What Are the Symptoms of Cerebral Infarction? - Oren Zarif - Cerebral Infarction
The brain shows distinct features of cerebral infarction. A wedge-shaped expansion of the cerebral hemispheres is a hallmark of a hemorrhagic infarction. This expansion is probably the result of an embolism to the middle cerebral artery branch. There is also a wedge-shaped zone of parenchymal loss. In addition, a section of the pons shows a remote infarct in the basis pontis, resulting from a hypertensive event.
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The mechanism of cerebral infarction is not known in all cases, but several risk factors have been implicated. For example, increased blood pressure, hypertension, and obesity are associated with an increased risk of cerebral infarction. The vascular risk factors underlying stroke may be genetic or environmental, but they are generally not inherited. In general, stroke risk factors include age, gender, family history, hypertension, and high blood cholesterol.
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Another form of cerebral infarction involves an embolus in the cerebral artery. This is caused by a small clot or a clot that lodges in a narrow vessel. Small emboli tend to lodge in the distal branches of superficial arteries, resulting in a gray-white infarct. Infarcts in the middle cerebral artery are most common. It is important to treat the condition promptly to reduce the risk of permanent damage.
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The most common type of cerebral infarction is arterial-to-artery embolism, but other causes can occur. Small artery occlusion is associated with a continuum of cerebral histology that may be characterized by isolated focal loss of neurons, axonal loss, or generalized hypotension. There are many other types of infarction, including ischemic stroke, ischemia rarefaction, and vascular infarction.
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Initial workup for suspected cerebral ischemia includes a full blood count, coagulation factors, and EKG. A stat non-contrast head CT is indicated to rule out hemorrhage and other mass lesions. Vascular imaging is also important for acute stroke etiology. An acute large vessel occlusion can be easily identified by vascular imaging. If the occlusion is caused by an acute source of cerebral ischemia, the patient may develop coma or even death.
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The clinical signs of a cerebral infarction vary from mild to severe. Surgical decompression may be used to save a life. It may be a surgical procedure, and surgical resection of infarcted tissue is another option. If medical management has failed, surgical intervention may be necessary. In many cases, patients will need to be hospitalized. A hemisphere of the brain is usually affected by a massive cerebral infarct, and decompression surgery can help.
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The symptoms of cerebral infarction are similar to those of a brain tumor. Atypical clinical course and an unreliable history make the diagnosis of cerebral infarction difficult. A physician must carefully assess all presenting symptoms and evaluate any accompanying signs and symptoms. He or she should be able to distinguish between a cerebral infarction and a brain tumor by the characteristic imaging findings. The following is a brief description of the most common symptoms and signs of cerebral infarction.
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The presence of an aortic arch plaque occluding aortic arteries may be an indicator of a large risk for recurrent stroke, peripheral embolism, and vascular death. Research on the natural history of this condition and the use of noninvasive methods to assess its composition are important. Future research may involve initiation of therapeutic trials. Research in this area is continuing to help physicians diagnose cerebral infarction and improve its treatment.
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Those patients with STEMI who arrive within 6 hours of their onset of symptoms are treated with fibrinolytic therapy or percutaneous coronary intervention. Regardless of the type of STEMI, the goal of treatment is to restore blood flow within 30 minutes to 90 minutes. There are certain absolute contraindications to fibrinolytic therapy, including intracranial malignancy, active bleeding, and suspected aortic dissection. Although most STEMI patients recover with these treatments, their risk of a stroke continues to increase.