Cerebral infarction: Difference between revisions
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{{Infobox medical condition | |||
| name = Cerebral infarction | |||
| image = [[File:Infarction.svg|250px]] | |||
| caption = Diagram of a cerebral infarction | |||
| synonyms = [[Ischemic stroke]], [[brain infarction]] | |||
| specialty = [[Neurology]] | |||
| symptoms = [[Sudden weakness]], [[numbness]], [[difficulty speaking]], [[vision problems]], [[headache]] | |||
| complications = [[Hemorrhagic transformation]], [[brain edema]], [[seizures]] | |||
| onset = Sudden | |||
| duration = Varies | |||
| types = [[Thrombotic]], [[embolic]], [[lacunar]] | |||
| causes = [[Atherosclerosis]], [[cardioembolism]], [[small vessel disease]] | |||
| risks = [[Hypertension]], [[diabetes mellitus]], [[smoking]], [[hyperlipidemia]], [[atrial fibrillation]] | |||
| diagnosis = [[CT scan]], [[MRI]], [[carotid ultrasound]] | |||
| differential = [[Intracerebral hemorrhage]], [[subarachnoid hemorrhage]], [[brain tumor]] | |||
| prevention = [[Antiplatelet therapy]], [[anticoagulation]], [[lifestyle modification]] | |||
| treatment = [[Thrombolysis]], [[mechanical thrombectomy]], [[supportive care]] | |||
| prognosis = Variable, depends on severity and treatment | |||
| frequency = Common | |||
}} | |||
{{Infobox medical condition (new) | {{Infobox medical condition (new) | ||
| name = Ischemic Stroke | | name = Ischemic Stroke | ||
| Line 21: | Line 42: | ||
}} | }} | ||
An '''ischemic stroke''' is a type of [[stroke]] that occurs when the [[blood supply]] to a part of the [[brain]] is interrupted or reduced due to a [[blood clot]] or [[plaque]] obstructing a [[blood vessel]]. This deprives brain tissue of oxygen and nutrients, leading to cell death within minutes. Ischemic strokes account for approximately 85% of all strokes. | An '''ischemic stroke''' is a type of [[stroke]] that occurs when the [[blood supply]] to a part of the [[brain]] is interrupted or reduced due to a [[blood clot]] or [[plaque]] obstructing a [[blood vessel]]. This deprives brain tissue of oxygen and nutrients, leading to cell death within minutes. Ischemic strokes account for approximately 85% of all strokes. | ||
== Causes == | == Causes == | ||
=== Atherosclerosis and Plaque Buildup === | === Atherosclerosis and Plaque Buildup === | ||
[[Atherosclerosis]] occurs when fatty deposits, known as [[plaque]], build up inside the [[arteries]]. This process can narrow the arteries, including those in the neck (such as the [[carotid arteries]]), reducing blood flow and increasing the risk of stroke. If a plaque ruptures, it can trigger the formation of a blood clot. | [[Atherosclerosis]] occurs when fatty deposits, known as [[plaque]], build up inside the [[arteries]]. This process can narrow the arteries, including those in the neck (such as the [[carotid arteries]]), reducing blood flow and increasing the risk of stroke. If a plaque ruptures, it can trigger the formation of a blood clot. | ||
=== Blood Clots and Emboli === | === Blood Clots and Emboli === | ||
Blood clots may form directly in cerebral vessels ('''thrombotic stroke''') or elsewhere in the | Blood clots may form directly in cerebral vessels ('''thrombotic stroke''') or elsewhere in the body—such as the [[heart]]—and travel to the brain ('''embolic stroke'''). Conditions like [[atrial fibrillation]], [[myocardial infarction]], and [[valvular heart disease]] can increase the risk of emboli. | ||
=== Inflammation === | === Inflammation === | ||
Chronic [[inflammation]] | Chronic [[inflammation]]—due to infections or autoimmune disorders such as [[lupus]] or [[rheumatoid arthritis]]—can damage vascular walls and promote clot formation, contributing to ischemic stroke risk. | ||
== Transient Ischemic Attack (TIA) == | == Transient Ischemic Attack (TIA) == | ||
A [[transient ischemic attack]] or "mini-stroke" is caused by a temporary blockage of blood flow to the brain. Symptoms usually resolve within minutes to hours and do not cause permanent damage, but TIAs are warning signs for future full-blown strokes. | A [[transient ischemic attack]] or "mini-stroke" is caused by a temporary blockage of blood flow to the brain. Symptoms usually resolve within minutes to hours and do not cause permanent damage, but TIAs are warning signs for future full-blown strokes. | ||
