Cerebral infarction (I63 according to ICD-10 classification) is a serious pathological condition characterized by necrosis (necrosis) of brain tissue. It occurs as a result of ischemic stroke - a violation of the blood supply in the cerebral arteries, which leads to oxygen starvation of the brain, causes damage to the tissues of a certain part of the brain and dysfunctions. For this reason, ischemic stroke itself is sometimes called cerebral infarction. This disease is one of the leading causes of death.
In case of damage to the anterior cerebral artery, involuntary grasping reflexes, paresis of the leg, disturbances in eye movements, and motor aphasia are observed.
Why does cerebral infarction develop, what is it and how does it differ from a stroke?
What causes a cerebral infarction? The immediate cause is acute ischemia, that is, insufficient blood supply to the brain. It can be caused by blockages, spasms, or compression of the arteries that supply blood to the brain. Emboli, blood clots, less often - air bubbles or drops of fat can clog the vessels. Sometimes a violation of the blood supply to the brain occurs due to cardiovascular insufficiency, leading to ischemia and hypoxia of the brain. The most common cause of ischemic stroke is thrombosis in cerebral atherosclerosis or as a result of cardiogenic embolism.
Regardless of what became the triggering mechanism of ischemia, the pathological process develops in the same way: a violation of blood flow leads to a violation of protein synthesis and the breakdown of glucose in nerve cells. The trophism of the brain is disturbed, oxygen starvation occurs. In the area of the brain where oxygen has ceased to flow, the process of cell death begins, i.e., necrosis develops. However, if the blood supply to the affected area is quickly restored, the nerve cells are restored. Otherwise, a massive cerebral infarction occurs.
Due to energy hunger, nerve cells cannot maintain the constancy of their metabolism and undergo necrosis. Swelling of the brain develops. Due to edema, the brain inside the cranium is compressed, its structures are displaced, possibly depression of the cerebellum, wedging of the medulla oblongata into the occipital foramen. This is often fatal.
In case of impaired blood flow in the middle cerebral artery - paresis and sensory disorder of the upper extremities and lower half of the face, sensory and motor aphasia, head tilting.
The main risk factors contributing to the development of cerebral infarction:
In addition to the listed diseases, there are risk factors associated with lifestyle, individual characteristics and bad habits:
Depending on the pathogenetic characteristics, the following types of cerebral infarction are distinguished:
Thromboembolic infarction includes atherothrombotic and cardioembolic. In atherothrombotic infarction, thrombosis or embolism of an arterial vessel occurs from foci of atherosclerosis of the intracerebral arteries. Cardioembolic cerebral infarction develops as a result of cardiocerebral embolism in heart disease. In this case, emboli formed in the cavities of the heart are brought into the arterial system of the brain with the blood flow.
With impaired blood circulation in the posterior cerebral artery, visual impairments occur, problems with understanding speech and memory.
The thromboembolic type also includes hemodynamic cerebral infarction, which occurs with a sharp drop in blood pressure against a background of gross stenosis of the vessels of the brain or neck.
The symptoms of cerebral infarction depend on the localization of the lesion. The disease can have an acute or subacute course, usually of a progressive (less often wavy) character. In most cases, everything happens within a few minutes, less often - hours or days.
The immediate cause is acute ischemia, that is, insufficient blood supply to the brain. It can be caused by blockages, spasms, or compression of the arteries that supply blood to the brain.
In the future, surgical intervention can be used to treat a heart attack. With the help of the operation, it is possible to eliminate the factors that led to the blockage of blood vessels, which reduces the risk of re-infarction by 70%. Also, surgical treatment can be used to increase blood perfusion, decrease intracranial pressure, and maintain cerebral blood flow.
Why is a cerebral infarction dangerous? The consequences of a cerebral infarction in the absence of timely medical care can be very serious, including death. This disease ranks second in the structure of mortality after myocardial infarction and belongs to the category of diseases requiring long-term rehabilitation measures.
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Content
Violation of cerebral blood supply of a hemorrhagic or ischemic nature, which leads to focal or extensive necrotic changes in brain tissue, is called a heart attack, stroke or apoplexy. As a rule, pathology is manifested by sudden weakness in the limbs, dizziness, facial asymmetry, impaired consciousness, speech, vision. Diagnose a violation of cerebral circulation on the basis of examination, the results of clinical studies.
