Auxiliary examinations for cerebral embolism

Written by Liu Yan Hao
Neurology
Updated on February 07, 2025
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Patients with cerebral embolism need to undergo a cranial MRI to observe the location of the embolism, the area of brain tissue necrosis, and the age of the lesion, which is helpful in assessing the severity of the disease and prognosis. Additionally, it is necessary to examine the cervical vasculature with Doppler ultrasound to check for the presence of carotid artery plaques, especially soft plaques which are prone to detachment and can form emboli, blocking cerebral vessels and potentially causing recurrence or exacerbation of cerebral embolism. Furthermore, an echocardiogram of the heart is required because another common source of emboli in cerebral embolism is mural thrombi in the heart, particularly in patients with arrhythmias or atrial fibrillation, who are more prone to form mural thrombi. Therefore, patients with cerebral embolism need to have an echocardiogram to check for the presence of mural thrombi. If present, anticoagulant medication is required for treatment. (Please use medications under the guidance of a professional physician.)

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Written by Zhang Hui
Neurology
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Symptoms and manifestations of cerebral embolism

The so-called cerebral embolism primarily refers to the presence of abnormal substances in the arteries, which block the smaller arteries leading to arterial occlusion, causing severe cerebral ischemia and hypoxia, and resulting in the necrosis of brain tissue. It generally occurs in patients with atrial fibrillation, where atrial fibrillation can form larger emboli that detach from the heart and can easily cause cerebral embolism. The symptoms of the onset are very sudden and rapidly reach their peak. Patients may experience coma and consciousness disorders, fixed staring of the eyes, paralysis of limbs, numbness of limbs, and an inability to sense pain and temperature in the limbs. Additionally, some may experience epileptic seizures and urinary and fecal incontinence. Cerebral embolism is a very dangerous disease, and once these symptoms appear, it is crucial to seek hospital treatment as soon as possible.

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Written by Zhang Hui
Neurology
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Is cerebral embolism the same as cerebral infarction?

Brain embolism is a form of cerebral infarction, so essentially, it is also a type of cerebral infarction. Cerebral infarction encompasses a wider range, including cerebral thrombosis, lacunar infarction, watershed infarction, and others. Brain embolism primarily refers to abnormal substances entering the bloodstream, which then enter the arteries of the brain, causing obstruction in these arteries and leading to ischemia and hypoxia of the brain tissue, thus presenting clinical symptoms of cerebral infarction. The onset of the condition in patients is quite severe, rapidly leading to paralysis of limbs and disorders of speech function. In cases of extensive brain embolism, patients may even experience coma and death as serious complications. Most patients with brain embolism have a history of atrial fibrillation. Atrial fibrillation can lead to the formation of mural thrombi, and when these thrombi dislodge, they can cause brain 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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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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Neurology
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Which department should I go to for a cerebral embolism?

The patient has experienced a cerebral embolism, and it is definitely recommended to seek appropriate medical care in neurology. Neurologists have seen many patients with cerebral embolism and have rich experience in the pathogenesis, diagnosis, and treatment of this disease. The onset of cerebral embolism is quite severe, and patients generally may have a history of cardiac diseases, such as atrial fibrillation. It is crucial to go to the hospital as soon as possible if a cerebral embolism occurs. If within the time window for thrombectomy, such as within eight hours, relevant thrombectomy treatment can be performed. Additionally, some hospitals carry out thrombectomy treatments in neurosurgery or interventional departments. Therefore, if a cerebral embolism requires surgical treatment, one can also visit the interventional department or neurosurgery. After the condition of a cerebral embolism patient stabilizes, routine anticoagulation therapy is necessary to prevent a recurrence of the cerebral embolism.