A cerebral infarction (ischemic stroke) develops in the event of a significant decrease in cerebral blood flow. Among the diseases causing its development, atherosclerosis, which destroys the main vessels, is in the first place. Often noted its combination with arterial hypertension, diabetes. In rare cases, various arteritis, rheumatism, congenital heart defects in the stage of decompensation, blood diseases, infectious pathologies, intoxications provoke a heart attack. The causes of the disease are also hidden in mental and physical stress. Most often, people from fifty to sixty years of age and older are affected.
Developing focal necrosis can be detected in various parts of the brain. They are usually observed in the middle artery basin. A cerebral infarction can be gray (white), red, or mixed. The most common are white. Pathogenetic mechanisms provoking cerebral infarction are very diverse. These include vascular thrombosis, embolism, spasms. In approximately half of all cases, cerebral infarction due to atherosclerosis occurred in the pathology of extracranial vertebral and carotid arteries.
Transient circulatory disorders precede the development of the disease. They are often called ischemic attacks. They are characterized by the manifestation of unstable focal symptoms (paresthesias, speech disorders, paresis). As a rule, they are the result of a short-term lack of blood supply to the area of the brain in which a heart attack will develop later. In some cases, transistor ischemic attacks become more often immediately before its occurrence. Thus, they form the clinic of the "prodrome" of a stroke. Sometimes there is a sharp pain in the head, general discomfort.
An ischemic stroke can occur at any time. Often it develops immediately after waking up or during sleep. In some patients, the initial manifestations of the condition are associated with a high load, the influence of the emotional factor, alcohol consumption, any general, including infectious disease or blood loss. Often, ischemic stroke follows myocardial infarction.
For the condition, the most characteristic is the strengthening of localized neurological signs, gradual, occurring within a few hours, and sometimes two to three days. Along with this, an undulating type of increase in manifestations may be noted. Sometimes the degree of their severity is amplified, then weakened. In some cases, an apoplectiform development of the condition is observed.
Cerebral infarction. Treatment.
Extensive lesions are characterized by a very serious condition of patients. The manifestation of focal symptoms depends on the affected vessel.
Therapeutic measures for heart attacks of the brain are carried out in the form of intensive care.
Cardiac thromboembolism involves the introduction of heparin or its low molecular weight derivatives (clevarin, fraxiparin). Subsequent use is made under the control of blood coagulability.
Antioxidants are also used ( Unitol intramuscularly or e-vitamin), membrane-stabilizing drugs (Essential intravenously). Today, intensive dehydration therapy with saluretics, osmouretics is practically not used due to inefficiency. The feasibility of using glucocorticoids is very doubtful.
Metabolic drugs are more commonly used. These include drugs "Instenon" and "Actovegin." At the same time, aerobic respiration is activated against the background of hypoxia and ischemia by enhancing the utilization of oxygen and glucose, stimulating lipid peroxidation and others.