Cerebral infarction: how dangerous is this disease? Cerebral infarction: what it is, symptoms and consequences.

Cerebral infarction is often called ischemic stroke. First you need to find out what exactly this disease is, what processes it affects. It all starts with the fact that blood cannot flow to a certain part of the brain. The result is tissue damage, their softening leads to ischemic stroke.

What causes the problem? Usually the cause of the disease is a complex of factors that have a detrimental effect on the patient’s health. Reduced blood flow, embolism, thrombosis, cardiovascular diseases can develop cerebral infarction and become a trigger.

Main reasons

Age. Older people are at great risk, and the disease is most common among this generation.
Bad habits – especially smoking.
An advanced form of atherosclerosis of the vertebral, cerebral, and carotid arterial vessels.
common among people suffering from diabetes.
Heart diseases.

The disease has specific symptoms. Its characteristic feature is gradual progression. Symptoms of a cerebral infarction may worsen for an hour or two. There are cases where patients develop symptoms over several days. They did not seek help, blaming other illnesses on poor health. In addition, the symptoms of an ischemic heart attack may disappear for some time, then appear and increase.

With an ischemic stroke, the main signs become more important, and the general ones are relegated to the background. The main indicators include speech disorders, paralysis of limbs, and paresis. A heart attack that is localized in the brain stem has additional disorders - dizziness, dysphagia, impaired coordination, nystagmus. Some patients complain of drowsiness, stupor, and disorientation. Loss of consciousness signals an extensive hemispheric infarction with edema.

Headache, nausea, vomiting are extremely rare sensations during ischemic stroke.

Lacunar infarction

This is a type of ischemic cerebral infarction. It appears as minor damage. Size - no more than 15 mm. This type of heart attack is still being studied, as it remains controversial what exactly can cause it. Most often, this disease is caused by blockages of nutrient vessels that appear due to atherosclerosis, inflammation, blood clots, fat droplets, viruses or bacteria.

The reason may be disturbance of local blood circulation, problems in the body's gas exchange. Lacunar infarction disrupts the functioning of the thalamus, perventicular region, basal ganglia, that is, penetration occurs into structures that are located deep in the brain. The frequency of patients diagnosed with cerebral infarction and victims of this particular type is about 30%

Lacunar infarction can occur regardless of age; this is a problem not only for the elderly generation. Males are more predisposed to this type of disease. The causes are similar to ischemic stroke, however, these are different diseases. A characteristic difference is that patients with rheumatism and diabetes are most at risk.

Symptoms are short-term in nature, can be bright and distinct, and sometimes insignificant. The localization of the damaged area plays an important role. Most often, the patient feels a lack of coordination and difficulty speaking. Headaches, vomiting, and lethargy are not typical manifestations of lacunar infarction.

An amazing fact is that patients with cerebral infarction are sixty-year-old healthy people who did not have a diagnosis of arterial hypertension, and their blood pressure was considered within normal limits. Many doctors cannot fully explain why this happens.

Is it possible to recover from a cerebral infarction?

In fact, the chances of recovery are high. Naturally, each patient's case is individual. It is necessary to take into account the location of the disease, how far it has spread, and the patient’s state of health. Small outbreaks that do not touch vital centers are not dangerous. As the damage disappears, a small cyst forms; it does not interfere with the functioning of the body, and the person can live a long, rich life.

Of course, in more severe cases, patients cope with the consequences of ischemic strokes for a long time, sometimes they remain incurable. The following complications are possible: paralysis of one or another part of the body, impaired speech, the occurrence of a neurological symptom.

A severe heart attack is a dangerous, unpredictable disease. The worst thing is death. One wrong move by the doctor, unfavorable circumstances, other diseases that worsen the situation, and saving the patient becomes more and more difficult.

Patients who have experienced an ischemic stroke need to take care of their health. Particular attention should be paid to those who have suffered from massive lesions in the brain.

In these cases, complications are rarely avoided; they make themselves felt in the first days after a heart attack. Patients cannot cope with minimal tasks. For example, take a spoon. Moreover, sometimes the functioning of the brain itself is disrupted; a person does not understand familiar things and their necessity. It is worth accustoming a person to eating after two days, from the moment the illness makes itself felt. You need to think about your diet. Try to maintain a relative balance of proteins, fats, and carbohydrates. Avoid fatty, fried and salty foods.

Water: the patient should drink at least two liters per day. If independent nutrition is a difficult task, then it is worth using a probe and special mixtures.

Cerebral infarction (I63 according to the ICD-10 classification) is a severe pathological condition characterized by necrosis (death) of brain tissue. It occurs as a result of ischemic stroke - a violation of blood supply in the cerebral arteries, which leads to oxygen starvation of the brain, causes damage to the tissues of a certain area of the brain and disruption of their functions. For this reason, ischemic stroke itself is sometimes called cerebral infarction. This disease is one of the leading causes of death.

When the anterior cerebral artery is damaged, involuntary grasping reflexes, leg paresis, impaired eye movements, and motor aphasia are observed.

Why does cerebral infarction develop, what is it and how does it differ from a stroke?

Causes

What causes a cerebral infarction? The immediate cause is acute ischemia, that is, insufficient blood supply to the brain. It can be caused by blockage, spasm, or compression of the arteries supplying blood to the brain. Emboli, blood clots, and, less commonly, air bubbles or drops of fat can clog blood vessels. Sometimes a disruption of the blood supply to the brain occurs due to cardiovascular insufficiency, leading to cerebral ischemia and hypoxia. The most common cause of ischemic stroke is considered to be thrombosis due to atherosclerosis of cerebral vessels or as a result of cardiogenic embolism.

Regardless of what became the trigger for ischemia, the pathological process develops in the same way: disruption of blood flow leads to disruption of protein synthesis and breakdown of glucose in nerve cells. Brain trophism is disrupted, oxygen starvation occurs. In the area of the brain where oxygen has stopped flowing, the process of cell death begins, i.e. necrosis develops. However, if blood supply to the affected area is quickly restored, the nerve cells are restored. Otherwise, a massive cerebral infarction occurs.

Due to energy starvation, nerve cells cannot maintain the constancy of their metabolism and undergo necrosis. Cerebral edema develops. Due to edema, the brain inside the skull is compressed, its structures are displaced, the cerebellum may be depressed, the medulla oblongata may be wedged into the foramen magnum. This often ends in death.

If blood flow in the middle cerebral artery is disrupted, paresis and sensory disturbances in the upper extremities and lower half of the face, sensory and motor aphasia, and head tilting occur.

The main risk factors contributing to the development of cerebral infarction:

lipid metabolism disorders;
atherosclerosis;
prolonged blood stagnation;
increased blood clotting;
autoimmune vascular diseases.

In addition to the listed diseases, there are risk factors associated with lifestyle, individual characteristics and bad habits:

alcohol abuse;
long-term smoking;
excess weight;
sedentary lifestyle;
hereditary predisposition;
elderly age;
metabolic disorders;
acute or chronic infections.

