, basal ganglia, internal capsule, or the limbs and knee regions within the internal capsule, it can lead to a variety of clinical symptoms. The range and types of these clinical symptoms are diverse, including pure sensory, pure motor, mixed sensorimotor numbness in limbs, and issues with peripheral circulation. Though generally, treatment is relatively quick and straightforward, delays in treatment could lead to more severe clinical symptoms.