Having a cerebral infarction, cerebral ischemia or ischemic stroke is the most common type of stroke. It is caused by ischemia – i.e. a sudden reduced blood flow to the brain – which can result in the death of nerve and brain cells.
What is a cerebral infarction?
The term cerebral infarction is mainly used when it is an ischemic stroke. This results in reduced blood flow to the brain, which leads to a reduced supply of glucose and oxygen to the organ.
In medicine, such a loss of blood flow is called ischemia. According to abbreviationfinder.org, blockages or narrowing of the arteries supplying the brain are responsible for the reduced blood flow. If the ischemia is not reversible, this leads to the death of brain and nerve cells, which in turn triggers a cerebral infarction.
From the medicine, the cerebral infarction is classified as an urgent emergency. Ischemic stroke is one of the leading causes of death in industrialized countries. People who are older than 70 years are particularly affected. Stroke is much more common in men than in women.
Causes
In most cases, a cerebral infarction is caused by arteriosclerosis, also known as hardening of the arteries. In most people, this occurs as a result of high blood pressure ( hypertension ), diabetes mellitus (diabetes) or the consumption of tobacco. The main reason for the blockage of blood vessels is hardening of the arteries.
Over time, plaque accumulates on the inner walls of the blood vessels. This refers to deposits of fat and cells. The larger the size of the plaque, the more the affected blood vessel narrows. People who suffer from diabetes, high cholesterol or high blood pressure are considered to be particularly susceptible to the formation of plaques.
If an artery is increasingly narrowed by the plaques, it is no longer possible for sufficient oxygen-rich blood to reach the tissue. There is also a risk of plaque tearing. This tear can lead to the formation of a thrombus ( blood clot ).
As a result, there is even a threat of complete occlusion of the vessel. This in turn leads to ischemia, during which the supply of oxygen to the tissue is interrupted. The patient then suffers a stroke. Another possible cause of a cerebral infarction is an embolism. The resulting embolus is free to move and able to follow the body’s blood flow.
In the worst case, it blocks a blood vessel in the brain and causes a stroke. Inflamed cerebral vessels, malformations of the heart or cardiac arrhythmia are usually responsible for an embolism. The risk factors for a cerebral infarction include old age, disorders of lipid metabolism, lack of exercise, alcoholism and smoking.
Symptoms, Ailments & Signs
The sudden onset of various symptoms is typical of an ischemic stroke. The affected persons suffer from a clouding of consciousness. This can manifest itself as tiredness, through unconsciousness, to a deep coma.
Other possible complaints are headaches, vertigo, the perception of double vision, nausea, vomiting, swallowing and speech disorders, visual field defects, hemiplegia or paralyzed individual limbs and memory loss.
In addition, neuropsychological deficits such as apraxia, attention disorders and cognitive dysphasia occur. Which symptoms are actually recorded depends on the affected vessel or brain area. Furthermore, there are different symptoms in men and women.
Diagnosis & disease progression
If the patient shows early warning signs such as temporary discomfort, brief signs of paralysis, speech disorders or memory problems, a doctor should be consulted immediately. The doctor first takes a detailed look at the patient’s medical history, which is followed by a neurological examination.
Imaging diagnostic methods such as computed tomography (CT) or magnetic resonance imaging (MRI) play an important role. By using them, it is possible to quickly distinguish between a cerebral infarction and a cerebral hemorrhage, which is important for further treatment.
The possible examination methods also include angiography, Doppler sonography, an EEG to check the brain waves, an ECG to diagnose cardiac arrhythmias and a lumbar puncture, in which the cerebral fluid (liquor) is checked. The course of a cerebral infarction depends on which brain region was damaged and to what extent.
Early treatment is extremely important for a favorable prognosis. While some patients experience only mild effects, others require ongoing care and are bedridden. It is not uncommon for chronic damage such as visual disturbances, speech disorders or paralysis to occur. In the worst case, the patient dies from the stroke.
Complications
Even if a cerebral infarction is treated quickly and professionally, there is a risk of complications occurring. These can further aggravate the consequences of the stroke. The feared complication is increased intracranial pressure. It is triggered by accumulations of water or bleeding in the brain. There is also a risk of an epileptic seizure or thrombosis (blood clots) from the stroke.
When complications arise, it plays a major role at which point in the brain the cerebral infarction occurs. For example, a larger infarction can sometimes cause only mild discomfort in certain areas, while a smaller infarction in other areas of the brain can result in severe disability. In principle, however, serious consequences must be expected in the event of a cerebral infarction.
The course of the disease in the first few weeks after the stroke must also be taken into account. Typical sequelae of cerebral infarction include permanent paralysis, swallowing problems associated with a risk of aspiration, and pneumonia. Aspiration is the passage of vomit, saliva, or food into the airways, which in turn causes pneumonia.
Numerous complications after a cerebral infarction arise from the subsequent confinement to bed. This includes, among other things, a pressure sore ( decubitus ), which occurs together with sensory disorders. Due to the restricted activity of the bladder and kidneys, there is a risk of urinary tract infections. Improper positioning of the patient can also lead to joint stiffness.
When should you go to the doctor?