Classification

Depending on the pathogenetic features, the following types of cerebral infarction are distinguished:

thromboembolic– infarction caused by thrombosis of the cerebral arteries, i.e. associated with occlusion of an intracranial vessel by a thrombotic mass or atherosclerotic formation;
rheological– caused by changes in the blood coagulation system. Blockage of blood vessels by blood clots in this case is due to an increase in viscosity and increased blood clotting due to polycythemia or erythrocytosis;
lacunar– formed when small intracranial arteries are blocked, usually resulting from arterial hypertension. The development of small foci of infarction is characteristic.

Thromboembolic infarction includes atherothrombotic and cardioembolic. In atherothrombotic infarction, thrombosis or embolism of an arterial vessel arises from foci of atherosclerosis in the intracerebral arteries. Cardioembolic cerebral infarction develops as a result of cardiocerebral embolism in heart disease. In this case, emboli formed in the cavities of the heart are introduced into the arterial system of the brain with the blood flow.

If the blood circulation in the posterior cerebral artery is impaired, visual disturbances, problems with understanding speech and memory occur.

The thromboembolic type also includes hemodynamic cerebral infarction, which occurs when there is a sharp drop in blood pressure against the background of severe stenosis of blood vessels in the brain or neck.

Symptoms of cerebral infarction

The symptoms of cerebral infarction depend on the location of the lesion. The disease can have an acute or subacute course, usually of a progressive (less often wavy) nature. In most cases, everything happens within a few minutes, less often – hours or days.

The immediate cause is acute ischemia, that is, insufficient blood supply to the brain. It can be caused by blockage, spasm, or compression of the arteries supplying blood to the brain.

In the future, surgery may be used to treat a heart attack. With the help of surgery, it is possible to eliminate the factors that led to blockage of blood vessels, which reduces the risk of another heart attack by 70%. Surgical treatment can also be used to increase blood perfusion, reduce intracranial pressure, and maintain cerebral blood flow.

Why is a cerebral infarction dangerous? The consequences of a cerebral infarction if timely medical care is not provided can be very serious, including death. This disease ranks second in the structure of mortality after myocardial infarction and belongs to the category of diseases requiring long-term rehabilitation measures.

Video

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Many people are familiar with the concept of “heart attack,” but few understand what a cerebral infarction caused by thrombosis of the cerebral arteries is.

This serious disease, which is not always completely treatable, can significantly impair brain function, negatively change a person’s quality of life, and even cause death.

A heart attack is tissue necrosis, that is, its irreversible death. The most common cause of cerebral infarction is considered to be complete blockage of the arteries, which provide a constant flow of blood and oxygen to the cells of the organ. Tissues that no longer receive nutrition begin to starve and then die.

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Mostly elderly people are susceptible to the disease. The older a person is, the greater the risk of developing a cerebral infarction.

Pathogenesis

Blood cannot pass through the artery, therefore, leaking through the walls of the vessels, and more often, breaking them, it enters the brain tissue. In this case, intracranial pressure increases, parts of the brain are displaced or pinched, its membranes are destroyed and swelling of the organ occurs.

The development of the disease is influenced by the following factors:

paralysis of intracerebral arteries caused by spasm and disruption of the nervous regulation of blood vessels;
embolism - blocking of the vascular lumen by particles formed from thrombotic deposits;
circulatory failure in the collateral (lateral or bypass) blood flow;
a general disorder of blood movement through the vessels (hemodynamics), caused by uneven pressure in different parts of the circulatory system;
changes in the physical, biological and chemical properties of blood.

Elderly people suffering from chronic heart disease, arterial hypertension, a history of diabetes mellitus, smoking and alcohol abusers, and women who have been taking hormonal contraceptives for a long time are also at risk.

Clinical picture

A few days before the blockage, patients may experience headache, numbness of the limbs, and dizziness. The condition continues to worsen, aphasia is observed - impaired or absent speech, paralysis of the limbs occurs.

Tendon reflexes decrease, pathological reflexes unusual for a healthy person may appear, muscles weaken, swelling occurs, joint tissue degeneration (arthropathy) occurs, accompanied by severe pain, and flexion or extension of the limbs is often difficult (contracture).

Diagnosis of cerebral infarction caused by thrombosis of cerebral arteries

It is important to notice the onset of the disease in order to prevent irreversible consequences in the brain as soon as possible.

There are the first signs indicating the formation of a blood clot in the vessels of the brain and impaired blood flow:

paralysis of limbs;
involuntary movements;
uncontrolled facial expressions;
impaired or lack of speech;
enlargement of one pupil on the affected side;
dullness or absence of pain.

Emergency diagnosis is most effective when using computed tomography, which allows you to identify a heart attack and distinguish it from a hemorrhage.

Magnetic resonance therapy is also used, which makes it possible to examine blood vessels.

Successful elimination of thrombosis reduces the likelihood of recurrent heart attacks by more than 70%

In the absence of modern diagnostic devices, a puncture of the spinal cord is performed and cerebrospinal fluid (CSF) is taken for analysis. The presence of blood impurities in it means that a cerebral hemorrhage has occurred.

Dopplerography or duplex scanning is used to study the carotid arteries. The most effective method is angiography of the cerebral arteries - examination of the vessels by introducing a radiopaque substance into them, which makes it possible to detect the localization of thrombosis and assess the degree of blockage of the lumen.

The latter diagnostic method is used strictly according to indications. There is always a risk of damage to blood vessels by the catheter through which the substance is administered, which can lead to a stroke.

Treatment

Cerebral infarction caused by thrombosis of the cerebral arteries requires emergency hospitalization of the patient. Therapy must be started within the first hours after the attack - this significantly increases the chances of saving the patient’s life.

Reducing the blood's ability to clot in the first two hours and using blood thinning medications can significantly reduce the risk of paralysis, as well as other serious complications. However, in case of cerebral hemorrhages, the administration of these drugs is contraindicated.

Treatment consists of systematic therapy:

stabilization of the acid-base balance of the blood;
restoration of blood circulation to the brain;
oxygen saturation of the blood through the use of antihypoxic drugs;
elimination of respiratory failure;
lowering blood pressure.

According to indications, the use of surgical treatment methods may be necessary. Blockage of the carotid artery is an indication for surgery.

In some cases, surgery is necessary to lower intracranial pressure, normalize cerebral blood flow, and increase perfusion pressure and oxygen supply to brain cells.

Dehydration drugs and diuretics are prescribed to eliminate excess water from the body. Anticoagulant therapy is mandatory - drugs that reduce blood clotting; fibrinolytic drugs are used to promote the resorption of blood clots and prevent their formation.

The patient continues to take medications to reduce swelling for several days.

The most important stage after emergency care and normalization of blood flow is the recovery period.

Rehabilitation consists of the following actions:

control of the stable functioning of the gastrointestinal tract, urinary system, heart rate;
maintaining stability of blood pressure, heart rate, breathing;
speech restoration;
return of muscle tone;
gradual return of the patient's motor activity.

Moral support from family members is also necessary, which will prevent a person from becoming depressed and losing the meaning of life.

If necessary, it is better to use the help of a specialist - a psychologist, who, using professional methods, will help restore the patient’s positive attitude and faith in a successful recovery.

