What should be done if the area of cerebral infarction is large?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on March 17, 2025
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If a large cerebral infarction occurs, brain edema often peaks within two to three days, and the mortality rate is extremely high. If medical attention is sought within six hours of onset, thrombolytic therapy can be considered. If emergency thrombolysis is exceeded, then only conservative drug treatment is available. For example, mannitol dehydration to reduce intracranial pressure, nourish neurons, protect brain cells, provide nutritional support, etc. After a stroke, it is essential to monitor changes in the patient's consciousness and pupils, dynamically assess the patient’s Glasgow Coma Score, and be aware of various potential complications. Family members should be well-informed about the patient's condition, etc. (Specific medications should be administered under the guidance of a doctor.)

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Written by Chen Ya
Geriatrics
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How long does one need to be hospitalized for a cerebral infarction?

The duration of hospitalization for cerebral infarction varies from person to person, depending on the different conditions of the stroke patients, the different causes of the stroke, and the different treatment goals. Generally, the hospitalization time is seven to fourteen days. If the condition of the cerebral infarction is relatively mild, it is also possible to be discharged in five to seven days. However, for some patients with severe conditions, even those who are in a coma or have complications, the hospitalization time will be longer.

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Written by Sheng Wang
Neurology
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How is lacunar stroke treated?

Lacunar infarction is a cerebrovascular disease. For lacunar infarctions caused by arteriosclerotic atherosclerosis, the main treatment is to prevent recurrence of infarction and dislodged plaques that cause blockages. Therefore, it is necessary to initiate treatments like aspirin, antiplatelet therapy, and atorvastatin to lower blood lipids and stabilize plaques. It is also important to control risk factors such as high blood pressure, diabetes, smoking, as well as conditions like hyperuricemia and hyperhomocysteinemia.

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Written by Tang Bo
Neurology
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How is lacunar infarction treated?

Lacunar stroke is a type of cerebral stroke characterized by lesions smaller than 1.5 cm in diameter. Often, these can be discovered incidentally on a CT or MRI scan in asymptomatic patients. In such cases, it's important to evaluate whether the patient has risk factors such as hypertension or diabetes, and consider the patient's age, smoking, and drinking habits. Further assessments with cranial MRI angiography or other vascular imaging are recommended to clarify the state of the blood vessels and guide treatment. Additionally, some patients may experience an acute onset with symptoms like slurred speech or limb weakness. Although these symptoms might be mild, it is crucial to seek prompt medical attention to assess the blood vessels and guide further treatment based on the physician's physical examination of the patient.

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Written by Li Min
Neurology
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Is lacunar infarction serious?

Lacunar stroke, with diameters ranging from 2mm to 15mm, may appear minor in scale but results from long-term arteriosclerosis of cerebral blood vessels, leading to ischemia and necrosis in surrounding tissues. Clinically, symptoms can manifest as pure sensory, pure motor, mixed-type numbness in limbs, among other symptoms. Symptoms are generally mild and recovery is likely; however, long-term oral antiplatelet medications like aspirin are required. Additionally, stabilizing plaques with statins in combination with other drugs is essential. It's also important to maintain a low-salt, low-fat diet, and manage conditions like hypertension and diabetes. Therefore, its severity is relatively mild compared to extensive strokes.

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Written by Tang Bo
Neurology
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CT manifestations of cerebral infarction

Brain infarction has different manifestations on CT scans at different stages. Generally, within 24 hours, the CT scan may not show any imaging of the cerebral infarction lesion. However, some patients, especially those with thrombosis in the middle cerebral artery, might exhibit a high density sign in the middle cerebral artery. In cases of large-scale cerebral infarction, some sulci on the side affected by the infarction may appear shallower, indicating possible brain swelling. Generally, within 24 hours, a CT scan can reveal a low-density image, which appears relatively darker. This condition is typically considered a brain infarction, and as time progresses, this dark, or low-density image, tends to become even darker. In some patients during the acute phase, although the infarction may not be apparent, a CT scan is performed to rule out bleeding, as CT is very sensitive to bleeding.