This term denotes an acute vascular catastrophe that develops as a result of chronic pathologies or abnormalities of cerebral vessels. Depending on the mechanism of development, there are two main types: hemorrhagic and ischemic.
In the first case, vascular insufficiency is caused by a rupture of the vessel, and in the second, by a violation of the patency of the cerebral arteries. Ischemic cerebral infarction accounts for about 80% of all cases of pathology, usually observed in patients over 50 years of age. The hemorrhagic form of the disorder is typical for people aged 30-40 years.
Extensive cerebral infarction causes necrotic changes in large areas of tissues due to a violation of trophic and oxygen supply. As a rule, pathology occurs due to the cessation of blood flow in one of the internal carotid arteries. Depending on the location of the lesion, a heart attack can have different consequences. With this type of cerebrovascular accident, the prognosis is poor.
Depending on the etiology and localization, the following forms are distinguished:
The severity of the lesion and clinical manifestations depend on the diameter of the blocked or ruptured vessel, its localization. The conditionally pathological process is divided into several stages:
Symptoms of cerebral circulation disorders begin to appear immediately after the first stage of the pathological process. With timely medical care (hospitalization, taking anticoagulants, etc.), which will restore the blood supply to tissues and cells, further development of pathology will not occur, complications, the consequences of an apoplectic stroke will be minimal.
The main reasons for the development of cerebral infarction are atherosclerotic vascular lesions and high blood pressure. Stress, nervous strain, high cholesterol, etc. can provoke apoplexy. Ischemic or hemorrhagic cerebral infarction, as a rule, does not occur suddenly, but develops over several months or years.
The defeat of the cerebral vessels is often a consequence of the dysfunction of several organs and systems at once. Among the main reasons for development are the following:
The clinical picture of pathology depends on the etiology, localization and volume of necrotic changes in cerebral tissue. Common symptoms include:
Any type of cerebral infarction can cause a number of adverse effects that reduce the patient's standard of living or lead to disability. These include:
To prescribe effective treatment, the doctor needs to assess the degree of brain damage, its nature and location of the necrotic focus. If a cerebral infarction is suspected, the following instrumental and laboratory tests are prescribed:
First aid to the victim is of great importance in cerebral infarction. With the right and timely measures, you can significantly reduce the risk of death and dangerous complications. There are the following recommendations for first aid for a heart attack:
Due to the rapid death of functional brain cells, neurological disorders develop. Depending on the type of infarction, the volume of the necrotic focus, the lesion may have the following outcome options:
The probability of death during the first weeks after the lesion, according to statistics, is about 20% in ischemic type of pathology and approximately 55% in hemorrhagic. The main causes of death are complications (heart failure, thromboembolism, myocardial infarction). In this case, the age of the patient and the presence of chronic diseases are of great importance.
In order to avoid a cerebral infarction, it is necessary to lead a healthy lifestyle, undergo regular medical examinations and timely treat chronic diseases. To prevent the development of such a dangerous pathology, there are a number of recommendations:
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Cerebral infarction is one of the most dangerous pathologies, while becoming more and more common, including among middle-aged people. The prognosis of the disease is largely determined by the timeliness of the provision of qualified medical care and the subsequent care of the patient.
The disease in question is an acute clinical syndrome manifested by impaired brain function due to the cessation of blood supply to one of its departments. The location and extent of the lesion may vary. If blood does not enter the brain tissues, regardless of the trigger mechanism, hypoxia (oxygen starvation) and a number of other metabolic disorders, pathobiochemical changes are observed. These processes, called the "ischemic cascade", lead to irreversible damage to the affected neurons and their death - a heart attack.
When ischemic cerebral infarction occurs, a zone is formed around the necrosis focus where blood flow is impaired, but has not reached a critical level ("ischemic penumbra"). In this area, neurons are not yet subjected to morphological changes, and for some time they retain their functioning. If treatment is started on time (no later than 3-6 hours after an attack), blood circulation is normalized, nerve tissues are restored. In the absence of therapy, these cells also begin to die off.