Prevention

Prevention of cerebral infarction and vascular thrombosis must begin in adulthood, trying to lead a healthy lifestyle, as well as reduce the effect of all negative factors affecting the effective functioning of the cardiovascular system.

Prevention measures are as follows:

Maintain normal blood pressure (140/90 mmHg)	If you have arterial hypertension, you must take medications prescribed by your doctor every day to lower your blood pressure and prevent its levels from rising.
It is important to quit smoking completely	Cigarettes are the main factor contributing to the formation of thrombosis and progressive atherosclerosis. People who smoke are 50% more likely to suffer from heart and brain infarctions.
Do not abuse alcoholic beverages	In old age, it is better to completely stop drinking alcohol. Toxic breakdown products remaining in the blood after drinking alcohol lead to increased blood pressure, complicate the course of hypertension, and also negatively affect kidney function, disrupt heart rhythm and often provoke cerebral infarction.
Treatment of heart defects, ischemia, heart failure	These pathologies increase the likelihood of cerebral infarction.
If a woman has a history of arterial hypertension, frequent migraines	It is better to abandon oral hormonal contraceptives. The risk of heart attack increases when this factor is combined with smoking.
Blood Sugar Control	Treatment of diabetes mellitus by following a special diet without carbohydrates and taking medications that reduce the amount of sugar significantly reduces the risk of heart attacks due to blockage of blood vessels.
Cholesterol support	It promotes the formation of atherosclerotic plaques in the coronary vessels and carotid arteries.

The brain is the most important organ responsible for all processes in the body. The irreversible consequences of a heart attack can completely deprive a person of a full life, the ability to move, walk, talk, which can cause serious nervous disorders and depression, and deprive the desire for life.

Cerebral infarction caused by thrombosis of the cerebral arteries is a disease that requires immediate treatment. The effectiveness of subsequent therapy and rehabilitation measures directly depends on the provision of first aid within two hours after the onset of a heart attack.

Emergency therapy will increase the chances of not only returning all the joys of life to a person, but also the opportunity to live for many more years.

The human body is essentially a fragile thing and danger to its life can lurk around every corner. So, if some injuries are not dangerous in themselves, their complications can lead to serious pathologies. One of these is cerebral embolism.

Features of the disease

A cerebral embolism is a sudden occlusion of cerebral vessels by an embolus, which sometimes results from the development of an ischemic stroke. The condition is dangerous because it may not manifest itself in the first days, and if not diagnosed in time, it leads to internal bleeding, cerebral hemorrhage and death.

Classification

Embolism can be single or multiple, as it can be caused by one or more blood clots. The most common embolic material is a thrombus, which occludes blood vessels in the brain. The thrombus can have different sizes, but in any case they speak of cardiogenic embolism (eg, cerebral vessels) or thromboembolism. According to the same principle, the disease is classified into:

Fat. In this case, the lipid droplet enters the bloodstream and blocks the capillaries, gradually moving to the brain.
Air. Blockage of blood vessels is caused by an air bubble.
Gas. It is similar to air in all respects, however, the blockage is caused by a gas bubble.
Cellular. Pieces of tissue enter the bloodstream and disrupt it.
Microbial. It is caused by microbes settling on the walls of the capillaries, which causes ulcers that block the blood flow.
Mechanical. In this case, the blockage is caused by a foreign body, such as a bullet.

Depending on the type, the causes and some treatment regimens vary. We’ll talk about the causes of cerebral embolism further.

Causes

The common cause for all forms of embolism is vascular trauma, for example, during accidents or surgical interventions. In this case, it may not be the brain itself that is injured: even childbirth in some cases can be complicated by embolism.

The most common causes of embolism:

fracture and injury of a tubular bone;
traumatization of subcutaneous fat tissue;
administration of oil-based medications;
pneumothorax;
abortion intervention;
carrying out caisson works;
rapid decompression;
anaerobic gangrene;
pathological processes that provoke tissue destruction;
severe microbial inflammation.

Embolism can also be caused by mechanical factors. This happens when injured by fragments of bombs and bullets: a foreign body blocks blood circulation.

Read on to find out what symptoms are characteristic of cerebral artery embolism.

Symptoms of cerebral embolism

The clinical picture of cerebral embolism is the severity of neurological infarction. Depending on the type and location of the blockage, symptoms may vary. The main symptoms are:

dizziness;
loss of consciousness;
dyspnea;
severe fatigue;
hemoptysis;
cough with phlegm;
convulsions;

In some young patients, embolism may not appear immediately, but may make itself felt after stress and physical activity. loads.

Diagnostics

The condition is diagnosed by examination and hardware tests. First, the doctor collects a medical history and complaints, and also conducts a physical examination for bluish skin and other signs of embolism. An accurate diagnosis can be made by CT scan of the brain, which allows you to determine the lesion and the possible location of the blockage.

For additional diagnostics to identify causes and associated pathologies, the following is prescribed:

blood and urine tests;
scintigraphy.

The most accurate examination is MRI, however, diagnosis with its help is expensive, and not every hospital has the necessary equipment.

Treatment

Treatment must be resorted to immediately after diagnosis, since any delay can be fatal. The main treatment measure is drug therapy, which can be carried out in combination with surgical and therapeutic methods.

Note! Treating embolism with folk remedies is strictly contraindicated! This can eliminate some of its manifestations, which will worsen control over the patient’s condition. On the advice of a doctor, you can take some herbal medicines, but it is forbidden to prescribe them to yourself.

Therapeutic

Patients with embolism are advised to rest completely. If the patient feels well, then treatment can be carried out at home, however, it is better to transport the patient to a hospital. The hospital is also indicated if the patient’s condition worsens.

When transporting, it is necessary to use a stretcher, keeping your head higher than your feet, and monitoring the condition so that foamy saliva does not enter the respiratory tract and lead to suffocation. After delivery to the hospital, the person must be carefully undressed and freed from tight clothing, and then the oral cavity must be cleaned of vomit and mucus must be sucked out from the respiratory tract.

If there is an increase in blood pressure, you can resort to bloodletting (200-300 ml at a time). It is also important to follow a diet, so vegetable fatty foods are indicated only on the 2nd day after you feel better, and until this time it is better to limit yourself to teas and light meals.

Medication

Drug therapy is prescribed depending on the manifestations of embolism:

In cases of severe ischemic status, i.e., low blood pressure and weakened pulse, cardiovascular drugs such as camphor and caffeine are prescribed.
For respiratory disorders, injections of lobeline and cititonin are used.
If prothrombin is reduced, vikasol and vitamin K are given. If prothrombin is elevated, it is optimal to take anticoagulants such as dicumarin, pelentan, phenylin and heparin.
Patients with thrombopenia are given vitamin C, blood transfusions and calcium chloride.
During a thrombotic stroke, thrombolytic drugs are indicated.
For ischemic stroke, pachycarpine is prescribed.
Patients with tachyarrhythmia and atrial fibrillation should take Medinal or novocainamide with novocaine.
Patients with pulmonary edema are given antifoaming agents, for example, antifomsilan.