== Risk Factors == | == Risk Factors == | ||
Common risk factors for ischemic stroke include: | Common risk factors for ischemic stroke include: | ||
* [[Hypertension]] | * [[Hypertension]] | ||
* [[Diabetes mellitus]] | * [[Diabetes mellitus]] | ||
| Line 56: | Line 70: | ||
* [[Psychosocial stress]], [[depression]], [[social isolation]] | * [[Psychosocial stress]], [[depression]], [[social isolation]] | ||
* Exposure to [[air pollution]] | * Exposure to [[air pollution]] | ||
[[File:Blood clot diagram.png|left|thumb|A blood clot can block blood flow to the brain, causing an ischemic stroke]] | |||
[[File:Blood clot diagram.png|thumb | |||
== Signs and Symptoms == | == Signs and Symptoms == | ||
Symptoms develop suddenly and may include: | Symptoms develop suddenly and may include: | ||
* [[Numbness]] or [[weakness]] on one side of the body | * [[Numbness]] or [[weakness]] on one side of the body | ||
* Trouble [[speaking]] or understanding language | * Trouble [[speaking]] or understanding language | ||
| Line 67: | Line 78: | ||
* [[Dizziness]] or [[loss of coordination]] | * [[Dizziness]] or [[loss of coordination]] | ||
* [[Severe headache]] without known cause | * [[Severe headache]] without known cause | ||
=== FAST Acronym === | === FAST Acronym === | ||
* '''F''' – Face drooping | * '''F''' – Face drooping | ||
| Line 73: | Line 83: | ||
* '''S''' – Speech difficulty | * '''S''' – Speech difficulty | ||
* '''T''' – Time to call [[emergency medical services]] | * '''T''' – Time to call [[emergency medical services]] | ||
== Complications == | == Complications == | ||
Without rapid treatment, ischemic stroke can lead to: | Without rapid treatment, ischemic stroke can lead to: | ||
* [[Brain edema]] or swelling | * [[Brain edema]] or swelling | ||
* [[Paralysis]] or [[muscle weakness]] | * [[Paralysis]] or [[muscle weakness]] | ||
| Line 86: | Line 94: | ||
* [[Depression]] and mood disorders | * [[Depression]] and mood disorders | ||
* [[Deep vein thrombosis]] and [[pulmonary embolism]] | * [[Deep vein thrombosis]] and [[pulmonary embolism]] | ||
== Diagnosis == | == Diagnosis == | ||
Evaluation involves: | Evaluation involves: | ||
=== Physical Examination === | === Physical Examination === | ||
* Neurological exam to assess mental status, motor strength, coordination, and cranial nerve function | * Neurological exam to assess mental status, motor strength, coordination, and cranial nerve function | ||
=== Imaging === | === Imaging === | ||
* [[CT scan]] – often the first test to rule out [[hemorrhagic stroke]] | * [[CT scan]] – often the first test to rule out [[hemorrhagic stroke]] | ||
* [[MRI]] – better for detecting ischemic changes | * [[MRI]] – better for detecting ischemic changes | ||
* [[CT angiography]] or [[carotid ultrasound]] – evaluates vascular blockages | * [[CT angiography]] or [[carotid ultrasound]] – evaluates vascular blockages | ||
=== Laboratory Tests === | === Laboratory Tests === | ||
* [[Blood glucose]], [[CBC]], [[coagulation profile]], [[electrolytes]] | * [[Blood glucose]], [[CBC]], [[coagulation profile]], [[electrolytes]] | ||
=== Cardiac Evaluation === | === Cardiac Evaluation === | ||
* [[Electrocardiogram]] (ECG) | * [[Electrocardiogram]] (ECG) | ||
* [[Echocardiogram]] to check for [[cardiac emboli]] | * [[Echocardiogram]] to check for [[cardiac emboli]] | ||
== Treatment == | == Treatment == | ||
An ischemic stroke is a medical emergency that requires immediate care. | An ischemic stroke is a medical emergency that requires immediate care. | ||
=== Medications === | === Medications === | ||
* '''tPA (Tissue Plasminogen Activator)''' – thrombolytic drug given within 3–4.5 hours of symptom onset | * '''tPA (Tissue Plasminogen Activator)''' – thrombolytic drug given within 3–4.5 hours of symptom onset | ||
* '''Antiplatelets''' – such as [[aspirin]] or [[clopidogrel]] | * '''Antiplatelets''' – such as [[aspirin]] or [[clopidogrel]] | ||
* '''Anticoagulants''' – including [[warfarin]] or [[direct oral anticoagulants]] (DOACs) for cardioembolic strokes | * '''Anticoagulants''' – including [[warfarin]] or [[direct oral anticoagulants]] (DOACs) for cardioembolic strokes | ||
