Cerebral Infarction - Oren Zarif - Cerebral Infarction
Cerebral infarction, also known as ischemic stroke, is a type of brain disorder in which blood vessels in the brain fail to supply the proper blood flow. This results in inadequate blood supply to brain cells, depriving them of oxygen and other important nutrients. When this happens, parts of the brain begin to die. The symptoms of cerebral infarction may be subtle and not immediately recognized. For this reason, the best way to determine the type of stroke a patient has is to get a CT scan or magnetic resonance imaging (MRI) scan.
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Cerebral infarction has various causes. The most common is generalized hypotension, although other conditions can cause cerebral infarction. In general, the infarction is characterized by swelling of gray or white matter, petechial hemorrhage, and ischemia. Some people also suffer from cerebral embolism, a condition in which a blood clot in the brain blocks blood flow to the ischemic region.
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There are two types of infarction: hemorrhagic and nonhemorrhagic. The former is a result of the initial lack of blood flow. Hemorrhagic infarction is caused by a secondary source of ischemic tissue, such as a ruptured aneurysm or trauma. The latter is more difficult to differentiate because it occurs if the patient's history or clinical course is unreliable.
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The symptoms of cerebral infarction depend on which part of the brain is affected. Those that affect the primary motor cortex usually experience weakness on one side of the body, or loss of sensation on the other side. Other symptoms can be abnormal pupil dilation and light reactions, as well as eye movement on the opposite side of the body. Speech infarction may lead to slurred speech, and reflexes may become aggravated.
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The treatment of cerebral infarction depends on its cause and location. Massive cerebral infarctions impinge on vital structures and can result in coma and death. While mechanical thrombectomy may be a life-saving procedure if it is performed within 6 hours of the onset of symptoms, late treatment is only indicated if substantial tissue is at risk. CT and MR perfusion imaging can identify the volume of infarcted tissue and the ischemic penumbra. A large mismatch between these two values indicates the presence of a substantial penumbra.
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Despite the importance of identifying possible risk factors for stroke, young people are particularly vulnerable. About 10% of young adults have stroke. Many young people have vascular risk factors that are undiagnosed or unknown. Cerebral infarction is a serious and often life-threatening disease, but it can be prevented. The prevention of young adults with a high-quality education program is crucial. This study provides the first evidence-based guidelines to develop a prevention program.
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A ruptured cerebral aneurysm affects about 30,000 people in the United States every year, and about 6 percent of people may have a smaller, unruptured one. About one percent of the population has an AVM. People with AVM have a four percent risk of experiencing hemorrhage each year. One in five suffers from a stroke, which is often fatal. Diagnosis of cerebrovascular problems is possible through diagnostic imaging. These tests allow neurosurgeons to look at brain tissue.
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Patients with an ischemic stroke can receive a blood transfusion of tissue plasminogen activator (TPA), an FDA-approved drug for ischemic stroke. However, this drug must be administered within a three-hour window from the onset of symptoms. Although effective in ischemic strokes, the risk of intracranial hemorrhage is substantial. For patients who have already received TPA, thrombolytic drugs may be administered, and a carotid endarterctomy may be necessary.
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TIAs are considered a precursor to a major stroke. While they are not classified as a full stroke, they serve as warning signs of another event. Because they are caused by blood clots, TIAs are not treated with the same care as a full stroke. Despite these risks, it is recommended to seek emergency medical care as soon as possible. In addition, about 10 to fifteen percent of people who experience TIAs go on to develop a major stroke within three months.
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Cerebral infarction is a complication of chronic meningitis. These infections are associated with high mortality and morbidity. TBM shares some clinical characteristics with cryptococcal meningitis, but is more severe in many cases. It can lead to neurological complications such as hydrocephalus and seizures. Because of these risks, early diagnosis is essential to maximize the patient's chance of survival. Early diagnosis and ventricular decompression are vital to preventing further cerebral ischaemia.