Many are interested in whether the concepts of "cerebral infarction" and "stroke" are equivalent, what is the difference between them. The term "heart attack" in medicine, meaning tissue necrosis due to lack of blood supply, is applicable to many organs, while "stroke" means the same, but only in relation to the brain. This distinction is made in order to avoid confusion, therefore cerebral infarction and cerebral stroke are synonyms.
In about twenty percent of cases, lacunar cerebral infarction develops, characterized by the appearance of a small necrotic focus in the deep tissues of the cerebral hemispheres or in the stem region. The maximum size of the affected tissues is 1.5-2 cm in diameter. The pathology is often caused by the defeat of small arteries that feed these parts of the brain. Subsequently, a cyst filled with cerebrospinal fluid forms in place of the dead tissue. Such education, as a rule, is not dangerous and does not provoke significant disorders.
When a massive cerebral infarction is diagnosed, this means that necrotic changes affect large areas of the cerebral hemispheres due to the cessation of blood flow in one of the carotid arteries. Depending on which of the hemispheres is affected (left or right), such a cerebral infarction has different consequences. In many cases, the prognosis for this type of pathology is poor.
Cerebral infarction associated with damage to cerebral vessels often does not occur suddenly, at once, but develops gradually in the presence of certain diseases and predisposing factors. Blockage of cerebral vessels can be provoked by:
In addition, circulatory disorders can occur when the integrity of the vessels is violated or due to their prolonged spasm. The causal factors are often:
Ischemic cerebral infarction with damage to a small area of nerve tissue in some cases is not easy to recognize due to the worn out symptoms, but with a large-scale lesion, the clinical picture is pronounced, and the consequences do not exclude death in about forty percent of victims. If help is provided in a timely manner, the chances of a favorable outcome are high.
With a cerebral infarction, precursor symptoms are sometimes observed, which appear in most patients in the early morning or at night, several hours or even days before the attack. This is often:
We list the main signs of a cerebral infarction, some of which are observed with one or another type of pathology:
The diagnosis of cerebral infarction can lead to many other pathologies, the most common of which are:
If a person nearby is found to have manifestations that may indicate a cerebral infarction, you should urgently call doctors and provide the victim with first aid:
Patients diagnosed with cerebral infarction are treated in the following basic directions:
Patients and their relatives should tune in to long-term treatment, be patient, be sure to believe in healing and follow all medical recommendations, which increases the chance of success. In some cases, neurosurgical interventions are required to restore vascular patency, but more often only conservative treatment is required. Drug therapy involves the use of the following groups of drugs:
Many are familiar with the concept of "heart attack", but few understand what a cerebral infarction caused by thrombosis of cerebral arteries is.
This serious disease, which is not always completely treatable, can significantly disrupt the functions of the brain, negatively change the quality of human life and even cause death.
A heart attack is tissue necrosis, that is, their irreversible death. The most common cause of cerebral infarction is a complete blockage of the arteries that provide a constant flow of blood and oxygen to the cells of the organ. Tissues that have ceased to receive nutrition begin to experience starvation, after which they die.
Mostly elderly people are susceptible to the disease. The older a person is, the greater the risk of developing a cerebral infarction.
Blood cannot pass through the artery, therefore, seeping through the walls of the vessels, and more often, breaking them, enters the brain tissue. At the same time, intracranial pressure increases, parts of the brain are displaced or infringed, its membranes are destroyed and the organ swells.
The following factors influence the development of the disease:
At risk are also elderly people suffering from chronic heart disease, arterial hypertension, with a history of diabetes mellitus, smoking, alcohol abuse and women who have been taking hormonal contraceptives for a long time.
A few days before the blockage, patients may experience a headache, numbness in the limbs, and dizziness. The condition continues to deteriorate, aphasia is observed - a violation or absence of speech, paralysis of the limbs occurs.
Tendon reflexes decrease, pathological reflexes unusual for a healthy person may appear, muscles weaken, swelling occurs, dystrophy of the joint tissues (arthropathy) occurs, accompanied by severe pain, flexion or extension of the limbs (contracture) is often difficult.
