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What Causes a Cerebral Infarction? - Oren Zarif - Cerebral Infarction

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A cerebral infarction (CI) is an ischemic disease characterized by a persistent focal neurologic deficit. Pulmonary infarction, on the other hand, is an ischemic disease characterized by a localized necrosis of lung tissue. Both types of CI have variable clinical manifestations, ranging from subclinical chest pain to severe, pleuritic chest pain and hemoptysis.

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While cerebellar infarcts are often idiopathic, they can be related to hypertension. Some breeds, such as Cavalier King Charles spaniels, are at increased risk of developing global ischemia. Surgery may be necessary in cases of CI if neurologic deterioration occurs. Surgical interventions include decompressive hemicraniectomy and resection of infarcted tissue.

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The frequency distribution of vascular risk factors is also important. In a study of young people, a study of 201 consecutive patients with first-onset cerebral infarction found that cardiac embolism, hematologic disease, and lacunar stroke were the most common etiologies. Nearly a third of first-time strokes had no obvious cause. However, the study's findings suggest that a vascular risk factor may be associated with the occurrence of cerebral infarction.

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Other common underlying causes of CI include pulmonary embolism, pericarditis, aortic dissection, and aortic disease. In addition to cerebral infarction, vascular conditions related to anemia and infection may lead to symptoms that are not associated with a cerebral infarction. Although a stroke can mimic CI, it is important to remember that the symptoms of CI will differ depending on where in the brain the infarction occurs.

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A focussed medical history is important in the evaluation of a patient suffering from a cerebral infarction. Other vascular risk factors may give clues as to the etiology of the stroke. Patients' current medication list is also important, as intravenous thrombolytics are contraindicated in patients on anticoagulants. Once the causes of the stroke are determined, the treatment may be based on the underlying cause.

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Acute cerebral infarction has a high mortality and morbidity rate. The diagnosis and treatment of CI is vital to maximizing survival potential. However, the most important step is to prevent further cerebral ischaemia by removing the thrombus that is occluding the artery. For this, primary stroke centers are using pharmacologic thrombolysis, which is a process that dissolves clots.

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Initial workup for CI should include a complete blood count, coagulation factors, EKG, and cardiac enzymes. Stat non-contrast head CT is useful for ruling out a mass lesion or hemorrhage. Vascular imaging can be invaluable for determining the source of the clot in the heart. It may reveal clots in the heart or an abnormality in the brain. Acute large vessel occlusion may also be obvious on imaging.

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Neuroimaging techniques for determining ischemic stroke are increasingly sophisticated. Newer techniques, such as computed tomography angiogram (CTA), can help physicians identify a variety of conditions. Large-vessel stenosis, for example, can account for up to a third of all ischemic strokes. Acute ischemic stroke is more difficult to diagnose than hemorrhagic stroke, which is why CT angiograms can be so helpful.

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Despite these advances, there are still many questions about aortic artery thrombosis. Nevertheless, aortic arch plaques are associated with an increased risk of vascular death, recurrent stroke, and peripheral embolism. Hence, an accurate diagnosis is impossible to obtain at bedside. A meningeal biopsy is an option for selected patients undergoing immunosuppressive therapy. If it is asymptomatic infarction, it is important to rule out any underlying large-vessel disease.

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Stroke is a common cause of death in the U.S., and ranks as the fifth leading cause of death in the country. According to the latest AHA report, approximately 20 million Americans have suffered a stroke. The prevalence of stroke increases with age; in fact, 75 percent of stroke cases occur in people over 65. Women's stroke risk increases when taking estrogen-based hormone therapies. Other symptoms of a stroke include loss of control over certain muscles, paralysis, difficulty speaking, swallowing, and language difficulties.

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Fortunately, the majority of TIAs are mild and reversible. Many patients experience just a brief episode of symptoms before seeking medical attention. A transient ischemic attack (TIA) is a warning sign that a stroke is imminent. If ignored, it can cost a life. However, if you notice a TIA, don't wait to call 911. By getting medical attention, you'll be on your way to a long and productive life.

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