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Cerebral infarction (Stroke)
Symptoms of cerebral infarction
For patients with cerebral infarction, during the acute phase, they typically exhibit clear symptoms of headache, dizziness, nausea, and vomiting. Patients may experience slurred speech, difficulty speaking, and obvious articulation disorders. Additionally, some patients may develop facial nerve paralysis, deviation of the mouth to one side, drooling, and often exhibit clinical signs such as a shallower nasolabial fold and disappearance of forehead wrinkles. Furthermore, some patients may also experience dysphagia, manifested by coughing when drinking water, and may be accompanied by aphasia or motor dysfunction, primarily presenting as motor aphasia, mixed aphasia, anomic aphasia, and resulting unilateral limb paralysis.
Causes of cerebral infarction
There are many causes of cerebral infarction, but the most common in clinical practice is the narrowing or occlusion of the carotid artery. Since the brain is supplied by four blood vessels, any issues with any of these vessels can potentially lead to a cerebral infarction. Conditions commonly known as the "three highs"—high blood pressure, high blood sugar, and high cholesterol—can easily lead to narrowing or even blockage of the blood vessels. Thus, these factors are fundamentally the cause. Additionally, smoking and drinking can also lead to vascular narrowing and cause cerebral infarction. In some special cases, autoimmune diseases can cause inflammation inside the vessels, leading to narrowing. Other causes include arterial tears due to trauma, which can lead to ischemia and infarction, or abnormal blood supply due to arrhythmias causing cerebral infarction.
Brain infarction belongs to which department?
Brain infarction is usually classified as a neurology disease. Patients with brain infarction often exhibit clear symptoms of headache, dizziness, nausea, vomiting, and significant swallowing dysfunction, leading to coughing while drinking. Some patients may also experience facial nerve paralysis to some extent, manifesting as unclear speech, difficulty speaking, and articulation disorders. When the aforementioned clinical symptoms occur, the possibility of brain infarction is considered high. Performing a cranial MRI scan for patients can help determine the specific location, number, and severity of the infarction. Generally, it is recommended to treat patients with brain infarction during the acute phase with drugs that enhance brain function, nourish the nerves, and promote blood circulation to remove blood stasis, and many patients can achieve satisfactory treatment results. (Specific medications should be used under the guidance of a physician.)
Methods of Cerebral Infarction
There are many methods for treating cerebral infarction, but it is essential to make judgments based on the situation, as each patient's condition is different and requires different treatment approaches. For patients with acute cerebral infarction, treatments such as emergency thrombolysis or thrombectomy can be undertaken. For chronic cerebral infarction, initially, medical treatment is applied, including managing blood pressure, lowering blood lipids, stabilizing blood sugar levels, quitting smoking and alcohol, etc. Subsequently, this includes the oral administration of antiplatelet aggregation medications, which can effectively reduce the recurrence of cerebral infarction. Finally, corresponding surgical treatments are considered, including endarterectomy, superficial temporal artery to middle cerebral artery anastomosis, and appropriate stent implantation surgeries, depending on the specific characteristics. (Specific medications should be administered under the guidance of a physician.)
What should be paid attention to in the diet for cerebral infarction?
There are many dietary considerations for patients with cerebral infarction: The first point is to definitely eliminate some unhealthy eating habits, including smoking, drinking alcohol, consuming large amounts of meat, binge eating, sitting for long periods, and not exercising, among other things. Improving these bad habits can greatly help in reducing the recurrence of cerebral infarction. The second point is to adopt a diet low in salt and fat and high in protein. It is essential to avoid greasy and pickled foods on a regular basis to also reduce the recurrence of cerebral infarction. The third point is to eat more green leafy vegetables on a daily basis, especially those that are local and seasonal. If blood sugar levels are stable, increasing the consumption of fruits can also enhance the body's resistance and reduce the recurrence of cerebral infarction.
How is a cerebral infarction treated?
