Stroke treatment methods

Written by Chen Yu Fei
Neurosurgery
Updated on September 11, 2024
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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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Precursors to cerebral infarction

For patients with cerebral infarction, before the onset of the illness, they often lack specific prodromal symptoms. Some patients may experience mild headaches, dizziness, nausea, and a clear feeling of discomfort. Additionally, some patients might experience numbness in the legs and involuntary twitching of facial muscles before the onset. Subsequently, some patients may also start to have drooping of the corner of the mouth to one side, drooling, slurred speech, and distinct articulation disorders. When these clinical presentations occur, it is necessary to be vigilant and seek timely medical attention at a local hospital. A cranial CT or MRI should be performed to confirm the diagnosis.

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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 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.

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Written by Gao Yi Shen
Neurosurgery
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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.)

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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.