Causes and Symptoms of Cerebral Infarction - Oren Zarif - Cerebral Infarction
There are many causes of cerebral infarction, including arterial occlusion, embolization, and internal cartoid artery anomalies. This disease can also be caused by a vascular lesion that leads to abnormal endothelium. Cerebral embolism is also associated with aneurysms, which may cause thrombus to embolize to the brain. Some patients with cerebral infarction have unruptured giant aneurysms.
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The symptoms of cerebral infarction vary based on which part of the brain is affected. The most common type is an ischemic infarct, while a secondary one is known as a hemorrhagic infarct. Other types of cerebral infarction include territorial infarct and lacunar infarct. Depending on where the infarction occurs in the brain, symptoms may include slurred speech, abnormal pupil dilation, loss of eye movement, and impaired memory.
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The first 24 hours after cerebral infarction are crucial for determining whether further treatment is necessary. The treatment is based on the degree of ischemia, and the earliest the best time to thrombectomy is possible is six hours after symptom onset. Mechanical thrombectomy is generally reserved for patients whose internal carotid artery has been occluded. But a comprehensive stroke center can justify later treatment if there is significant tissue at risk. Imaging tests such as CT or MR perfusion can identify the volume of infarcted tissue and ischemic penumbra, and a large mismatch indicates a substantial amount of penumbra.
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Some types of ischemic stroke are caused by increased blood pressure and reduced blood supply to the brain. Some of these conditions cause blood clots to break off and travel to the brain, causing a cerebral embolism. Other causes include atrial fibrillation, a condition in which the heart is irregular and unable to pump blood. This can cause a blood clot to travel to the brain. And there are many causes of cerebral infarction.
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Although the incidence of young stroke is relatively low, the risk for this condition is still significant, particularly in young adults. One study found that the most common etiologies for young adults included cardiac embolism, hematologic causes, and lacunar stroke. However, nearly a third of first strokes were associated with no known cause. This study shows the importance of assessing risk factors to prevent stroke. So how can we best treat young patients?
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The treatment for acute cerebral ischaemia varies, depending on where it originated. Some patients have a sudden and rapid onset of symptoms. Other causes may include hemorrhage into a tumor, migraine, or a postepileptic paralysis. Neuroimaging is an essential part of this evaluation. In addition, bedside glucose testing is mandatory. Ultimately, the only way to distinguish between ischemic stroke and other causes is to perform the right diagnostic tests.
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Hemicraniectomy may be an option for patients with a massive cerebral infarction. This surgical procedure may be helpful in reducing pressure on the brain and repairing blood vessel problems associated with hemorrhagic strokes. Surgical clipping of an aneurysm can prevent the clot from bursting or bleeding and may also prevent the recurrence of the stroke. The risk of death increases the longer the stroke continues.
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MR imaging is a useful tool for identifying acute ischemic stroke. The area of infarction had a reduced specific gravity and increased water content. This reflected edema. However, MRI is not a definitive test of cerebral infarction. Patients should be followed up for a few weeks after the event to ensure that there are no complications. And the treatment for acute ischemic stroke depends on the severity and duration of the infarction.
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The workup for cerebral infarction is based on the presence of risk factors and etiologies. Multiple risk factors may contribute to a recurrence of the disease. The three primary ischemic stroke mechanisms are embolism, decreased perfusion, and thrombosis. Some of these mechanisms are associated with each other and may occur simultaneously. In addition to the primary causes, there are also subtypes of the disease.
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Another type of stroke is a hemorrhagic stroke. The artery is blocked and clots in the blood flow can travel to the brain. A heart problem or a heart surgery may also contribute to the development of embolic stroke. Approximately 15% of people with an embolic stroke also suffer from atrial fibrillation, a condition that affects the upper chambers of the heart. An embolic stroke can also be caused by aneurysms.
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The risk of a stroke is greatest in men. The older you are, the more likely you are to develop a stroke. Certain hormone therapies, including estrogen, can also increase your risk. It's important to seek immediate medical attention if you notice any of these symptoms, even if they only happen rarely. Getting medical treatment for an TIA early on will prevent the risk of another stroke. The Mayo Clinic offers free health information and expert guidance.