The treatment principles for cerebral infarction include thrombolysis, anticoagulation, volume expansion, lowering blood pressure, and brain protection. The main goal is to improve the blood circulation in the ischemic area of the brain as soon as possible and promote the recovery of neurological functions. During the acute phase, patients should rest in bed as much as possible, enhance care for skin, oral cavity, respiratory tract, and excretion, and maintain electrolyte balance. If a patient still cannot eat 48 to 72 hours after onset, nasogastric feeding with liquid nutrition should be provided to ensure nutritional supply. The priority should be given to the patient's daily care, diet, and the management of other comorbidities. Since some patients with cerebral infarction cannot take care of themselves during the acute phase and may even have difficulty swallowing, without adequate nutrition, metabolic issues can arise quickly. In such cases, even the best medications can fail to achieve positive outcomes. Since cerebral thrombosis is the most common type of cerebral infarction characterized by high incidence, high mortality, high recurrence rate, and high disability rate, patients may experience mild hemiplegia or severe scenarios leading to loss of life. Therefore, lifelong medication is necessary to prevent recurrence, achieve secondary prevention, and ultimately reduce the recurrence of cerebral infarction.
Can a cerebral infarction be treated?
Stroke is treatable, but it must also be judged based on the situation. The meaning of "treatable" here is that various treatment plans can be used to reduce the further occurrence of cerebral infarction and the situation of recurrence. However, the nerve cells that have already suffered ischemic necrosis cannot be restored to exactly the same condition as before. This means that the best scenario is recovery to the point of being able to take care of oneself, but it is absolutely impossible to return to the state of freedom before the illness, such as running and jumping. Currently, there are many treatment methods, including medication and surgical treatment. Each of these is a mode of treatment, and each case's differences determine different treatment plans. Decisions must be made according to the situation.
Can a cerebral infarction recover?
Most patients who experience a stroke have relatively good recovery after active treatment and rehabilitation exercise, but very few patients can recover to the physical state they were in before the stroke. This is mainly because after the stroke, brain cells are damaged due to ischemia and hypoxia. Since brain cells are non-regenerative tissues, it is difficult for them to regenerate once they are damaged. The function of the damaged brain cells is mainly compensated by the undamaged brain neurons. Therefore, even with active treatment, it's not possible to return to a completely normal state. However, even so, it is still crucial to actively pursue treatment and rehabilitation exercises after a stroke, as these can significantly reduce the disability and mortality rates caused by the stroke.
What location is used for moxibustion in the treatment of cerebral infarction?
For patients with cerebral infarction, it is usually recommended during the acute phase to conduct a cranial MRI to determine the location and severity of the stroke and to decide the next treatment plan. If surgery is indicated, treatment can be administered through intravenous thrombolysis. If surgery is not indicated, or the optimal treatment time has been missed, it is recommended that the patient be hospitalized for treatment. During the acute phase, medications that invigorate the brain and improve blood circulation while nourishing the nerves are administered, and it is important to monitor any changes in the patient's condition. The effectiveness of moxibustion in treating cerebral infarction is generally moderate. During the recovery phase, patients can try moxibustion, but it is generally advised to seek treatment under the guidance of a Traditional Chinese Medicine physician at a reputable tertiary hospital.
What tests are done for a cerebral infarction?
For patients with cerebral infarction, it is recommended to take the patient to a local hospital for timely treatment during the acute phase. A cranial CT scan or MRI should be performed to help assess the current situation. Cranial MRI plays an important auxiliary diagnostic role in identifying the specific location, extent, and severity of the cerebral infarction. It is advised to perform a cranial MRI during the acute phase for a clear diagnosis, and then decide the next step of the treatment plan based on the situation. Within the surgical window, thrombolytic therapy can be applied to achieve dissolution of the clot. If the optimal timing for thrombolysis has been missed, it is recommended that the patient be hospitalized to receive treatment, including intravenous drips, brain-nourishing drugs, nerve nutrition, and medications that invigorate blood circulation and remove blood stasis, to help improve the state of ischemia and hypoxia in the brain tissue.