It is important to notice the onset of the disease in order to prevent irreversible consequences in the brain as soon as possible.
There are the first signs indicating the formation of a blood clot in the vessels of the brain and impaired blood flow:
Emergency diagnosis is most effective when using computed tomography, which allows you to identify a heart attack, to distinguish it from hemorrhage.
Magnetic resonance therapy is also used, which makes it possible to examine the vessels.
Successful elimination of thrombosis by more than 70% reduces the likelihood of repeated heart attacks
In the absence of modern diagnostic devices, spinal cord puncture is performed and cerebrospinal fluid (CSF) is taken for analysis. The presence of impurities in her blood means that a cerebral hemorrhage has occurred.
Doppler or duplex scanning is used to examine the carotid arteries. The most effective method is angiography of the cerebral arteries - examination of the vessels by introducing a radiopaque substance into them, which allows detecting the localization of thrombosis and assessing the degree of blockage of the lumen.
The last diagnostic method is used strictly according to indications. There is always a risk of damage to the blood vessels by the catheter through which the substance is injected, which can lead to a stroke.
Cerebral infarction caused by thrombosis of cerebral arteries requires urgent hospitalization of the patient. Therapy should be started within the first hours after the attack - this significantly increases the chances of saving the patient's life.
A decrease in the ability of blood to clot in the first two hours, the use of medications that thin the blood, can significantly reduce the risk of paralysis, as well as other serious complications. However, in case of cerebral hemorrhage, the administration of these drugs is contraindicated.
Treatment consists of systematic therapy:
According to indications, it may be necessary to use surgical methods of treatment. Blockage of the carotid artery is an indication for surgery.
In some cases, surgery is necessary to lower intracranial pressure, normalize cerebral blood flow, increase perfusion pressure and supply oxygen to brain cells.
Dehydration drugs, diuretics are prescribed to eliminate excess water from the body. Therapy with anticoagulants is mandatory - drugs that reduce blood clotting, fibrinolytic drugs are used that promote the resorption of blood clots, preventing their formation.
The patient continues to take medications to reduce the swelling for several days.
The most important stage after the provision of emergency care and normalization of blood flow is the recovery period.
Rehabilitation consists of the following actions:
Also, moral support of family members is needed, which will not allow a person to fall into depression, to lose the meaning of life.
If necessary, it is better to use the help of a specialist - a psychologist who, using professional methods, will help return the patient to a positive attitude and faith in a successful recovery.
Prevention of cerebral infarction and vascular thrombosis should be started even in adulthood, trying to lead a healthy lifestyle, and also to reduce the effect of all negative factors affecting the effective functioning of the cardiovascular system.
Preventive measures are as follows:
| Maintain normal blood pressure (140/90 mm Hg) | In the presence of arterial hypertension, it is necessary to take daily medications prescribed by the doctor that reduce blood pressure and prevent the growth of its indicators. |
| It is important to quit smoking completely | Cigarettes are the main factor contributing to the formation of thrombosis, progressive atherosclerosis. People who smoke are 50% more likely to suffer from heart and brain infarction. |
| Do not abuse alcoholic beverages | In old age, it is better to completely refuse to take alcohol. Toxic decay products remaining in the blood after drinking alcohol, lead to an increase in blood pressure, complicate the course of hypertension, and also negatively affect the functioning of the kidneys, disrupt the heart rhythm and often provoke a cerebral infarction. |
| Treatment of heart defects, ischemia, heart failure | These pathologies increase the likelihood of cerebral infarction. |
| If a woman has a history of arterial hypertension, frequent migraines | It is better to give up oral hormonal contraceptives. The risk of heart attack increases when this factor is combined with smoking. |
| Controlling blood sugar | Treatment of diabetes mellitus by following a special diet without carbohydrates, taking drugs that reduce the amount of sugar, significantly reduces the risk of heart attacks against the background of blockage of blood vessels. |
| Cholesterol Support | It promotes the formation of atherosclerotic plaques in the coronary vessels and in the carotid arteries. |
The brain is the most important organ responsible for all processes in the body. The irreversible consequences of a heart attack can completely deprive a person of a full life, the ability to move, walk, talk, than cause serious nervous disorders and depression, and deprive the craving for life.
