What to do about cerebral embolism?

Written by Zhang Hui
Neurology
Updated on September 12, 2024
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The onset of cerebral embolism is very sudden, and most cases of cerebral embolism are caused by heart disease. For instance, atrial fibrillation or myocardial infarction can lead to cerebral embolism, which requires immediate medical attention. If it is within the time window for arterial thrombectomy, it is best to proceed with the arterial thrombectomy treatment, and this window typically ranges from six to eight hours. If the time window is missed, the patient should primarily be kept on bed rest and given medications to protect and nourish brain cells. If intracranial pressure is high, medications to reduce dehydration and lower cranial pressure should be administered. After the acute phase, anticoagulation treatment should also be provided to prevent future occurrences of cerebral embolism. Additionally, care should be taken to prevent complications such as pulmonary infections, urinary system infections, and bedsores.

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Written by Liu Yan Hao
Neurology
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Can people with cerebral embolism run?

Patients with cerebral embolism can jog moderately, but walking is highly recommended. This is because the common source of the embolus in cerebral embolism patients is a mural thrombus in the heart. The common causes of mural thrombus formation include arrhythmia and atrial fibrillation. Therefore, patients with cerebral embolism, who may also have coronary artery disease, atrial fibrillation, or cardiac mural thrombus, are not well-suited for running, which is a relatively intense form of exercise. They can jog moderately, but the distance and duration should not be too long. The most recommended form of exercise is walking. Walking is the best form of exercise to prevent worsening the condition after running, and it could also exacerbate coronary artery disease conditions.

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Written by Zhang Hui
Neurology
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What fluid is infused for cerebral embolism?

Cerebral embolism is a type of ischemic cerebrovascular disease, occurring when an abnormal clot travels to the brain and blocks an artery, leading to corresponding clinical symptoms. Patients may experience speech impairments, motor dysfunctions, limb numbness, and even consciousness disturbances among other clinical manifestations. Some individuals with cerebral embolism may even develop epilepsy. The primary treatment for patients with cerebral embolism involves anticoagulation therapy. Additionally, intravenous medications are mainly used to reduce cerebral edema, activate blood circulation and remove stasis, protect brain cells, and eliminate free radicals. Medications to improve collateral circulation via intravenous routes are also applicable. Generally, the prognosis of cerebral embolism is not very good; it is prone to transition to cerebral hemorrhage and may leave sequelae such as epilepsy. (Please use medications under the guidance of a professional physician, and do not self-medicate.)

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Written by Zhang Hui
Neurology
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Causes of cerebral embolism

Any abnormal substance entering the cerebral arteries causing ischemia, hypoxia, and necrosis of brain tissue is called cerebral embolism. The causes of cerebral embolism mainly include the following types: The first type is cardiogenic cerebral embolism, which is caused by heart diseases. For example, the most common atrial fibrillation is the most common cause of cerebral embolism. Atrial fibrillation can lead to the formation of some mural thrombi. These thrombi form, detach, and enter the cerebral arteries causing embolism. Additionally, myocardial infarction is also an important cause, and patients with myocardial infarction can also form some abnormal thrombi in the heart. Second, other causes, such as air embolism. In patients with fractures, a large amount of fatty tissue enters the cerebral arteries, which can also cause cerebral arterial embolism. Moreover, some venous thrombi from the lower limbs can also form cerebral embolism. During childbirth, the entry of amniotic fluid into the brain can also cause cerebral embolism.

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Written by Zhang Hui
Neurology
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Guidelines for Thrombolytic Therapy for Cerebral Embolism

Cerebral embolism is a particularly dangerous type of ischemic cerebrovascular disease. Patients present with a very abrupt onset, typically with a history of atrial fibrillation. Acute onset rapidly leads to limb paralysis, and may also cause disturbances in consciousness and seizures, among other clinical manifestations. Current guidelines for thrombolytic treatment of cerebral embolism do not address extensive cerebral embolism, as thrombolysis in extensive cerebral embolism carries a certain risk of bleeding and is not generally advocated in clinical practice. Mainly, arterial thrombectomy treatment can be administered within an eight-hour window, which can provide significant therapeutic effects for some patients. Additionally, if the cerebral embolism is considered small and the patient's consciousness is relatively intact, intravenous thrombolytic treatment can be given. The time window for intravenous thrombolysis is generally within four and a half hours, so it is crucial to get to a hospital as quickly as possible in the event of a suspected cerebral embolism.

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Written by Tang Li Li
Neurology
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What department should one go to for a cerebral embolism?

Patients with cerebral embolism should visit the department of neurology. Cerebral embolism is not a special disease but rather one type of cerebral infarction. Cerebral infarction generally includes two types: cerebral thrombosis and cerebral embolism. The former refers to the formation of a thrombus at the site of the vessel occlusion. The latter involves a thrombus originating from another location, which blocks the vessel at the infarct site. The sources of such thrombi are varied, with the most common being from the heart, frequently seen in patients with long-term chronic atrial fibrillation. This condition forms a mural thrombus in the atrium, which, during episodes of atrial fibrillation, can detach, be flushed by the blood stream into the brain, and cause cerebral embolism. Secondly, it occurs in cardiac valve diseases, such as rheumatic heart disease, mitral valve alterations, and others. There are also some other sources of thrombi, such as tumor-induced cancer, amniotic fluid embolism in pregnant women, and fat embolism in patients with fractures.