Cerebral infarction is a medical emergency. Without prior warning, the affected person loses control of various functional systems of the organism and is often no longer able to speak. If you lose consciousness, you need intensive medical care as soon as possible. Since the person concerned is at risk of suddenly dying, an immediate reaction must be taken. Every minute until medical care decides on the life of the person concerned and possible consequential damage.
An ambulance is therefore required and until they arrive, first aid measures must be taken. An emergency doctor should be contacted as soon as the first unexpected abnormalities occur. If the sufferer reports sudden discomfort, weakness, or double vision, there is cause for concern. A doctor is required if you experience nausea, vomiting, dizziness or speech disorders. If concentration, orientation or attention disorders occur, emergency medical care must be provided. In the event of motor problems or signs of paralysis, the person concerned needs immediate help.
A doctor’s visit is necessary in the event of memory loss, acute fatigue, unsteady gait or complaints in one side of the body. If the victim falls into a comatose state, an ambulance should be called. Medical help is required as soon as possible if there are signs of confusion, difficulty swallowing or loss of vision. Observers of the event must ensure ventilation of the person concerned.
Treatment & Therapy
Immediate treatment is required for a cerebral infarction. This should take place in the hospital in a so-called stroke unit. There, the patient receives optimal diagnostics and therapy. He is also closely monitored. Body temperature, pulse, blood pressure, respiration and blood sugar are checked.
Furthermore, several medical disciplines such as neurology, neurosurgery, radiology and internal medicine work closely together. One possible treatment option for a cerebral infarction is lysis therapy, which is intended to dissolve the blood clot.
In the early stages of an ischemic stroke, blood-thinning medication can also be administered. These include primarily acetylsalicylic acid (ASA). However, this must not be taken during lysis therapy. Sufficient saturation of the blood with oxygen and thrombosis prophylaxis are also important.
Outlook & Forecast
The time of the first medical aid as well as the location and the size of the cerebral infarction are decisive for a prognosis. The later the affected person is cared for and treated in intensive care, the poorer the chances of recovery are in most cases. At the same time, the location of the damage in the human brain is relevant for a good prognosis. With very quick care and good subsequent rehabilitation, there are good prospects for recovery. At present, however, every second patient with a cerebral infarction remains disabled, severely disabled or in need of care for life.
The extent of the damage to the brain must be assessed and classified individually. If areas of the brain tissue are affected that regulate important functions of the organism, such as locomotion, thinking or speaking, impairments that have lifelong effects on the state of health can be expected. Symptoms may improve, but recovery is unlikely.
In addition to the physical changes, a cerebral infarction often has side effects. Due to the mental stress caused by the changed living conditions, psychological complications are to be expected. These usually worsen the healing process, lead to delays or can almost completely prevent recovery. With good mental strength and motivation in the patient, many physical improvements can be achieved. However, if paralysis occurs, it is permanent and irreparable.
Prevention
To prevent a cerebral infarction from occurring in the first place, the risk factors for arteriosclerosis should be reduced. This includes regular monitoring of blood pressure and blood sugar and a lifestyle that includes a low-fat and low-sugar diet and sufficient exercise. In addition, the consumption of tobacco products should be avoided because the risk of a cerebral infarction increases significantly.
Aftercare
A cerebral infarction often results in speech and perception disorders or even paralysis. When it comes to aftercare, it is therefore important to start rehabilitation measures as early as possible. Recognizing and treating swallowing difficulties should be done as early as possible. Long-term damage can be minimized in this way. According to studies, the first three months after a stroke are crucial for brain regeneration.
Unfortunately, it is part of the clinical picture that those affected can suffer further strokes after the acute treatment of the cerebral infarction. Experts therefore recommend that you seek inpatient rehabilitation. The reduction in brain performance is difficult to diagnose in outpatient rehabilitation. This can involve various symptoms, such as impaired perception, memory or short-term memory.
It is difficult to make a general statement about the correct aftercare for a cerebral infarction. It requires exact research into the cause in order to be able to follow it up with optimal aftercare. However, it is precisely the control and reduction of risk factors that should be taken into account during aftercare.
Smoking, obesity and a generally unhealthy lifestyle massively increase the risk of another cerebral infarction. Sufficient exercise, a healthy diet and little alcohol and tobacco products can ensure that another cerebral infarction does not happen again, even at an advanced age.
You can do that yourself
A cerebral infarction is also referred to as a stroke, in which every minute counts in order to be recognized as such. If this is treated successfully as quickly as possible, follow-up care will be essential. The longer the diagnosis is delayed, the more damage can be caused to the patient. In the case of consequential damage caused by the disease, such as unilateral paralysis or speech difficulties, the person concerned must take professional rehabilitation measures. This should be done by a specialist in his practice. It takes a lot of patience and empathy to achieve effective recovery. With timely recognition and treatment as well as the necessary therapy, it is possible in many cases for the patient to be completely cured.
To avoid a subsequent cerebral infarction, the patient will need to make lifestyle changes, stop smoking and drinking to excess, and may need to change their diet to a healthy diet. If another incident does occur, it is important to take immediate action. These are to be taken to the hospital immediately or to call the emergency services, who are told on the phone that a cerebral infarction has already occurred. The signs are one-sided impairment of movement, speech difficulties, visual impairments that are recognizable.