Cerebral infarction (Stroke)

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Written by Chen Yu Fei
Neurosurgery
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Causes of Cerebral Infarction

The specific causes of cerebral infarction are mostly seen in older patients with several underlying diseases, such as hypertension, diabetes, and hyperlipidemia. Over time, without well-controlled blood pressure, blood sugar, and blood lipids, arteriosclerosis can easily form within the blood vessels, or atherosclerotic plaques can develop. Once the plaque forms, under certain triggers, the unstable detachment of the vascular plaque can occur. The embolus then moves with the blood flow into the brain and lodges in a narrowed part of the vessel, causing local blood supply areas to experience narrowing or blockage. At this point, a cerebral infarction is likely to form, leading to ischemia, necrosis, and degeneration of the brain tissue supplied by the vessel, resulting in a softening lesion. On a cranial CT scan and MRI, a local low-density shadow can be observed, which is the specific cause of the cerebral infarction.

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Written by Chen Yu Fei
Neurosurgery
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What department should I go to for a cerebral infarction?

When a patient suffers a stroke, it is advised to promptly visit a local hospital and consult a neurologist to assess the condition. Often, when an acute stroke occurs, treatment can be administered through thrombolysis. If the window for thrombolytic therapy is missed, conservative pharmacological treatment is recommended. Clinically, it is generally recommended to treat patients with medications that enhance brain function, promote blood circulation to remove blood stasis, and nourish the nerves. Patients’ vital signs should be closely monitored, and dynamic reassessment through head CT or MRI should be conducted to observe changes in the patient's condition. In cases of extensive stroke, it may be necessary to transfer the patient to neurosurgery for decompressive craniectomy surgery.

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Written by Chen Yu Fei
Neurosurgery
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Causes of Cerebral Infarction

At present, there is no consensus on the specific causes of cerebral infarction. It is mostly seen in patients with underlying diseases such as hypertension, diabetes, and hyperlipidemia, where there has not been adequate control of the patient's blood pressure, blood sugar, and cholesterol. This can lead to significant increases in blood pressure, blood sugar, and cholesterol. Over time, this might result in the formation of atherosclerotic plaques in the patient’s blood vessels. When these plaques break off and enter the bloodstream, they travel with the blood flow and can lodge in the narrow vessels of the brain. This causes blockage of the blood vessel and leads to ischemia, necrosis, softening, and degeneration of the brain tissue in the affected blood supply area, ultimately causing a cerebral infarction.

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Written by Shu Zhi Qiang
Neurosurgery
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How to rehabilitate from a cerebral infarction?

Brain infarction is one of the most common cerebrovascular accidents, accounting for about 65% of all cerebrovascular diseases. The types of brain infarction include lacunar infarction, cerebral thrombosis, and cerebral embolism; sometimes it also includes cerebral venous sinus thrombosis. Any type of brain infarction, or cerebral infarction, can cause certain neurological dysfunctions. Therefore, once the patient's condition is stabilized, it is advisable to actively consider rehabilitation treatments. These rehabilitation treatments mainly include hyperbaric oxygen therapy, acupuncture rehabilitation, and physical rehabilitation therapy.

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Written by Gao Yi Shen
Neurosurgery
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Premonitory symptoms of cerebral infarction recurrence

The symptoms preceding the recurrence of a cerebral infarction mainly involve observing the symptoms presented during the initial incidence of the stroke. In many cases, the recurrent symptoms are very similar to those initially experienced. For example, if dizziness was a symptom during the previous episode, then dizziness could also be a precursor symptom in a recurrence, with similar nature and intensity of dizziness as before. Additionally, if previous symptoms included limb numbness, weakness, or speech impairment, similar signs might precede a recurrence. Clinically, it is imperative to address these issues before an actual recurrence occurs, such as actively pursuing antiplatelet aggregation therapy, lipid-lowering, and stabilizing plaques, and resorting to surgical treatment if necessary, to better reduce the chances of stroke recurrence.