=== Surgical/Endovascular Procedures === | === Surgical/Endovascular Procedures === | ||
* '''[[Thrombectomy]]''' – mechanical removal of the clot | * '''[[Thrombectomy]]''' – mechanical removal of the clot | ||
* '''[[Carotid endarterectomy]]''' – removes plaque from carotid arteries | * '''[[Carotid endarterectomy]]''' – removes plaque from carotid arteries | ||
* '''[[Angioplasty]] and [[stenting]]''' – opens narrowed vessels with balloons and stents | * '''[[Angioplasty]] and [[stenting]]''' – opens narrowed vessels with balloons and stents | ||
== Rehabilitation == | == Rehabilitation == | ||
Stroke rehabilitation includes: | Stroke rehabilitation includes: | ||
* [[Physical therapy]] – to regain strength and coordination | * [[Physical therapy]] – to regain strength and coordination | ||
* [[Occupational therapy]] – to relearn daily tasks | * [[Occupational therapy]] – to relearn daily tasks | ||
* [[Speech therapy]] – for communication and swallowing difficulties | * [[Speech therapy]] – for communication and swallowing difficulties | ||
* [[Neuropsychology]] – for cognitive and emotional support | * [[Neuropsychology]] – for cognitive and emotional support | ||
== Prevention == | == Prevention == | ||
Preventive strategies include: | Preventive strategies include: | ||
* Managing [[blood pressure]], [[blood sugar]], and [[cholesterol]] | * Managing [[blood pressure]], [[blood sugar]], and [[cholesterol]] | ||
* Stopping [[smoking]] | * Stopping [[smoking]] | ||
| Line 137: | Line 131: | ||
* Treating [[atrial fibrillation]] and [[sleep apnea]] | * Treating [[atrial fibrillation]] and [[sleep apnea]] | ||
* [[HPV vaccination]] and control of [[chronic infections]] | * [[HPV vaccination]] and control of [[chronic infections]] | ||
== Prognosis == | == Prognosis == | ||
Prognosis depends on the severity, timing of treatment, and location of brain damage. Early intervention improves survival and functional recovery. Some individuals may recover fully, while others face lifelong disability. | Prognosis depends on the severity, timing of treatment, and location of brain damage. Early intervention improves survival and functional recovery. Some individuals may recover fully, while others face lifelong disability. | ||
== See Also == | == See Also == | ||
* [[Stroke]] | * [[Stroke]] | ||
Latest revision as of 20:55, 4 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
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| Cerebral infarction | |
|---|---|
| |
| Synonyms | Ischemic stroke, brain infarction |
| Pronounce | N/A |
| Specialty | Neurology |
| Symptoms | Sudden weakness, numbness, difficulty speaking, vision problems, headache |
| Complications | Hemorrhagic transformation, brain edema, seizures |
| Onset | Sudden |
| Duration | Varies |
| Types | Thrombotic, embolic, lacunar |
| Causes | Atherosclerosis, cardioembolism, small vessel disease |
| Risks | Hypertension, diabetes mellitus, smoking, hyperlipidemia, atrial fibrillation |
| Diagnosis | CT scan, MRI, carotid ultrasound |
| Differential diagnosis | Intracerebral hemorrhage, subarachnoid hemorrhage, brain tumor |
| Prevention | Antiplatelet therapy, anticoagulation, lifestyle modification |
| Treatment | Thrombolysis, mechanical thrombectomy, supportive care |
| Medication | N/A |
| Prognosis | Variable, depends on severity and treatment |
| Frequency | Common |
| Deaths | N/A |
An ischemic stroke is a type of stroke that occurs when the blood supply to a part of the brain is interrupted or reduced due to a blood clot or plaque obstructing a blood vessel. This deprives brain tissue of oxygen and nutrients, leading to cell death within minutes. Ischemic strokes account for approximately 85% of all strokes.
Causes[edit]
Atherosclerosis and Plaque Buildup[edit]
Atherosclerosis occurs when fatty deposits, known as plaque, build up inside the arteries. This process can narrow the arteries, including those in the neck (such as the carotid arteries), reducing blood flow and increasing the risk of stroke. If a plaque ruptures, it can trigger the formation of a blood clot.
Blood Clots and Emboli[edit]
Blood clots may form directly in cerebral vessels (thrombotic stroke) or elsewhere in the body—such as the heart—and travel to the brain (embolic stroke). Conditions like atrial fibrillation, myocardial infarction, and valvular heart disease can increase the risk of emboli.
Inflammation[edit]
Chronic inflammation—due to infections or autoimmune disorders such as lupus or rheumatoid arthritis—can damage vascular walls and promote clot formation, contributing to ischemic stroke risk.
Transient Ischemic Attack (TIA)[edit]
A transient ischemic attack or "mini-stroke" is caused by a temporary blockage of blood flow to the brain. Symptoms usually resolve within minutes to hours and do not cause permanent damage, but TIAs are warning signs for future full-blown strokes.
Risk Factors[edit]
Common risk factors for ischemic stroke include:
- Hypertension
- Diabetes mellitus
- Hyperlipidemia
- Smoking
- Atrial fibrillation and other cardiac arrhythmias
- Carotid artery disease
- Use of oral contraceptives
- Obesity and physical inactivity
- Excessive alcohol consumption and drug abuse
- Chronic kidney disease
- Sleep apnea
- Age (risk increases over 55)
- Sex (men at younger age; women higher lifetime risk)
- Race and ethnicity (higher in African Americans, Native Americans, Hispanics)
- Genetics and family history
- Psychosocial stress, depression, social isolation
- Exposure to air pollution
Signs and Symptoms[edit]
Symptoms develop suddenly and may include:
- Numbness or weakness on one side of the body
- Trouble speaking or understanding language
- Vision loss in one or both eyes
- Dizziness or loss of coordination
- Severe headache without known cause
FAST Acronym[edit]
- F – Face drooping
- A – Arm weakness
- S – Speech difficulty
- T – Time to call emergency medical services
Complications[edit]
Without rapid treatment, ischemic stroke can lead to:
- Brain edema or swelling
- Paralysis or muscle weakness
- Aphasia or language impairment
- Cognitive decline and dementia
- Seizures
- Pneumonia due to swallowing dysfunction
- Urinary incontinence
- Depression and mood disorders
- Deep vein thrombosis and pulmonary embolism
Diagnosis[edit]
Evaluation involves:
Physical Examination[edit]
- Neurological exam to assess mental status, motor strength, coordination, and cranial nerve function
Imaging[edit]
- CT scan – often the first test to rule out hemorrhagic stroke
- MRI – better for detecting ischemic changes
- CT angiography or carotid ultrasound – evaluates vascular blockages
Laboratory Tests[edit]
Cardiac Evaluation[edit]
- Electrocardiogram (ECG)
- Echocardiogram to check for cardiac emboli
Treatment[edit]
An ischemic stroke is a medical emergency that requires immediate care.
Medications[edit]
- tPA (Tissue Plasminogen Activator) – thrombolytic drug given within 3–4.5 hours of symptom onset
- Antiplatelets – such as aspirin or clopidogrel
- Anticoagulants – including warfarin or direct oral anticoagulants (DOACs) for cardioembolic strokes
Surgical/Endovascular Procedures[edit]
- Thrombectomy – mechanical removal of the clot
- Carotid endarterectomy – removes plaque from carotid arteries
- Angioplasty and stenting – opens narrowed vessels with balloons and stents
Rehabilitation[edit]
Stroke rehabilitation includes:
- Physical therapy – to regain strength and coordination
- Occupational therapy – to relearn daily tasks
- Speech therapy – for communication and swallowing difficulties
- Neuropsychology – for cognitive and emotional support
Prevention[edit]
Preventive strategies include:
- Managing blood pressure, blood sugar, and cholesterol
- Stopping smoking
- Healthy diet and regular exercise
- Use of statins, antiplatelets, and anticoagulants when indicated
- Treating atrial fibrillation and sleep apnea
- HPV vaccination and control of chronic infections
Prognosis[edit]
Prognosis depends on the severity, timing of treatment, and location of brain damage. Early intervention improves survival and functional recovery. Some individuals may recover fully, while others face lifelong disability.
See Also[edit]
- Stroke
- Hemorrhagic stroke
- Transient ischemic attack
- Atherosclerosis
- Neurorehabilitation
- FAST (stroke)
- Cerebrovascular disease
| Stroke and related topics | ||||||||||
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| Cardiovascular diseases | ||||||||||
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This cardiovascular disease related article is a stub.
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