Classification of Cerebral Infarction - Oren Zarif - Cerebral Infarction
The symptoms of cerebral infarction are classified according to the part of the brain affected. Cerebral infarction in the primary motor cortex results in slurred speech, loss of sensation and muscle weakness on one side of the body. Other symptoms of cerebral infarction include abnormal pupil dilation, abnormal light reactions and loss of eye movements on the affected side of the body. The left side of the brain can be affected by cerebral infarction and may lead to reflexes that are affected.
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Some strokes start suddenly, causing the symptoms to be short-lived. Others have a rapid progression. For these reasons, TIAs are commonly the first signs of a stroke. While the symptoms of TIA are very similar to those of a stroke, neuroimaging helps differentiate them. A short-lived stroke can be caused by new-onset infarction or ischemia. Until thrombolytic drugs are available, precise classification of cerebral infarction remains a challenge.
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There are two common types of infarction. The first type is called hemorrhagic infarction, and the second is called non-hemorrhagic infarction. In hemorrhagic infarction, the blood flow returns after the initial lack of blood is induced. In contrast, in hemorrhagic infarction, blood flow returns after the infarcted tissue has been deprived of oxygen and nutrients.
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Young adults are particularly vulnerable to stroke, which is why it is so important to study these people. A hospital-based registry of young people found that the most common etiologies were cardiac embolism, hematologic causes and lacunar stroke. However, almost one-third of all first strokes had no clear etiology. Therefore, prevention of cerebral infarction should be based on careful evaluation of these risk factors.
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Subacute infarctions may look like brain tumors because they have similar features. In addition to showing contrast enhancement, they are more likely to mimic a neoplasm. In addition, subacute infarctions have vascular distribution and minimal or no mass effect. During the early stages of the infarction, MRI may mask the infarction because of the pseudonormalization of the apparent diffusion coefficient.
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Most people are at risk for recurrent strokes. One in four survivors of stroke will experience another one within five years. The risk of a second stroke is highest immediately after the first one. However, it decreases over time. With each recurrent stroke, the likelihood of death and severe disability increases. Overall, 3% of first stroke survivors will experience another in the first 30 days. In addition, about one-third of those who survive stroke will have a recurrent stroke within two years.
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In one study, 28 patients with chronic meningitis had cerebral infarction secondary to TBM. These patients accounted for 47% of the cryptococcal and tuberculous meningitis cases. Seventeen patients had single-infarctions and 13 patients had multiple infarctions. The most common location of cerebral infarction was the cortex. In a study of patients with suspected TBM, only 10% had good outcomes and the remainder had poor outcomes.
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Despite its seriousness, there is no known cure for cerebral infarction. A lack of blood flow in the brain causes a limited supply of oxygen to the brain's cells. Ultimately, the brain dies as a result of the lack of oxygen. However, doctors can treat this condition and prevent further complications. A blood clot can lodge in the blood vessels of the brain and travel to other areas. The treatment for cerebral infarction will depend on whether the clot is caused by a disease or is a result of a blood clot.
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Surgery is often an option if the bleeding is large and a blood clot is present. Surgical procedures are needed to relieve pressure on the brain and repair blood vessel problems associated with hemorrhagic strokes, including aneurysms and arteriovenous malformations. Surgical clipping of an aneurysm may prevent the aneurysm from bursting or bleeding again. Although it is difficult to predict the outcome of such procedures, the benefits are well worth the risk.
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