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Written by Chen Yu Fei
Neurosurgery
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Stroke treatment methods

For patients who suffer a stroke, it is crucial to immediately transport them to the nearest local hospital. At the emergency room of the local hospital, a cranial CT scan or MRI should be conducted to confirm the presence of a stroke, as well as to determine its exact range and severity. If there is an acute indication for surgery, thrombolytic therapy is recommended. If the optimal time window for thrombolysis has passed, it is advisable to use medications that invigorate the brain, improve blood flow to remove stasis, nourish the nerves, and enhance microcirculation in the brain tissue. This can effectively help improve the conditions of ischemia and hypoxia in the brain nerves. Furthermore, further treatment should be adjusted based on the patient’s condition. During treatment, attention should be paid to the prevention and treatment of various complications or comorbidities, such as pulmonary infections, urinary tract infections, hypoproteinemia, deep vein thrombosis, etc.

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Written by Guo Zhi Fei
Neurosurgery
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Is a brain infarction dangerous?

The risk associated with a cerebral infarction primarily depends on the extent and location of the infarction. If the infarction is small and located in less critical areas of brain function such as the frontal or temporal lobes, the symptoms may not be severe and might only include dizziness and sleepiness. If the infarction is extensive and occurs in crucial areas such as the basal ganglia, thalamus, or brainstem, the symptoms can be very severe. This could potentially lead to hemiplegia, aphasia, and even coma or death.

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Written by Gao Yi Shen
Neurosurgery
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Can cerebral infarction be cured completely?

Stroke is not a disease that can be completely cured. Instead, the goal of treatment is to prevent further occurrences and developments of stroke, and there is also the potential for some relative improvement later on. This is considered a very good treatment goal. In the case of stroke, it involves the ischemic necrosis of nerve cells. Additionally, nerve cells have a characteristic that once they die, they cannot regenerate. Therefore, in clinical practice, there are no treatments available that can promote the regeneration of nerves. Treatment can only compensate for the functions of the surrounding healthy nerves to take over the functions of the dead nerves. However, this compensatory process is very slow, often taking two to three months to show significant progress. Hence, it is necessary to continue active rehabilitation exercises later to promote the formation of this compensatory mechanism.

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Written by Gao Yi Shen
Neurosurgery
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What is a cerebral infarction?

Cerebral infarction is essentially a manifestation of ischemic necrosis of nerve cells. However, in clinical practice, there are many factors that can cause cerebral infarction. It is essential to treat the underlying causes to effectively prevent the further occurrence and progression of cerebral infarction. One characteristic of nerve cells is that once necrosis occurs, they cannot regenerate. Consequently, all patients who suffer from cerebral infarction may have some residual neurological deficits. Mild symptoms include headaches and dizziness, while severe cases may experience numbness and weakness in the limbs, speech impairments, and even more severe conditions such as a vegetative state or death. Therefore, in the case of cerebral infarction, it is crucial to focus on prevention early on to reduce the extent of necrosis. This can effectively ensure one's safety and reduce the occurrence of various complications and sequelae.

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Written by Gao Yi Shen
Neurosurgery
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Is it good to drink milk after a stroke?

Patients with cerebral infarction can drink milk, but it must be analyzed according to the specific condition at the time because patients with cerebral infarction often experience coma and accompanying dysphagia with coughing. In such cases, drinking milk is not a problem, but attention must be paid to changes in dietary habits. If necessary, a gastric tube must be inserted through the nose into the stomach for feeding to avoid direct oral intake, which can cause coughing, aspiration, and lead to pneumonia. Therefore, this point must be carefully considered. For ordinary people in daily life, a cup of milk a day is a very good choice because milk mainly contains protein and does not contain a lot of fat and sugar. For patients with cerebral infarction, this diet is very ideal. If fresh milk can be used in everyday life, it is more beneficial for promoting the patient's recovery.