The cerebral infarction (ischemic stroke) develops ina significant reduction in cerebral blood flow. Among the diseases that cause its development, on the first place is atherosclerosis, which destroys the main vessels. Often there is a combination of it with arterial hypertension, diabetes mellitus. 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 ailment are also hidden in the mental and physical overstrain. Most often, people from fifty to sixty years of age and older are affected.
Developing focal necrosis can be detected indifferent parts of the brain. Usually they are observed in the basin of the middle artery. The cerebral infarction can be gray (white), red or mixed. The most common are white. Provoking the cerebral infarction pathogenetic mechanisms are very diverse. These include vascular thrombosis, embolism, spasms. Approximately half of all cases of cerebral infarction against the background of atherosclerosis occurred in the pathology of extracranial parts of vertebral and carotid arteries.
Pre-development of the disease is transientcirculatory disorders. 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 in the aftermath. In some cases, transistor ischemic attacks become more frequent just before it occurs. Thus, they form a clinic for the "prodrome" of a stroke. Sometimes there is a sharp pain in the head, general discomfort.
Ischemic stroke can occur in anytime. Often it develops immediately after awakening or during sleep. In some patients, initial manifestations of the condition are associated with a high load, the influence of the emotional factor, the use of alcohol, any general, including infectious disease or blood loss. Often an ischemic stroke follows a myocardial infarction.
For the state the most characteristic isthe intensification of localized neurological signs is gradual, occurring within a few hours, and sometimes two to three days. Along with this, there can be an undulating form of growth of manifestations. Sometimes the degree of their expression is then increased, then weaken. In some cases, apoplectiform development of the condition is observed.
A cerebral infarction. Treatment.
Extensive lesions are characterized by very serious condition of patients. The manifestation of focal symptoms depends on the affected vessel.
Therapeutic measures in infarction of the brain are carried out in the form of intensive therapy.
Cardiac thromboembolism involves the administration of heparin or its low-molecular derivatives (cleavage, fractiparin). Subsequent application is made under the control of blood coagulability.
Used and antioxidants (the drug "Unitol"intramuscular or e-vitamin), membrane-stabilizing drugs ("Essentiale" intravenously). Today, dehydration intensive therapy with the help of saluretics, osmouretics is practically not applied due to inefficiency. The expediency of using glucocorticoids is very doubtful.
Metabolicimpact. These include drugs "Instenon" and "Actovegin." In this case, aerobic respiration is activated against hypoxia and ischemia by increasing the utilization of oxygen and glucose, stimulating lipid peroxidation and other.</ p>>