Causes of cerebral infarction

Written by Gao Yi Shen
Neurosurgery
Updated on November 15, 2024
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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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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 Tang Li Li
Neurology
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Can a cerebral infarction be cured?

Stroke is the most common cerebrovascular disease. It occurs when the arteries supplying blood to the brain become blocked, leading to ischemic necrosis of the brain tissue in that region. This results in a series of neurological deficits. Theoretically, once a stroke has occurred, it cannot be completely cured because brain cells are non-regenerative. Once they die, they cannot be revived, and the function of the neurons in that area is completely lost. However, the significance of acute phase treatment lies in the rescue of the ischemic penumbra. The function of these cells can be restored after treatment, and thereafter, they may compensate for the function of the central necrotic area. Thus, patients who receive treatment may regain some neurological functions. Another condition is that the patient must be brought to the hospital within 4.5 hours of the onset of symptoms. If there are no clear contraindications, RT-PA intravenous thrombolytic treatment can be administered. The success rate of this thrombolysis is relatively high, and about 30% of patients may be fully cured without any sequelae.

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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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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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Written by Gao Yi Shen
Neurosurgery
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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.