Causes of Cerebral Infarction

Written by Chen Yu Fei
Neurosurgery
Updated on September 25, 2024
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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 Gao Yi Shen
Neurosurgery
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Can the blood vessels in a cerebral infarction be unblocked?

Whether the blood vessels in a cerebral infarction can be reopened is closely related to time. If it is within the hyperacute phase, which means within six hours from the onset of clinical symptoms to hospital admission, the majority of cases can undergo thrombolysis intravenously, or arterial thrombectomy to reopen the blood vessels. However, if the time exceeds this window, reopening is no longer feasible, and forced reopening at this stage can easily lead to the detachment of distal thrombi or cause reperfusion injury, which is more detrimental to the patient's condition. Therefore, it is impossible to reopen the blood vessels during the chronic phase or non-hyperacute phase. If treatment of this vascular occlusion is desired, vascular anastomosis can be considered, though the specific type of anastomosis surgery depends on the patient's specific condition at the time. Thus, the possibility of reopening a blood vessel in a cerebral infarction certainly depends on timing.

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Written by Liu Dong Yang
Neurosurgery
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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.

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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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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 Chen Yu Fei
Neurosurgery
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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.