Other drugs may also be used, depending on symptoms and response to treatment.

Operation

Surgery is indicated when breathing stops. During this condition, the patient undergoes a tracheostomy, that is, an incision is made in this area, after which a temporary anastomosis is created between the trachea and the environment.

Patients with a tracheostomy must be given oxygen through a tube after removing mucus and phlegm.

Prevention

Prevention of cardiac embolism involves avoiding conditions that can lead to it. Often, this is impossible to do, since the list of these conditions is very wide. During surgery, the doctor must monitor the quality of blockage of blood vessels, that is, cauterization, dressing of wounds, etc. You can reduce the risk of developing embolism if you monitor your health and fully comply with the doctors’ requirements.

Other types of surgeries aimed at restoring normal circulation may also be used.

Complications

Embolism is a serious condition that is often complicated by:

internal bleeding;
cerebral hemorrhage;
cerebral edema;
circulatory disorders;
heart rhythm disturbances.

The most serious complication of a cerebral embolism is respiratory arrest, which can be fatal if first aid is not provided in time.

Forecast

The prognosis for the treatment of embolism depends entirely on its timely diagnosis. There are no exact statistics, but in most cases, when an embolism affects a person outside of a hospital setting, the patient dies because he does not immediately see a doctor.

With early diagnosis and proper treatment, the likelihood of a full recovery is high. Sometimes patients may experience residual effects such as paresis, circulatory disorders and concomitant diseases.

Cerebral infarction (ischemic stroke) is a dangerous pathology that develops as a result of a serious circulatory disorder. As a result, a fairly rapid death of nerve cells is observed, which leads to irreversible consequences for the human body. The danger of this disease is explained by the structure of the brain. It consists of specific tissues that have a high need for oxygen and are extremely sensitive to its lack. If blood circulation is impaired, irreversible changes are observed in the brain. They lead to disruption of basic functions, which provoke all the negative phenomena associated with this disease.

The most dangerous consequence of a cerebral infarction is the death of a person, which occurs in 25% of cases during the first day. 40% of patients die a little later - within 20 days. Also, 50% of all surviving patients remain permanently disabled. In this case, there remains a high risk of death within 5 years.

What causes ischemic stroke?

The causes of impaired blood flow in the brain are specific. These include:

atherosclerosis. This pathology most often provokes cerebral infarction in combination with other aggravating problems, which include arterial hypertension. This factor is found in 70% of patients. It increases the risk of stroke by 12 times. Also, a heart attack in combination with atherosclerosis can be caused by diabetes mellitus, syphilis, various pathologies of the blood, heart (congenital defect, myocardial infarction), blood vessels, after serious injuries, in the presence of infectious diseases of various types, etc. The presence of several factors at once aggravates the human condition . Very often there are cases when the causes of blockage of cerebral vessels are precisely secondary causes;
the presence of serious pathologies in the structure of the vertebral or carotid arteries. In the presence of this factor, cerebral infarction develops as a result of stenosis (narrowing of the lumen) or vascular thrombosis;

after breaking large bones. In this case, the stroke is provoked by a fat embolism that develops with this condition;
surgical intervention. It very rarely happens that during certain operations (most often on an open heart), an air bubble can enter the bloodstream. It impedes normal blood circulation, which leads to stroke;
blockage of the artery with blood clots that form during thrombophlebitis of the lower extremities;

development of air embolism. It develops when the chest or neck is injured;
prolonged smoking, alcohol abuse, exposure to drugs;
blockage of blood vessels can occur as a result of the accumulation of decay products of various tumors;
long-term use of oral contraceptives (especially in combination with smoking), which leads to blood clots;
psycho-emotional or physical stress.

Considering all the factors that lead to the development of the disease, it is clear that people over 50 years of age are most susceptible to this disease. However, we should not forget that stroke can also develop in young people with certain health problems.

Signs of the disease

Blockage of blood vessels, which is caused by certain negative factors, or any other disorder of cerebral circulation leads to a gradual or sharp increase in various neurological signs. The characteristic symptoms of a heart attack can actively develop over several hours or even days. A peculiarity of a stroke is that its symptoms may increase over time or, conversely, weaken.

In most cases, the symptoms of a cerebral infarction are as follows:

complete absence of pain. Stroke symptoms rule this out because there are no pain receptors in the brain;
complete or partial paralysis. A person cannot make many movements, there is numbness in any part of the body or half of it;
the appearance of involuntary movements. This is explained by the activity of the segmental apparatus of the spinal cord;
difficulty speaking or complete loss of speech. These symptoms appear much less frequently in women than in men. This is due to the fact that the fair sex has one speech center in each of the hemispheres of the brain;

violation of facial expressions. A person cannot smile, move his lips normally, or make other similar movements;
There is uneven dilation of the pupils. This can happen when blood flow is disrupted in only one hemisphere of the brain. In this case, a dilated pupil will be detected in one eye, and a normal one in the second;
impairment of consciousness, which often has different manifestations. The person may feel drowsy or fall into a coma. Most often there is a short-term loss of consciousness;

dizziness, which is often accompanied by vomiting and nausea;
the appearance of autonomic disorders - increased sweating, dry mucous membranes, tachycardia, etc.;
temporary hearing loss, deafness;
drowsiness;
pale skin;
a sharp decrease in blood pressure.

The symptoms of a heart attack are largely determined by the area of the brain where there is insufficient blood supply. Based on developing symptoms, a preliminary diagnosis can be made and the problem area can be identified.

Classification of the disease

Cerebral infarction is divided into several types:

Atherothrombotic stroke. This pathology develops as a result of the concomitant course of hypertension, coronary heart disease, etc. This type of cerebral infarction is caused by thrombosis of the cerebral arteries and, most often, occurs in the morning or during sleep. In this case, tissue damage occurs on different scales. A person’s condition may rapidly deteriorate (or there may be short-term episodes of improvement).

Cardioembolic stroke. Occurs when arteries are blocked by emboli of cardiac origin. With the development of this type of cerebral infarction, an acute onset is observed. The causes of this pathology are various heart diseases. Emotional or physical stress is also considered an aggravating factor leading to this problem.

Lacunar stroke. This is a pathology caused by damage to small vessels that supply blood to the deep structures of the brain. In this case, there is an increase in blood pressure, but there are no signs of impairment of higher nervous activity. This disease rarely lasts longer than 3 weeks, and may not even be detected during brain imaging.

Hemodynamic stroke. In this case, insufficient blood supply to the brain tissue is explained by a sharp decrease in blood pressure. This type of cerebral infarction most often occurs in elderly people with severe vascular atherosclerosis. A feature of this pathology is that it can develop gradually or suddenly.

Hemorheological stroke. In this case, cerebral infarction occurs due to a clear violation of blood flow. This can occur against the background of heart disease, when using hormonal contraceptives, diuretics, drinking excessive amounts of coffee, alcohol and for other reasons.