Cerebral infarction caused by thrombosis of cerebral arteries is a disease that requires immediate treatment. The effectiveness of subsequent therapy and rehabilitation measures directly depends on the provision of first aid within two hours after the onset of a heart attack.
Emergency therapy will increase the chances of not only returning all the joys of life to a person, but also the opportunity to live for many more years.
The human body, in fact, is a fragile thing and danger to its life can lie in wait at every corner. So, if some injuries in themselves are not dangerous, then their complications can lead to serious pathologies. One of these is cerebral vascular embolism.
A cerebral embolism is a sudden occlusion of the cerebral vessels by an embolus, which is sometimes a consequence of the development of ischemic stroke. The condition is dangerous in that it may not manifest itself in the first days, while, with untimely diagnosis, it leads to internal bleeding, cerebral hemorrhage and death.
Embolism can be single or multiple, since it can be caused by one or more thrombus. The most common embolic material is a thrombus, which clogs up the blood vessels in the brain. A thrombus can have different sizes, but in any case, they speak of cardiogenic embolism (eg, cerebral vessels) or thromboembolism. According to the same principle, the disease is classified into:
The causes and some treatment regimens differ depending on the type. Let's talk about the causes of cerebral embolism further.
A common cause for all forms of embolism is vascular trauma, for example, in accidents or surgical interventions. In this case, the brain itself may not be injured: even childbirth in some cases can be complicated by embolism.
The most common causes of embolism are:
Also, embolism can be caused by mechanical factors. This happens when injured by fragments of bombs and bullets: a foreign body blocks blood circulation.
Read on to find out what symptoms are typical for cerebral artery embolism.
The clinical picture of cerebral embolism is the severity of neurological infarction. Symptoms may vary depending on the type and location of the blockage. The main symptoms are:
In some young patients, embolism may not appear immediately, but make itself felt after stress and physical. load.
The condition is diagnosed by examination and hardware studies. First, the doctor collects a history of life and complaints, and also conducts a physical examination for cyanosis of the skin and other signs of embolism. An accurate diagnosis can be made by CT scan of the brain, which allows you to determine the lesion and possible localization of the blockage.
For additional diagnostics, allowing to identify the causes and concomitant pathologies, appoint:
The most accurate examination is MRI, however, diagnosis with its help is expensive, and not every hospital has the necessary equipment.
Treatment must be resorted to immediately after diagnosis, since any delay is fatal. The main therapeutic measure is drug therapy, which can be carried out in conjunction with surgical and therapeutic methods.
Note! It is strictly contraindicated to treat embolism with folk remedies! This can eliminate some of its manifestations, which aggravate control over the patient's condition. On the advice of a doctor, you can take some herbal remedies, but it is forbidden to prescribe them to yourself.
Patients with embolism are shown complete rest. If the patient feels well, then treatment can be carried out at home, however, it is better to transport the patient to a hospital. The hospital is also indicated when the patient's condition worsens.
During transportation, it is necessary to use a stretcher, while keeping your head above your legs, while monitoring the condition so that frothy saliva does not enter the respiratory tract and does not lead to suffocation. After delivery to the hospital, the person must be carefully undressed and freed from tight clothes, and then the oral cavity must be cleaned of vomit, and mucus must be sucked out of the respiratory tract.
If there is an increase in blood pressure, you can resort to bloodletting (200-300 ml at a time). It is also important to follow a diet, for example, plant-based fatty foods are shown only 2 days after the improvement in well-being, and until that time it is better to limit yourself to teas and light meals.
Drug therapy is prescribed depending on the manifestations of embolism:
Other drugs may also be used, depending on symptoms and response to treatment.
Surgery is indicated when breathing stops. During this condition, the patient undergoes a tracheostomy, that is, an incision is made in this area, after which a temporary anastomosis of the trachea and the environment is constructed.
Patients with tracheostomy need to supply oxygen through a tube, after removing mucus and phlegm from there.
Prevention of heart embolism consists in avoiding conditions that can lead to it. Often, it is unrealistic to do this, since the list of these conditions is very wide. During surgical intervention, the doctor must monitor the quality of vascular occlusion, that is, cauterization, dressing of wounds, etc. The risk of embolism can be reduced if you monitor your health and fully comply with the requirements of doctors.
