Guidelines for Thrombolytic Therapy for Cerebral Embolism

Written by Zhang Hui
Neurology
Updated on September 20, 2024
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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.

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

Patients with cerebral embolism can eat lamb, but should do so in moderation and not excessively. This is because a common cause of cerebral embolism is the formation of atherosclerotic plaques in the neck arteries, particularly soft plaques. When these soft plaques detach, they form an embolus that, carried by the bloodstream, can block cerebral vessels and cause a cerebral embolism. Thus, many of these patients often have hyperlipidemia, with a basis of arteriosclerosis and arterial plaques. Therefore, their diet should be low in salt and low in fat, and overall light. Foods that are overly greasy or high in fat should be avoided as much as possible, such as animal organs and fatty meats which are high in fat. Lamb can be eaten in proper amounts. Other dietary considerations include avoiding overly salty foods, as excessive salt intake can lead to increased blood pressure, further aggravating arteriosclerosis and arterial plaques, and leading to the onset of cerebral embolism.

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Written by Zhang Hui
Neurology
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What is a brain embolism?

Cerebral embolism refers to various abnormal emboli that enter the intracranial arteries with blood circulation, causing acute occlusion of the cerebral arteries and leading to ischemic hypoxic necrosis of the brain tissue in the supplied area. The onset is usually very sudden and dangerous, with patients rapidly developing limb paralysis, speech dysfunction, facial paralysis, and in some cases, coma, seizures, and other clinical manifestations. The most common source of embolism is the heart, such as atrial fibrillation or myocardial infarction forming mural thrombi that dislodge and enter the brain causing an embolism. Additionally, there are non-cardiac sources of embolism, such as the detachment of atherosclerotic plaques causing an embolism, as well as air embolisms and cancer cell embolisms. Cerebral embolism is an emergency and severe condition that requires prompt medical attention.

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Written by Zhang Hui
Neurology
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How many days for brain embolism infusion?

Cerebral embolism is a particularly dangerous disease that is very concentrated. It primarily refers to the entry of abnormal substances into the arteries, leading to the occlusion of the cerebral arteries and causing corresponding clinical manifestations in patients. Symptoms may include disturbances in consciousness, coma, limb paralysis, numbness, slurred speech, and even possibly seizures. The most common cause of cerebral embolism is atrial fibrillation. Treatment generally requires hospitalization for intravenous infusion. If the condition is relatively stable, an infusion lasting about 10 to 14 days may suffice, followed by administration of anticoagulant drugs for treatment. If the area affected by the cerebral embolism is very large and the patient is in severe danger, infusion treatment may need to last about 3 to 4 weeks. The specific approach should be based on the patient's condition. Additionally, certain medications to reduce dehydration and intracranial pressure, as well as neuroprotective drugs, should be administered. (Please use medication under the guidance of a doctor.)

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Written by Zhang Hui
Neurology
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Can cerebral embolism be treated with thrombolysis?

Cerebral embolism is a relatively common ischemic cerebrovascular disease. If the area of cerebral embolism is very large and it exceeds the time window for thrombolysis, and if the patient is elderly with multiple underlying diseases, then thrombolysis is not recommended. Patients with large-area cerebral embolism have a higher probability of transitioning to cerebral hemorrhage, thus the risk of thrombolysis is very high. However, if it is within the time window for arterial thrombectomy, it is advocated to undergo arterial thrombectomy treatment. Family members can communicate more with the doctor to choose the appropriate treatment plan. If the symptoms of cerebral embolism are relatively mild, the affected area is considered small, and it is within three hours, then intravenous thrombolysis treatment could be considered. Patients undergoing intravenous thrombolysis must ensure that a cranial CT is rechecked within 24 hours to exclude any secondary bleeding.