How to rehabilitate from a cerebral infarction?

Written by Shu Zhi Qiang
Neurosurgery
Updated on September 18, 2024
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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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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.

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The difference between lacunar infarction and cerebral infarction

Lacunar stroke is a type of cerebral infarction and is considered the mildest form within strokes. Generally, the area affected by a lacunar infarction is very small, so if it is a single incident or there are not many lacunar strokes, it usually does not cause any symptoms. Many middle-aged and elderly people over the age of fifty or sixty who undergo routine CT scans during physical examinations exhibit signs of lacunar stroke on their CT images, yet most of them do not present any clinical symptoms. Therefore, lacunar stroke may only affect brain function and result in symptoms such as speech difficulties, slow reactions, weakened muscle strength in the limbs, or lack of coordination when there are numerous occurrences. Cerebral infarction can include strokes that affect larger areas of the brain, which are much more severe than lacunar strokes. These larger strokes are sufficient to cause clinical symptoms, which may include hemiplegia, drooping of the corner of the mouth and drooling, abnormal limb movements, and even fatal events in cases of extensive cerebral infarction. Thus, lacunar stroke, being a type of cerebral infarction, represents the mildest form of stroke.

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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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Is a cerebral infarction serious?

Stroke is a very serious disease; its essence lies in the ischemic necrosis of nerve cells. A characteristic of nerve cells is that once they undergo ischemic necrosis, they cannot regenerate. Along with cardiac muscle cells, they are the only cells in the human body that cannot regenerate once they have died. Therefore, for the part of the tissue where nerve cells have already died, such as in cases of cerebral thrombosis or stroke where the tissue has already been affected, it is impossible to completely restore it. If the affected area is relatively small, some compensation might be possible. However, if the affected area is relatively large, this will lead to a significant amount of ischemic necrosis in the neural tissue, which can cause total dysfunction of various tissue structures in the body, and in more severe cases, can lead to coma and eventually the death of the patient. Therefore, it is imperative to take this seriously in clinical practice.

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Can people with cerebral infarction drink alcohol?

Patients with cerebral infarction should not drink alcohol. Although alcohol can have certain effects in promoting blood circulation and removing blood stasis, the specific content of alcohol and its degree, as well as each person's tolerance, vary. While in some cases, certain components can promote blood circulation, this does not mean it always activates blood circulation. In fact, excessive promotion of blood circulation at times can even lead to cerebral hemorrhage and other changes in medical conditions, posing even greater risks to patients. Another point is that drinking alcohol can cause excitement, which may lead to increased blood pressure. If there are plaques or other impurities in the arteries, they might dislodge and lead to further exacerbation of cerebral infarction. Therefore, it is also advised not to drink alcohol for these reasons.