Other types of surgeries can also be used to restore normal circulation.
Embolism is a serious condition that is often complicated by:
The most serious complication of cerebral embolism is respiratory arrest, which can be fatal if first aid is not provided on time.
The prognosis for the treatment of embolism depends entirely on its timely diagnosis. There are no exact statistics, but in most cases, when an embolism affects a person outside a hospital setting, the patient dies, because he does not immediately see a doctor.
With early diagnosis and proper treatment, the likelihood of complete recovery is high. Sometimes patients may have residual effects such as paresis, circulatory disorders and concomitant diseases.
A cerebral infarction (ischemic stroke) is a dangerous pathology that develops as a result of a serious circulatory disorder. As a result, a rather rapid death of nerve cells is observed, which leads to irreversible consequences for the human body. The danger of this disease is due to the structure of the brain. It consists of specific tissues that have a high demand for oxygen and are extremely sensitive to oxygen deficiency. In case of impaired blood circulation in the brain, irreversible changes are observed. They lead to a violation of the basic functions that provoke all the negative phenomena associated with this disease.
The most dangerous consequence of a cerebral infarction is the death of a person, which occurs in 25% of cases during the first day. 40% of patients die a little later - within 20 days. Also, 50% of all surviving patients remain permanently disabled. In this case, there is a high risk of death for 5 years.
The causes of impaired blood flow in the brain are specific. These include:
Considering all the factors that lead to the development of the disease, it is clear that people over 50 years old are most susceptible to this disease. However, it should not be forgotten that young people with certain health problems can also develop a stroke.
Blockage of blood vessels, which is caused by certain negative factors, or any other violation of cerebral circulation leads to a gradual or sharp increase in various neurological signs. The characteristic symptoms of a heart attack can develop actively over several hours or even days. A feature of a stroke is that its symptoms may increase over time or, conversely, weaken.
In most cases, the symptoms of a cerebral infarction are as follows:
The symptoms of a heart attack are largely determined by the area of the brain where there is insufficient blood supply. Based on the developing signs, a preliminary diagnosis can be made and the problem area can be established.
Cerebral infarction is divided into several types:
Cerebral infarction can be detected using the following diagnostic procedures:
A cerebral infarction is a disease that requires urgent hospitalization of the patient. The sooner treatment measures are taken, the higher the likelihood of a favorable outcome. It is best when medical attention is given within 2 hours of the onset of symptoms.
In a hospital setting, treatment is used, which is aimed at restoring cerebral circulation, at protecting tissues from further destruction.
Most often this happens using the following means:
Also, the treatment of cerebral infarction can occur by surgery. Most often, carotid endarterectomy is performed, which allows you to remove the inner wall of the carotid artery, which is affected by atherosclerotic plaques. Surgical intervention has its own indications and contraindications, which must be taken into account to obtain the desired effect.
Cerebral infarction is a clinical syndrome that manifests itself in an acute disorder of local cerebral functions. It lasts more than 24 hours, or leads to the death of a person during this time. Acute circulatory disorders in cerebral infarction occurs due to blockage of its arteries, which provokes the death of neurons in the area that feeds on these arteries.
A cerebral infarction is also called ischemic stroke. This problem is very relevant in the modern world, since a huge number of people die every year due to cerebral infarction. Mortality in ischemic stroke is 25%, another 20% of patients die during the year, and 25% of the surviving people remain disabled.
- Cerebral infarction treatment
Symptoms of a cerebral infarction
The symptoms of a cerebral infarction depend on where the lesion is located.
Nevertheless, the general symptoms of this pathological process can be distinguished, among which:
Headache;
Loss of consciousness, coma may sometimes develop;
Dizziness;
Dysfunction of the pelvic organs;
Pain in the eyeballs;
Feeling hot;
Dry mouth;
Nausea and vomiting against a background of severe headache;
Convulsions (not always present).
