Diseases

Cerebral Infarction

Neurological disease

Cerebral infarction is caused by a blockage of a blood vessel in the brains. Part of the brains is without oxygen and nutrients and experiences damage and function loss or dies. Cerebral infarction, as well as cerebral hemorrhage and TIA, falls under the heading of ‘stroke’.


Cause

Cerebral infarction can occur when an artery in the brains gets clogged. This is called atherosclerosis. Fats accumulate on the inside of the blood vessels. If a portion breaks off, it may block a blood vessel in the brains. Clogging of the artery takes time. There are progressively more and more deposits against the artery wall, which ultimately leads to the situation that no blood can pass through anymore. Then we speak of cerebral infarction.

It may also be that a blood clot goes through the heart to the brains and shuts off an artery there. Then the brains receive no more blood and oxygen. The clot can get stuck in the brains itself or in a vein that carries blood towards the brains. The main places where blood clots occur are the carotid arteries, the heart and the valves.


Symptoms

A cerebral infarction occurs rapidly and unexpected and can be identified by the following signs and symptoms:


Diagnosis

The doctor can identify a cerebral infarction on the basis of physical examination and a description of what has happened. The doctor can usually determine on the basis of the neurological symptoms, which artery in the brains is blocked. The typical sound of blood swirls in the carotid artery (audible with a stethoscope) may indicate narrowing.

Making the exact diagnosis requires several examinations, including a CT or MRI scan of the brains, blood tests and possibly an ECG or an examination of the blood vessels in the neck.

First, a doctor must determine whether the patient has had a cerebral infarction or a cerebral hemorrhage. This is not visible from the outside. The symptoms are the same, but for treatment it is crucial to know.


Treatment

In case of a cerebral infarction, treatment must be started as quickly as possible. This treatment is called thrombolysis. The patient is given an infusion of clot-dissolving drugs. The sooner one receives thrombolysis, the less chance of permanent damage. Thrombolysis can reduce the damage, but it also has a major drawback: the risk of bleeding increases.

And with a cerebral hemorrhage, the bleeding should just be stopped. Therefore, thrombolysis may only worsen the situation in case of cerebral hemorrhage. Thrombolysis should start at least within 4.5 hours after the occurrence of the first failures. After 4.5 hours, the chance of recovery decreases rapidly. The risks of treatment (especially bleeding) do no longer outweight the benefits (proper recovery) then.

After cerebral infarction, the patient will also receive medication to lower blood pressure and cholesterol.


Prognosis

Approximately ten percent of the patients who have had a cerebral infarction, recover almost completely and about twenty-five percent recovers largely. Approximately forty percent of the patients have moderate to severe disabilities, for which special care is needed and about ten percent should be cared for in a nursing home or other care facility. Some patients have both serious physical and mental impairment and cannot move, speak or eat normally anymore. Approximately fifteen percent of the patients with cerebral infarction dies in hospital. In the elderly, this percentage is higher.


Considerations

Once a person has had a brain infarction, he or she is at increased risk of getting it again. This risk can be reduced by taking the following measures:


Facts


Synonyms

Brain Infarction, Cerebral Infarct


See also

Atherosclerosis

Cerebral Hemorrhage

Diabetes Mellitus

Headache

High Blood Pressure

High Cholesterol

Obesity

Stress

Stroke

Transient Ischemic Attack (TIA)

Vertigo

Blood Test

CT Scan

Electrocardiography (ECG)

Magnetic Resonance Imaging (MRI)

Alcohol

Fat

Healthy Food

Physical Exercise

Smoking

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