Can the blood vessels in a cerebral infarction be unblocked?

Written by Gao Yi Shen
Neurosurgery
Updated on September 03, 2024
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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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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.

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Is a lacunar infarct a minor stroke?

Lacunar stroke is, in a sense, a milder form of stroke. It may not involve complete paralysis of limbs or consciousness disorders. Such cases typically show symptoms of sudden large vessel blockage. However, it results from blockages in many small vessels and manifests in various ways. Additionally, it gradually worsens, displaying an increasing range of symptoms including cognitive impairments, dementia, unstable gait, slurred speech, and dysarthria. These symptoms significantly affect the quality of life, so it can be considered not mild.

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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 Gao Yi Shen
Neurosurgery
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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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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.