If the focus of cerebral infarction is localized in the right hemisphere, then the following clinical picture is characteristic:
Complete immobility (hemiparesis) or significant decrease in strength (hemiplegia) of the left extremities;
Sensitivity in the left half of the body and face disappears or sharply decreases;
Speech impairments will occur in left-handed people. In right-handers, speech disorders develop exclusively with damage to the left hemisphere. The patient cannot reproduce words, but conscious gestures and facial expressions are preserved;
The face becomes asymmetrical: the left corner of the mouth goes down, the nasolabial fold is smoothed out.
Depending on which half of the brain is damaged, the symptoms of cerebral infarction will be observed from the opposite side. That is, if the lesion is located in the left hemisphere, then the right half of the body will suffer.
If a cerebral infarction develops in the vertebrobasilar vascular basin, then the patient has the following symptoms:
Dizziness, which increases when the head is thrown back;
Coordination suffers, static disorders are observed;
There are disturbances from the movement of the eyeballs, vision deteriorates;
A person pronounces individual letters with difficulty;
Problems with swallowing food appear;
Paralysis, paresis, impaired sensitivity of the limbs will be observed from the side opposite to the lesion focus.
It is worth considering separately the symptoms of cerebral infarction, depending on which cerebral artery is damaged:
Anterior cerebral artery - incomplete paralysis of the legs, the occurrence of grasping reflexes, eye movement disorders, motor aphasia;
Middle cerebral artery - incomplete paralysis and sensory disorder of the hands, as well as of the lower half of the face, sensory and motor aphasia, head laterofixation;
Posterior cerebral artery - visual disturbances, the patient understands the speech of another person, he can speak himself, but he forgets most of the words.
In severe cases, depression of consciousness occurs and the person falls into a coma, which can occur with damage to any part of the brain.
Causes of cerebral infarction
The following causes of cerebral infarction are distinguished:
Atherosclerosis. It develops in men earlier than in women, since at a young age, female vessels are protected from atherosclerotic lesions by sex hormones. First of all, the coronary arteries are affected, then the carotid, and subsequently the blood supply to the brain;
Hypertension. Mild hypertension (pressure up to 150/100 mm Hg), which is the most dangerous, enhances atherosclerosis and disrupts the adaptive reactions of the arteries;
Heart diseases. So, people who have had myocardial infarction have high risks of developing a cerebral infarction. In 8% of patients after myocardial infarction, ischemic stroke will develop within the first month, and in 25% of patients within six months. The danger is also ischemic heart disease, heart failure;
High blood viscosity;
Atrial atrial fibrillation. They are the reason that blood clots form in the left atrial appendage, which are subsequently transferred to the brain;
Disorders in the work of the endocrine system, first of all, it is diabetes mellitus;
Vascular diseases (pathologies of their development, Takayasu's disease, anemia, leukemia, malignant tumors).
In addition, do not forget about the risk factors that increase the likelihood of a cerebral infarction, among them:
Age (every ten years of life increases the risk of developing a cerebral infarction by 5-8 times);
Hereditary predisposition;
Hypodynamia;
Excess weight;
Smoking (if this bad habit is supplemented by taking oral contraceptives, then smoking becomes a leading risk factor for the development of cerebral infarction);
Alcohol abuse;
Acute stress, or prolonged psycho-emotional stress.
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Consequences of a cerebral infarction
The consequences of a cerebral infarction can be very serious and often pose a direct threat to human life, among them are:
Cerebral edema. It is this complication that develops more often than others and is the most common reason for the death of a patient in the first week after an ischemic stroke;
Congestive pneumonia is the result of the patient being in a horizontal position for a long time. It develops most often in 3-4 weeks after suffering a cerebral infarction;
Pulmonary embolism;
Acute heart failure;
Bedsores due to long motionless lying of the patient in bed.
In addition to the listed consequences of cerebral infarction, which develop in the early stages, long-term complications can also be distinguished, among which:
Impaired motor function of the limbs;
Decreased sensitivity in the arms, legs, and face;
Speech problems;
Deterioration of mental abilities;
Mental disorders;
Difficulty swallowing food;
Impaired coordination when walking, during turns;
Epileptic seizures (up to 10% of people who have had a cerebral infarction are susceptible to them);
Malfunctions of the pelvic organs (the bladder, kidneys, intestines, reproductive organs suffer).
