Cerebral Infarction

General information about a cerebral infarction / ischemic stroke :

Ischemic Stroke, (Clots) occurs as a result of an obstruction within a blood vessel supplying blood to the brain, cutting off the blood flow to brain cells. After just a few minutes, the starved brain cells begin to die. When someone has shown symptoms of a stroke or a TIA (transient ischemic attack), they require immediate medical attention.

Clots are caused by either  thrombosis or arterial embolism, or a build up of plaque in an artery due to atherosclerosis. The underlying condition for this type of obstruction is the development of fatty deposits lining the vessel walls.

If the plaque ruptures, tiny pieces of clooted blood and plaque, travel in the bloodstream to the brain. If it lodges in a smaller bloodvessel/artery, the blood flow to part of the brain parts stops.

Normally the brains receive blood through two major pairs of arteries which branch throughout braintissue and supply the braincells with a constant bloodflow of oxygen ,glucose and nutriens. Neccessary for their functions.

STROKE SIGNS AND SYMPTOMS: THINK YOU ARE HAVING A STROKE? CALL the national emergency number IMMEDIATELY! F.A.S.T. is an easy way to remember the sudden signs of stroke. When you can spot the signs, you'll know that you need to call for help right away. F.A.S.T. is:

Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven? Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward? Speech Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly? Time to call the emergency number – If someone shows any of these symptoms, even if the symptoms go away, call and get the person to the hospital immediately. Check the time so you'll know when the first symptoms appeared. Make notice of the TIME!

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• Cerebral thrombosis refers to a thrombus (blood clot) that develops at the clogged part of the vessel.

• Cerebral embolism refers generally to a blood clot that forms at another location in the circulatory system, usually the heart and large arteries of the upper chest and neck. A portion of the blood clot breaks loose, enters the bloodstream and travels through the brain's blood vessels until it reaches vessels too small to let it pass. A second important cause of embolism is an irregular heartbeat, known as atrial fibrillation. It creates conditions where clots can form in the heart, dislodge and travel to the brain. 

TREATMENT OF CEREBRAL INFARCTION (thrombosis)

 
For a stroke caused by a cerebral thrombosis, a treatment called thrombolysis, is possible within 4.5 hours after the first failure symptoms, such as paralysis of the arm or leg, or trouble talking.

When you get an thrombolysis you'll get an IV with clot-dissolving drugs.

This treatment reduces the damage after a stroke. Thrombolysis is a treatment for a limited group of patients with cerebral infarction.

The first condition is that thrombolysis should occur within 4.5 hours. The chance of recovery is getting smaller and the risk of complications (mainly bleeding) is relatively large.

Reviews the neurologist on the basis of a CT scan if there is a stroke or brain hemorrhage. If the CT scan shows signs of bleeding, thrombolysis is not possible. 


Thrombolysis is not further performed if:

• the deficits rapidly reduce

• a CT scan shows a very large stroke

• the blood pressure is too high

• the bloodsugar gets too low or too high

• there is a high risk of bleeding, for example, by the use of anti-coagulant or heparin

• someone has had a bleeding in or around the brains previously

• someone has had a major surgeryin the two weeks before the stroke 

• someone has had a heart attack or bleeding in the gastrointestinal tract or urinary tract in the 3 weeks before the stroke

STROKE VIDEOS:

THE EFFECTS OF A STROKE / CVA 

The effects of a stroke stroke can be great:


Neurological effects as a cripple on one side of the body (hemiparesis), or an arm or leg, or even a complete paralysis (hemiplegia), but also a face half palsy (facial palsy). Often in the early stages the muscle weakness is characteristic. Later on often are seen coordinationproblems and spontaneous contraction (spasm or spasms) of the muscles which can be very annoying.

 

• Loss of sensory registration. The sense doing it yet, but the receipt by the brains is disrupted; sometimes reinforced, sometimes less.

•  Epilepsy

• Aphasia; Usually when the hemorrhage was in the left hemisphere, because in 90% of humanity the language-area is situated there. Current research suggests that right-handers and about 70% of left-handers utilise the left brain for speech.

The aphasia (a = not, phasia = speaking) can present itself as difficulty in speaking (Broca's aphasia) as also in a disrupted language comprehension (listening and reading) Wernicke's Aphasia.
Often both forms occur at the same time = global aphasia. Aphasia is an acquired communication disorder that impairs a person's ability to process language, but does not affect intelligence. Aphasia impairs the ability to speak and understand others, and most people with aphasia experience difficulty reading and writing.

• Impairment in spatial information. Often this will happen after a hemorrhage in the right hemisphere. Getting lost in rooms, buildings, street etc. Not recognizing areas. Struggling with new info.

• Invisible effects as cognitive disorders. See also the list on the subpage "invisible effects of brain injury"

Hemiparesis and hemiplegia
 
The words 'hemiparesis' and 'hemiplegia' are used next to each other in practice.
In fact,  'plegia' means complete paralysis and 'paresis' means partial paralysis;
Hemi = on one side of the body.

On one side of the body both arm and leg and face can be affected. It may also be that only the arm is affected, or only the leg or face.
 
At a stroke in the right hemisphere one is left paralyzed and vice versa. Paralysis is not always the case. The speech and language center is located in the left hemisphere in right-handers.
 
A stroke in the left hemisphere often gives  an impairment in the use of language (both speaking and understanding).
 
A stroke in the right hemisphere can cause paralysis on the left side, but also often results only in other, less immediately striking disorders.
 
 
Striking or not, they can be indeed very restrictive for everyday life.
As more brain tissue is damaged, the consequences are more serious.

Sources:

The American Heart Association, http://watchlearnlive.heart.org/CVML_Player.php?moduleSelect=iscstr Stroke Association http://www.strokeassociation.org/STROKEORG/Professionals/CommunityResourcesandPatientEd/Stroke-Community-Resources-and-Patient-Education_UCM_451855_SubHomePage.jsp Porth, C.M. Matfin, G.