Diagnosis of cerebral infarction

Cerebral infarction can be detected using the following diagnostic procedures:

CT scan. Using this study, you can easily distinguish hemorrhage from cerebral infarction;
MRI (magnetic resonance imaging). Using this diagnostic procedure, you can determine the condition of the cerebral vessels;
cerebrospinal fluid examination. During a cerebral infarction, no blood is detected in the cerebrospinal fluid;
duplex scanning, Dopplerography to study the condition of the carotid arteries;
cerebral angiography. A modern method of x-ray examination of blood vessels located in the brain. This diagnostic method is indispensable if surgical intervention is necessary, but can be dangerous due to the high risk of vascular rupture.

Cerebral infarction is a disease that requires urgent hospitalization of the patient. The sooner treatment measures are taken, the higher the likelihood of a favorable outcome. It is best when medical care is provided within 2 hours after the onset of symptoms of the disease.

In a hospital setting, treatment is used that is aimed at restoring cerebral circulation and protecting tissues from further destruction.

Most often this happens using the following means:

thrombolytics. Medications are used to dissolve blood clots that lead to blockage of the arteries;
anticoagulants. Prevents the formation of new blood clots, reduces blood clotting;
antiplatelet agents. Drugs in this group slow down platelet aggregation;
neuroprotectors. They help stop biochemical reactions that are triggered during the death of damaged brain cells.

Cerebral infarction can also be treated surgically. Most often, carotid endarterectomy is performed to remove the inner wall of the carotid artery, which is affected by atherosclerotic plaques. Surgery has its own indications and contraindications, which must be taken into account to obtain the desired effect.

Cerebral infarction is a clinical syndrome that is expressed in acute disruption of local brain functions. It lasts more than 24 hours, or leads to the death of a person during this time. An acute circulatory disorder during a cerebral infarction occurs due to blockage of its arteries, which provokes the death of neurons in the area that is fed by these arteries.

Cerebral infarction is also called ischemic stroke. This problem is very relevant in the modern world, since a huge number of people die every year due to cerebral infarction. The mortality rate for ischemic stroke is 25%, another 20% of patients die within a year, and 25% of the surviving people remain disabled.

Treatment of cerebral infarction

Symptoms of cerebral infarction

Symptoms of a cerebral infarction depend on where the lesion is located.

However, general symptoms of this pathological process can be identified, including:

Headache;

Loss of consciousness, sometimes coma may develop;

Dizziness;

Disturbances in the functioning of the pelvic organs;

Pain in the eyeballs;

Feeling hot;

Dry mouth;

Nausea and vomiting accompanied by severe headache;

Convulsions (not always present).

If the focus of a cerebral infarction is localized in the right hemisphere, then the following clinical picture is characteristic:

Complete immobility (hemiparesis) or significant decrease in strength (hemiplegia) of the left limbs;

Sensitivity in the left half of the body and face disappears or sharply decreases;

Speech impairment will be observed in left-handed people. In right-handed people, speech disorders develop exclusively when the left hemisphere is damaged. The patient cannot reproduce words, but conscious gestures and facial expressions are preserved;

The face becomes asymmetrical: the left corner of the mouth goes down, the nasolabial fold is smoothed out.

Depending on which half of the brain is damaged, symptoms of a cerebral infarction will be observed on the opposite side. That is, if the lesion is located in the left hemisphere, then the right half of the body will suffer.

If a cerebral infarction develops in the vertebrobasilar vascular system, then the patient’s symptoms are as follows:

Dizziness that increases when you tilt your head back;

Coordination suffers, static disorders are observed;

There are disturbances in the movement of the eyeballs, vision deteriorates;

A person pronounces individual letters with difficulty;

Problems with swallowing food appear;

Paralysis, paresis, and loss of sensation in the limbs will be observed on the side opposite to the lesion.

It is worth considering separately the symptoms of cerebral infarction depending on which cerebral artery is damaged:

Anterior cerebral artery – incomplete paralysis of the legs, the occurrence of grasping reflexes, impaired eye movements, motor aphasia;

Middle cerebral artery – incomplete paralysis and sensitivity disorder of the hands, as well as the lower half of the face, sensory and motor aphasia, laterofixation of the head;

Posterior cerebral artery – visual disturbances, the patient understands the speech of another person, can speak himself, but he forgets most words.

In severe cases, consciousness is depressed and the person falls into a coma, which can occur when any part of the brain is damaged.

Causes of cerebral infarction

The following causes of cerebral infarction are distinguished:

Atherosclerosis. It develops in men earlier than in women, since at a young age female blood vessels are protected from atherosclerotic lesions by sex hormones. The coronary arteries are the first to be affected, then the carotid ones, and subsequently the cerebral blood supply system;

Hypertension. Mild hypertension (pressure up to 150/100 mm Hg), which is the most dangerous, enhances atherosclerosis and disrupts the adaptive reactions of the arteries;

Heart diseases. Thus, people who have had a myocardial infarction have a high risk of developing a cerebral infarction. In 8% of patients after myocardial infarction, ischemic stroke will develop within the first month, and in 25% of patients - within six months. Coronary heart disease and heart failure are also dangerous;

High blood viscosity;

Atrial fibrillation. They cause blood clots to form in the left atrial appendage, which are subsequently transported to the brain;

Disorders of the endocrine system, primarily diabetes mellitus;

Vascular diseases (pathologies of their development, Takayasu's disease, anemia, leukemia, malignant tumors).

In addition, do not forget about risk factors that increase the likelihood of a cerebral infarction, including:

Age (every ten years of life increases the risk of developing cerebral infarction by 5-8 times);

Hereditary predisposition;

Physical inactivity;

Excess weight;

Smoking (if this bad habit is supplemented by taking oral contraceptives, then smoking becomes a leading risk factor for the development of cerebral infarction);

Alcohol abuse;

Acute stress or prolonged psycho-emotional stress.

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Consequences of cerebral infarction

The consequences of a cerebral infarction can be very serious and often pose a direct threat to human life, among them are:

Brain swelling. It is this complication that develops more often than others and is the most common cause of death of a patient in the first week after an ischemic stroke;

Congestive pneumonia is the result of the patient being in a horizontal position for a long time. It most often develops 3-4 weeks after a cerebral infarction;

Pulmonary embolism;

Acute heart failure;

Bedsores due to the patient lying motionless in bed for a long time.

In addition to the listed consequences of cerebral infarction, which develop in the early stages, long-term complications can also be identified, including:

Impaired motor function of the limbs;

Decreased sensation in the arms, legs and face;

Speech problems;

Deterioration of mental abilities;

Mental disorders;

Difficulty swallowing food;

Coordination problems when walking and turning;

Epileptic seizures (up to 10% of people who have had a cerebral infarction are susceptible to them);

Malfunctions of the pelvic organs (bladder, kidneys, intestines, reproductive organs suffer).

What is the difference between a cerebral infarction and a stroke?

When a cerebral infarction occurs, the blood supply to the brain is disrupted, as a result of which the tissues of the affected area begin to die. Insufficient blood flow to the brain occurs due to atherosclerotic plaques that prevent its normal flow, due to heart rhythm disturbances, or due to problems with the blood coagulation system.

With a hemorrhagic stroke of the brain, on the contrary, the blood flow to it increases, which causes an artery rupture. The cause is vascular pathologies or hypertensive crisis.