What is the difference between a cerebral infarction and a stroke?
With a cerebral infarction, a violation of its blood supply occurs, as a result of which the tissues of the affected area begin to die off. Insufficient blood flow to the brain occurs due to atherosclerotic plaques that interfere with its normal flow, due to heart rhythm disturbances or due to problems with the blood coagulation system.
In case of hemorrhagic stroke of the brain, on the contrary, the blood flow to it increases, due to which the artery ruptures. The cause is vascular pathology or hypertensive crisis.
There are differences in the course of the disease. So, a cerebral infarction develops gradually, over several hours or even days, and a hemorrhagic stroke occurs almost instantly.
Cerebral infarction treatment
Treatment of cerebral infarction is primarily based on thrombolytic therapy. It is important that the patient is admitted to the neurological unit within the first three hours of the onset of the attack. It is necessary to transport the patient in an elevated position. The head should be 30 degrees higher than the body. If a thrombolytic is administered to the patient at the specified time, then the drug will very quickly dissolve the existing thrombus, which is most often the cause of the disruption of the blood supply to the brain. The effect can often be seen almost instantly, in the first seconds of drug administration.
If thrombolytic therapy is not carried out in the first three hours after the onset of cerebral infarction, then it no longer makes sense to carry it out. Changes will occur in the brain, the nature of which is irreversible.
It should be borne in mind that thrombolysis is performed only when the doctor has made sure that the patient has a cerebral infarction, and not a hemorrhagic stroke. In the latter case, such therapy will be fatal.
If there is no possibility of introducing a thrombolytic agent, then the following measures are shown:
Decrease in blood pressure;
Taking antiplatelet agents (Aspirin), or anticoagulants (Clexan, Fraxiparin, Heparin);
Prescription of medicines aimed at improving cerebral blood supply (Trental, Piracetam, Cavinton).
Also, patients are prescribed B vitamins, carry out rehabilitation treatment, and are engaged in the prevention of pressure sores. Self-medication is unacceptable; at the first signs of a cerebral infarction, an ambulance must be called. It is worth remembering that it is impossible to distinguish a cerebral infarction from a hemorrhagic stroke at home.
The surgical method for treating cerebral infarction is surgical decompression, aimed at lowering intracranial pressure. This method allows you to reduce the mortality rate in cerebral infarction from 80 to 30%.
An important component of the general treatment regimen for cerebral infarction is competent rehabilitation therapy, which is called "neurorehabilitation".
You need to start it from the first days of the illness:
Movement disorders are corrected with the help of physiotherapy exercises, massage and physiotherapy methods. At the moment, there are special simulators that help people recover from a cerebral infarction;
Speech disorders are corrected during individual lessons with a speech therapist;
Swallowing dysfunctions are leveled by special devices that stimulate the work of the laryngeal and pharyngeal muscles;
Classes on a stabilized platform help to cope with coordination problems;
Psychological assistance to the sick is no less important. A psychotherapist helps to cope with emotional problems;
For life, a person is prescribed statins and Aspirin drugs;
To improve the functioning of the brain, it can be recommended to take such medicines as Cavinton, Tanakan, Bilobil, etc.
It is important for the patient himself to constantly monitor the level of blood pressure, blood sugar and cholesterol levels, as well as give up bad habits and lead a healthy lifestyle with the obligatory presence of moderate physical activity.
Ischemic stroke is an acute condition in which there is a violation of the cerebral circulation. As a result, a focus of ischemia appears in the zone of circulatory insufficiency. The basic vital functions of the brain are impaired, depending on the damaged area.
Brain infarction is one of the leading causes of death in humans.
Mortality from cerebral infarction ranks second after death from coronary heart disease. And recently this figure has been steadily growing.
Of the entire structure of vascular diseases of the brain, infarction occupies about 75-85%, cerebral hemorrhage - 15-20%, subarchnoid hemorrhage - 5-10%.
There are several groups of causes of ischemic stroke:
1. Local factors:
2. Systemic:
There are cerebral and focal neurological symptoms:
General cerebral symptoms:
Focal neurological symptoms:
The clinical picture is determined by which vessel is damaged:
Treatment principles:
Specific therapy:
