Infarction of the brain is one of the most dangerous pathologies, while becoming more common, including among middle-aged people. The prognosis of the disease is largely determined by the timeliness of the provision of qualified medical care and the subsequent care of the patient.
A cerebral infarction - what is it?
The disease in question is an acute clinical syndrome, manifested by impaired brain function due to the cessation of blood supply to one of its departments. The localization and extent of the lesion may vary. When the blood does not reach the brain tissues, regardless of the triggering mechanism, hypoxia (oxygen starvation) and a number of other metabolic disorders, pathobiochemical changes, are observed. These processes, called the "ischemic cascade", lead to irreversible damage to the affected neurons and their death - an infarction.
When an ischemic cerebral infarct occurs, a zone is formed around the necrosis foci, where the blood flow is disturbed, but has not reached the critical level ("ischemic penumbra"). In this area, neurons are not yet subjected to morphological changes, and for some time retain their functioning. If the treatment is started in time (no later than 3-6 hours after the attack), the blood circulation is normalized, the nerve tissues are restored. In the absence of therapy, these cells also begin to die.
What is the difference between a cerebral infarction and a cerebral stroke?
Many are interested in whether the concepts of "cerebral infarction" and "stroke" are equivalent, what is the difference between them. The term "infarct" in medicine, meaning tissue necrosis due to lack of blood supply, is applicable to many organs, whereas "stroke" means the same, but only to the brain. This distinction of concepts is taken to avoid confusion, so cerebral infarction and brain stroke are synonyms.
Lacunar infarction of the brain - what is it?
Approximately twenty percent of cases develop a lacunar cerebral infarction, characterized by the appearance of a small necrotic focus in the deep tissues of the cerebral hemispheres or in the trunk region. The maximum size of the affected tissue is 1.5-2 cm in diameter. The pathology is often caused by the defeat of small arteries feeding these areas of the brain. Subsequently, on the site of dead tissue, a cyst is formed, filled with cerebrospinal fluid. Such education, as a rule, is not dangerous and does not provoke significant disorders.
Extensive cerebral infarction
When an extensive cerebral infarct is diagnosed, this means that necrotic changes affect large areas of the cerebral hemispheres due to cessation of blood flow in one of the carotid arteries. Depending on which of the hemispheres is affected (left or right), such a cerebral infarction has different consequences. In many cases, the prognosis for this type of pathology is unfavorable.
Cerebral infarction - causes
Cerebral infarction associated with cerebral vascular injury often does not occur suddenly, at the same time, but develops gradually in the presence of certain diseases and predisposing factors. Occlusion of cerebral vessels can provoke:
- thrombi (blood clots);
- destroyed atherosclerotic plaques;
- fragments of disintegrated tumors;
- intravascular air embolus;
- fat embol.
In addition, a blood circulation disorder can occur when the integrity of the vessels is violated or because of their prolonged spasm. Causal factors are often:
- hypertension ;
- atherosclerosis;
- rheumatic endocarditis ;
- ischemic heart disease ;
- heart failure accompanied by reduced pressure;
- atrial fibrillation;
- migraine;
- diabetes;
- hematological diseases;
- pathology of vascular development;
- vascular tumors;
- osteochondrosis of the cervical spine;
- excessive body weight;
- stress;
- alcohol abuse;
- smoking;
- lack of mobility;
- physical overload, etc.
Infarction of the brain - symptoms and consequences
Ischemic cerebral infarction with lesions of a small area of the nervous tissue in some cases is difficult to recognize because of the erosion of symptoms, but with a large-scale lesion, the clinical picture is pronounced, and the consequences do not exclude a lethal outcome in about forty percent of the victims. If assistance is provided in a timely manner, the chances of a favorable outcome are great.
Infarction of the brain - symptoms
With a cerebral infarction, sometimes symptoms are foreshadowing, appearing in most patients in the early morning or at night for several hours and even days before the attack. Often this is:
- severe dizziness accompanied by darkening in the eyes;
- numbness in any part of the upper or lower limb;
- short-term speech disturbance.
We list the main signs of a cerebral infarction, some of which are observed in this or that type of pathology:
- loss of consciousness;
- nausea, vomiting;
- headache;
- a sudden feeling of heat;
- convulsions;
- strong weakness;
- speech defects;
- impaired vision;
- sensation of deafness;
- inadequate emotional state;
- loss of sensitivity in the limbs;
- loss of memory;
- uncontrolled movements;
- skewed face to one side, etc.
Infarction of the brain - consequences
The diagnosis of "cerebral infarction" can lead to many other pathologies, the most common among which are:
- congestive pneumonia;
- pulmonary embolism;
- acute heart failure;
- edema of the brain;
- pressure sores;
- immobility;
- violation of speech, sight, hearing;
- deterioration of mental activity;
- epileptic seizures;
- coma;
- memory loss.
Cerebral infarction - treatment
If a manifestation is found in a person nearby that can indicate a cerebral infarction, you should immediately call the doctors and give the victim first aid:
- lay the patient on his back, placing a small roller on his shoulder, shoulders, and head;
- to get rid of crushing clothes, accessories;
- provide fresh air;
- when vomiting - turn your head to one side, cleanse the airways of the vomit;
- to measure blood pressure.
Patients who are diagnosed as having a cerebral infarction are treated in the following basic directions:
- normalization of respiratory functions;
- stabilization of cardiac activity;
- control of blood pressure;
- regulation of water-salt balance, glucose level;
- maintaining body temperature;
- reduction of cerebral edema ;
- symptomatic therapy depending on clinical signs;
- prevention of complications.
Patients and their relatives should tune in for long-term treatment, have patience, believe in healing and follow all medical recommendations, which increases the chance of success. In some cases, neurosurgical interventions are required to restore vascular patency, but more often only conservative treatment is required. Drug therapy includes the following groups of drugs:
- antiplatelet agents (Aspirin);
- anticoagulants (Heparin, Warfarin);
- nootropic drugs (Cerebrolysin, Pyracetam);
- calcium antagonists (Nimotop, Akatinol);
- means for improving the rheological properties of blood (Reopoliglyukin, Pentoxifylline);
- hypotensive drugs (lisinopril, Furosemide);
- antidepressants (Fluoxetine, Amitriptyline);
- lipid-lowering drugs (rosuvastatin, simvastatin).
Cerebral infarction - rehabilitation
A cerebral infarction caused by various factors requires a long recovery period, during which most of the lost brain functions can be restored. Rehabilitation after this pathology includes the following measures:
- physiotherapy (paraffin baths, electrostimulation, etc.);
- physiotherapy;
- massage;
- psychotherapeutic practices;
- exercises to restore speech;
- training of operative memory (memorizing verses, table games with elements of memorization);
- social adaptation (search for hobbies, visits to theaters, exhibitions).