There are differences in the course of the disease. Thus, cerebral infarction develops gradually, over several hours or even days, and hemorrhagic stroke occurs almost instantly.

Treatment of cerebral infarction

Treatment of cerebral infarction is primarily based on thrombolytic therapy. It is important that the patient is admitted to the neurological department within the first three hours from the onset of the attack. The patient must be transported in an elevated position. The head should be 30 degrees higher than the body. If a thrombolytic is administered to the patient at the specified time, the drug will begin to very quickly dissolve the existing blood clot, which most often causes a violation of the blood supply to the brain. The effect can often be seen almost instantly, in the first seconds of drug administration.

If thrombolytic therapy is not carried out in the first three hours from the onset of cerebral infarction, then it no longer makes sense to continue it. Changes will occur in the brain, the nature of which is irreversible.

It is worth considering that thrombolysis is performed only when the doctor is sure that the patient has a cerebral infarction and not a hemorrhagic stroke. In the latter case, such therapy will lead to death.

If it is not possible to administer a thrombolytic, then the following measures are indicated:

Reduced blood pressure levels;

Taking antiplatelet agents (Aspirin) or anticoagulants (Clexane, Fraxiparin, Heparin);

Prescription of medications aimed at improving cerebral blood supply (Trental, Piracetam, Cavinton).

Patients are also prescribed B vitamins, undergo restorative treatment, and are involved in the prevention of bedsores. Self-medication is unacceptable; at the first signs of a cerebral infarction, you must call an ambulance. It is worth remembering that at home it is impossible to distinguish a cerebral infarction from a hemorrhagic stroke.

The surgical method for treating cerebral infarction is surgical decompression aimed at reducing intracranial pressure. This method can reduce the mortality rate in cerebral infarction from 80 to 30%.

An important component of the overall treatment regimen for cerebral infarction is competent rehabilitation therapy, which is called “neurorehabilitation.”

You need to start it from the first days of illness:

Movement disorders are corrected with the help of physical therapy, massage and physiotherapy methods. At the moment, there are special simulators that help people recover after a cerebral infarction;

Speech disorders are corrected during individual sessions with a speech therapist;

Swallowing dysfunctions are leveled out by special devices that stimulate the laryngeal and pharyngeal muscles;

Stabilization platform exercises help to cope with coordination problems;

Psychological assistance to patients is no less important. A psychotherapist helps to cope with emotional problems;

A person is prescribed statins and Aspirin for life;

To improve brain function, it may be recommended to take medications such as Cavinton, Tanakan, Bilobil, etc.

It is important for the patient himself to constantly monitor blood pressure, blood sugar and cholesterol levels, as well as give up bad habits and lead a healthy lifestyle with the obligatory presence of moderate physical activity.

Cerebral infarction is a life-threatening condition also known as ischemic stroke. It develops as a result of an acute circulatory disorder, in which blood either flows poorly to certain parts of the brain or stops flowing altogether. The danger of the disease is that if the situation is not corrected within 7 minutes, then irreversible changes occur in the affected parts. The consequences can be very different.

In most cases, untimely assistance to a patient leads to his death. The gray matter that forms the cerebral cortex is the most sensitive to oxygen starvation. But it is this part that is responsible for performing the most complex functions in the body.

Reasons for appearance

So, anything can provoke a cerebral infarction. It is especially often diagnosed in people over 50 years of age, although young people are not immune from it. The following are the main reasons for the development of pathology:

Atherosclerosis. Blocked blood vessels combined with high blood pressure can lead to a stroke.
Damage to the carotid or vertebral artery. This cause is diagnosed in half of all cases of brain disease.
Surgery on the heart or blood vessels.

Too much psychological or physical stress.
Atrial fibrillation.
Thromboangiitis obliterans.
Stenosis of the cerebral arteries.

Blood clotting disorder.
Infectious arteritis.
Bad habits: smoking, alcohol abuse.

Disturbances of the endocrine system.
Excessive body weight.
Kidney diseases.
Low mobility.

Systemic connective tissue lesions.
Oncological blood pathologies.
Chronic progressive subcortical encephalopathy.

We listen carefully to the advice of neurologist Mikhail Moiseevich Shperling about the problem:

Cervicocerebral arterial dissection.
Systemic decrease in pressure.
Taking contraceptives that can disrupt the hormonal system.

All these reasons can be prevented, so you should carefully monitor your health. Cerebral infarction often leads to the death of the patient or severe consequences that greatly reduce his quality of life.

How does the pathology manifest itself?

Symptoms of damage depend on which hemisphere of the brain is affected, how extensive the damage is, and how severely the blood flow is impaired. In general, ischemic stroke has the following manifestations:

Violation of movements and facial expressions.
Confusion.
Speech problems.
Pale skin.
Drowsiness.

Blood pressure surges.
Visual impairment.
Paralysis and paresis.

Enlarged pupils on the affected side.
Involuntary movements.

You can also identify symptoms that appear depending on how part of the brain is damaged:

Disturbances in the middle cerebral artery basin have the following manifestations: impaired muscle tone, hemiplegia, pathological reflexes of the feet, paresis and paralysis of the arms, impaired swallowing, apraxia.
If a heart attack occurs in the area of the anterior cerebral artery, then it is characterized by the following symptoms: paralysis and paresis of the legs, mental disorders.
In the event of a disturbance in the blood supply to the posterior cerebral artery, the patient has the following symptoms: dizziness, nystagmus, and a feeling of numbness.

The presented symptoms are characterized by the fact that they appear on the side of the body that is opposite to the affected hemisphere.

Classification of the disease

The disease can be classified according to several criteria:

By etiopathogenetic subtypes:

Atherothrombotic cerebral infarction. The cause of a stroke is a blood clot that forms and blocks a blood vessel. This type of lesion is most often observed after sleep in the morning. The pathological condition appears suddenly, and brain damage can be extensive.
Cardioembolic. Symptoms of pathology are expressed at the very beginning of its development. The disease can be triggered by an artificial heart valve, atrial fibrillation, emotional or physical stress.

Lacunar stroke. In this case, small blood vessels going into the deep structures of the brain are susceptible to pathological changes. Over time, cysts form at the site of the lesions. A characteristic sign of pathology is increased pressure. Higher nervous activity is practically not disturbed, there are no general cerebral symptoms. This form of the disease lasts no more than 21 days. Its diagnosis is very difficult, since it is not always detected even with CT scans. This type of pathology is provoked by diabetes mellitus, chronic lung disease, and changes in the blood vessels of the fundus.
Hemodynamic. This type of cerebral infarction is typical for older people who are diagnosed with atherosclerosis and low blood pressure. The onset of an attack can be gradual or sudden.

Hemorrhagic. The cause of the development of pathology is a violation of blood flow. Impaired brain function may be accompanied by complete loss of mobility, problems with breathing and swallowing. The risk of death of the patient in this case is very high. A heart attack can happen at any time and anywhere. The rehabilitation period here begins in 2-4 weeks.

According to the vascular basin that is affected:

Internal carotid artery. The most common disease that affects it is atherosclerosis. However, complete blockage may not cause a cerebral infarction, since replacement blood circulation will occur.
Anterior cerebral artery. This pathological condition is characterized by paresis of the arms and legs. It is characterized by urinary incontinence, spontaneous flexion or extension reflexes, and mental disorders.
Middle cerebral artery. This type of disease occurs more often than others. If there is a blockage of the main trunk of the presented vessel, then an extensive infarction occurs.

The figure shows the main arteries of the neck and head

Depending on the affected area:

Infarction of watershed zones. The lesion is located at the junction of the blood supply territories.
Lacunar. Blood circulation is impaired in the area of the base of the pons. It is usually multiple, and the diameter of the lesions is 1.5 cm.
Territorial. In this case, the main arteries of the brain are affected.

Neurologist, head of the neurological department Vladimir Petrovich Shepotinnik talks in more detail about the classification, symptoms and treatment of the disease in this video:

Symptoms that arise as a result of brain damage can also be divided into several types:

Spicy. It is characterized by the initial manifestation of neurological signs.
Wavy. This type of symptoms is observed at the initial stage of the development of a heart attack. Their intensity increases over several hours.
Tumor-like. Neurological symptoms also increase gradually. They say that the brain is swollen, and...

To effectively treat a cerebral infarction, it must be recognized in time. Any delay is fraught with consequences.

How is the disease diagnosed?

The patient is examined using the following methods:

CT. Using this procedure, it is possible to distinguish between a cerebral hemorrhage and a heart attack.
MRI. The presented study allows us to examine in detail all the vessels of the head.
Doppler sonography or duplex scanning of the blood vessels of the brain.

Cerebrospinal fluid analysis. If there is no blood in the cerebrospinal fluid, then a diagnosis of ischemic stroke can be made.
Angiography. This research method is used if the patient requires surgical intervention.

Correct diagnosis is the key to effective treatment of cerebral infarction. But the time to conduct the examination is very limited, so an experienced specialist is needed.

Traditional and surgical treatment

Therapy is aimed primarily at restoring normal blood circulation in the brain. You also need to relieve the symptoms that the disease provokes. First aid is provided to the victim while still in the ambulance. It must be transported in a strictly horizontal position, and the head should be raised. To normalize blood pressure, Dibozol or Clonidine is administered intravenously to the victim. You may also need anticonvulsants and medications to stop bleeding. It is important to maintain the functionality of the respiratory organs and heart.

For further treatment, the patient is prescribed the following drugs:

Anticoagulants: Heparin. They are an essential part of treatment for brain damage, but these medications may not always be taken. There are the following contraindications: severe impairment of liver function, exacerbation of stomach ulcers, hemorrhagic diathesis.
Antiplatelet agents. The drugs presented are necessary to prevent the formation of blood clots that clog blood vessels.
Thrombolytic drugs. They are injected directly into the vessels and help dissolve the blood clot. If the patient has a cerebral hemorrhage or bleeding due to a stomach ulcer.

In very severe cases of cerebral infarction, the patient is advised to undergo surgery. The most common intervention is carotid endarterectomy. It involves removing a fragment of the wall of an artery affected by atherosclerotic plaque.

In case of cerebral infarction, another operation is performed: stenting. It is indicated when there is a risk of consequences from a previous intervention.

Treatment for brain damage is quite difficult and lengthy. Even if doctors and relatives of the patient responded quickly and eliminated the lesion, the consequences may remain. The patient will require long-term rehabilitation aimed at restoring motor and other body functions.

You can learn useful information about the disease, treatment and rehabilitation in this video from specialists from the Scientific Center for Neurology of the Russian Academy of Medical Sciences:

During the recovery period, the patient needs to stabilize blood pressure, pulse, and breathing. He also needs to try to resume at least a partial amount of previously acquired skills. The most difficult thing to correct is mental disorders. The patient will need the help of psychotherapists, as he is capable of becoming depressed, which worsens his general condition.

Consequences and prevention of the disease

A cerebral infarction can leave serious complications. If the patient does not die, then he remains with the following consequences:

Persistent impairment of mental activity.
Paralysis of half the body or complete immobilization.

Cognitive disorders.
Epilepsy.

Blindness.
Difficulty swallowing.
Urinary incontinence.

Almost half of the patients who have an ischemic stroke lose their ability to work and become disabled. When the first symptoms of a cerebral infarction appear, you should not self-medicate or hope that everything will go away on its own. The consequences can be extremely severe.

As for prevention, to prevent cerebral infarction it is necessary to exclude all those factors that can provoke the disease. For example, it is better to give up bad habits. It is important for people who suffer from hypertension to carefully monitor their health. It is also necessary to carry out secondary prevention of pathology: timely treatment of chronic diseases of the endocrine and cardiovascular systems.

The human brain has two hemispheres, penetrated by a network of deep and superficial vessels.

Changes in blood pressure directly affect the tension of large-caliber vessels, which leads to so-called cerebral infarctions.

This disease is determined when a large area of the cerebral cortex is affected. What is a massive heart attack?

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Risk group

As with other types of disease, there are risk groups for heart attack.

People belonging to the main groups are most susceptible to this disease:

People suffering from high blood pressure are hypertensive.
People who have pathologies of the cardiovascular system. This is associated with an increasing risk of the formation of emboli and blood clots (prosthetic heart valves, acquired and congenital heart defects,).
People who have had transient ischemic attacks. These attacks are called micro-stroke. If proper treatment is not carried out, a massive heart attack will be provoked. Symptoms include local muscle numbness, sudden weakness, problems with balance, speech and vision, and severe headaches.
Population diagnosed with diabetes mellitus and high blood cholesterol.
Population diagnosed with carotid artery stenosis.
People with nicotine and alcohol addiction, as well as using various psychotropic drugs.
People who have been diagnosed with varying degrees of obesity resulting from an unhealthy lifestyle.

Kinds

The impact of a large heart attack is taken by a fairly large area of nervous tissue, which subsequently (but not always) spreads to all two or one hemisphere. Accordingly, the affected part of the hemispheres loses all functions, which entails incompatibility with the full functioning of the body.

Extensive damage to the hemispheres is mainly caused by pathology of the main branches and the carotid arteries themselves. Most often this is observed in people with atherosclerotic narrowing of the vessels mentioned above. In most cases, such a narrowing occurs hidden and the person does not realize that he is susceptible to a heart attack almost every second.

Some patients suffer transient ischemic attacks, which are also harbingers of a major heart attack. These attacks are triggered by the formation of thrombotic masses on the plaques of the carotid arteries and their transfer by blood into the blood vessels, which leads to circulatory disturbances in the brain itself of a temporary and reversible nature.

It is important to examine the cervical and head vessels for people who have suffered at least one such attack. These include Dopplerography and ultrasound examination of blood vessels. If the examination reveals a significant narrowing, then it may be suggested to prevent a massive heart attack.

To determine the proportion of the lesion, it is necessary to conduct magnetic resonance and computed tomography

Extensive heart attack has two main types:

If the second type of heart attack leads to instant death, then the patient with cerebral ischemia can be saved.

An ischemic heart attack affects both sides of the brain - left and right. Speech function is affected by damage to the left lobe. There are a number of symptoms that help visually identify the lesion.

An extensive infarction of the right hemisphere of the brain can be determined by several symptoms:

depressed, passive state;
left-sided paralysis of the body and facial muscles;
speech and memory impairment - although in some cases speech will persist, which leads to difficulties during diagnosis.

With left-sided brain damage, the following is observed:

impaired speech and logical thinking;
right-sided paralysis of the body and facial muscles;
pronounced deviations in the patient’s psyche.

In cases of extensive infarction of certain areas, the patient loses certain functions. For example, if Broca's center in the brain has been damaged, the patient has speech function, but can only express himself in fits and starts, and can use and understand short sentences.

In addition to the left and right extensive infarction, five more main groups are distinguished, but short-term attacks and transient ischemic attacks are not taken into account:

Micro-occlusive infarction	Caused by a blood clotting disorder (fibrinolysis, hemostasis).
	Caused by blockage of arteries. A distinction is made between complete and partial.
Hemodynamic infarction	The most common type of heart attack is associated with a sharp drop in blood pressure. Affects most of the cerebral hemispheres.
Extensive	Causes a protracted clinical picture. It is caused by blockage of the vascular system and its other pathologies. This type of heart attack is predicted and predicted when a blood clot is detected in large vessels.
	It got its name from the cavities formed (lacunae). Arising as a result of damage to perforating vessels. The diameter of the lacunae varies between 0.05 – 5 mm. This heart attack develops gradually and can occur during sleep.

Causes

Our brain is fed by arterial vessels, and when they are compressed or undergo prolonged spasm, an ischemic infarction occurs. It occurs in more than 70% of cases. The formation of atherosclerotic plaques and blood clots leads to atherothrombotic infarction. Also among the causes of its occurrence are transient ischemic attacks.

Blockage of the arteries can be caused by emboli, which occur with arrhythmias, heart defects and other types of diseases. A heart attack caused by such a blockage is called cardioembolic.

More rarely, cases of extensive infarction caused by hemodynamic causes are observed. Such reasons include a sharp drop in blood pressure. A striking example is a strong state of shock.

Ischemic infarction is much more common than hemorrhagic infarction, but the latter has much more serious consequences. It is caused by a rupture of the primary blood vessel wall and extensive hemorrhage in the brain.

The reasons are:

Symptoms

Its symptoms depend on the type of heart attack and which hemisphere is affected. Most often, these cases have pronounced symptoms and are quite severe, so they can be diagnosed without much difficulty.

Among the main symptoms are:

changes in consciousness lead to stupor or coma of various stages;
dizziness or sharp pain (with a hemorrhage called subarachnoid, the patient feels a blow to the back of the head);
vomiting, fear of death, nausea, palpitations, dry mouth, shortness of breath, redness of the face and pale skin, cold sweat (these symptoms are called vegetative);
convulsions;
complete or partial paralysis of the muscles of the face and body (with an infarction of the left hemisphere, the right half of the body suffers, and, conversely, with the right, the left);
the occurrence of paresthesia and loss of sensitivity on the opposite side of the affected hemisphere of the brain;
the onset of aphasia (speech impairment) - occurs only when the left side of the brain is damaged;
impairment of human memory, so-called lapses;
problems with orientation, hearing, vision, smell;
disturbance of orientation and coordination;
disturbance of the patient's mental state.

The difficulty in recognizing a heart attack is caused by instant coma and loss of consciousness, because it is impossible to identify problems with vision, motor skills, sensitivity and speech.

A test of the pupils and their reaction to light will help - one pupil is wider than the other and does not narrow in the light.

The patient can survive and restore functions that were lost during a massive heart attack only with timely hospitalization. It takes only three hours from the onset of a heart attack for neurons to completely die.

If there is the slightest suspicion of a heart attack, a person should be placed on a hard surface and doctors should be called. It is also important to make the room in which the patient lies not stuffy and to ventilate it.

Direct treatment takes place under the strict supervision of doctors (neurosurgeons and neurologists) at the hospital. Among the medications, drugs that can reduce blood clotting are also used.

A decrease in blood glucose, which is caused by medications, is also necessary. Some cases require surgery.

Hemorrhagic stroke requires the administration of hemostatic drugs and drugs that can form blood clots. Sometimes the only salvation is a neurosurgical operation aimed at stopping heavy bleeding.

The treatment period for each person and in each case is individual and depends on the characteristics of the body and ending with the degree of damage

Consequences

If a person is lucky and receives full, timely medical care, the following consequences arise:

vegetative state caused by brain death;
various human mental disorders;
epileptic seizures;
balance and coordination disorders;
inability to formulate connections and conclusions, as well as lack of logical thinking (cognitive functions of the brain);
the patient loses the ability to assimilate information, and even memory;
paralyzes the muscles of the palate and bulbar syndrome (impaired swallowing process);
varying degrees of hearing, vision and smell impairment;
motor and sensory aphasia – inability to understand speech and speak;
opposite loss of sensitivity - left-sided infarction - right side, and vice versa;
hemiparesis occurs on the left or right half of the face and body.

It is not possible to completely restore brain functionality. But by making maximum efforts during treatment, you can minimize the manifestations of the abnormalities that have arisen, but they cannot be completely cured.

Patient care

After overcoming the death threshold and the dangerous period of the disease, the patient needs full care. In most cases, a person who survives a heart attack remains disabled and therefore needs constant care.

The patient can be cared for by both qualified health workers in rehabilitation centers and close relatives at home.

For a person who has suffered a major heart attack, the following care is necessary:

fight against soft tissue necrosis (bedsores);
prevention in the restoration and formation of muscle contracture;
specialized gymnastics for recovery;
respiratory gymnastics;
prevention of pneumonia (pneumonia);
prolonged immobilization leads to thromboembolic complications, so they must be prevented in time;
prevention to avoid a second wave of heart attack;
constant monitoring of blood pressure;
careful hygiene of the room in which the patient lies and the patient himself;
following a special diet;
timely intake of all medications prescribed by the doctor;
speech restoration;
adaptation in society and psychological assistance.

A large heart attack is accompanied by severe disability and a high risk of death, so prevention is very important. This is especially true for people who fall into one of the risk groups.

First aid

The main thing is to diagnose the disease in time. If there is even the slightest suspicion of a heart attack, then you should immediately call an ambulance.

Before qualified help arrives, the patient must be placed horizontally on a hard surface (floor, board, etc.) and fresh air must be supplied to the room. If possible, you should use an oxygen mask. Such methods will increase the patient’s chances of surviving and leading a normal life.

Unfortunately, the risk of disease is very high. Almost every third elderly person is susceptible to it. There are many reasons for this – poor nutrition, stress, poor environment and genetics, and an inactive way of life.

The risk of disease should be prevented in advance. But if a heart attack occurs, then the patient’s closest relatives need to have greater psychological endurance.

A lot of effort and energy is spent on providing timely, and most importantly, correct treatment. And don’t forget about your mood, because it is transmitted to the patient.