cerebral thrombosis
Introduction
Introduction to brain thrombosis Cerebral thrombosis is the most common type of cerebral infarction. Is cerebral artery trunk or cortical atherosclerosis caused by vascular thickening, stenosis and thrombosis, causing local blood flow reduction or interruption of blood supply, brain tissue ischemia and hypoxia leading to softening and necrosis of focal neurological symptoms . basic knowledge Sickness ratio: 0.1% Susceptible population: This disease is more common in elderly people with arteriosclerosis between 50 and 60 years old. Mode of infection: non-infectious complication:
Cause
Cause of cerebral thrombosis
Cause:
The most common diseases are atherosclerosis, diabetes, hyperlipidemia and hypertension, which can accelerate the development of cerebral atherosclerosis. The most common sites of cerebral thrombosis are the common carotid artery, internal carotid artery, lower basilar artery, and vertebra. Upper arterial segment, vertebral-basal artery junction, middle cerebral artery trunk, posterior cerebral artery and anterior cerebral artery, etc. Other causes include non-specific arteritis, leptospirosis, aneurysm, collagen disease, polycythemia vera, and head and neck Department of trauma and so on.
Prevention
Cerebral thrombosis prevention
1, living
1 diet adjustment
According to the variety, the right amount and balanced diet principles, arrange food for three meals a day, eat more foods that are good for preventing stroke, it is reported that milk, fish, soybeans, soybean meal, peanuts, garlic, onions, strawberries, etc. Thrombosis is beneficial.
2 plenty of drinking water
The daily normal drinking water should reach 2000~2500 ml. For the elderly, it is necessary to drink more water. The elderly have different characteristics of thick, sticky, poly, and coagulated blood. Drinking more water is beneficial to lower blood viscosity. Reducing cerebral thrombosis has the characteristics of thick, sticky, poly, and condensed. Drinking more water is beneficial to reduce viscosity and reduce the risk of cerebral blood test.
3 quit smoking and drinking
To stop smoking and drinking alcohol, limit the intake of salt, it is best not to exceed 5 grams per day, and the diet should not be fatty.
4 work and rest
Use the brain to be moderate, do not last too long, those who are under 60 years old use the brain for one hour, should rest for about 10 minutes, those who are over 60 years old should use the brain for half an hour, should rest for 5 to 10 minutes, so as not to cause excessive stroke and induce stroke.
5 rules of life
The life of the elderly should be regular, because the elderly's physiological regulation and adaptive function decline, life is irregular, easy to cause metabolic disorders, and promote thrombosis.
6 sleep after eating
After the meal, the blood gathers in the gastrointestinal tract to help the blood supply of the digestive organs, while the blood supply to the brain is relatively reduced. At the same time, when the meal is eaten, the blood is lowered, the blood pressure is lowered, the blood supply to the brain is further reduced, the blood flow is slow, and the blood clot is easy to form. Therefore, it is best to sleep half an hour after a meal.
7 position change is slow
Cerebral thrombosis often occurs at night, especially when going to the toilet. Because the blood flow at night is slow, and the position changes when getting up, it is easy to cause insufficient blood supply to the heart and brain. Therefore, when you go to the toilet at night, you must wake up slowly and get up. In fact, usually Do housework should also pay attention to body position changes not too fast, so as not to cause brain ischemia.
8 pay attention to weather changes
The weather adaptability of the elderly is weakened. Overheating and overheating can increase the viscosity of the blood and induce stroke. Therefore, it is necessary to take corresponding preventive measures when the temperature changes suddenly and suddenly.
9 control weight
Excessive body fat is consumed by exercise to reduce blood lipids and reduce the risk of stroke.
10 caution with drugs for long-term use of hypnotics, sedatives, antipsychotics, hemostatic drugs, diuretics, (heating drugs such as compound aminopyrine), (anti-asthma drugs such as aminophylline), can increase the chance of stroke.
2, emotional care
Emotions should be stable, always optimistic, open-minded, happy mood, avoid ecstasy, anger, worry, grief, because of long-term mental stress, mood swings, easy to make neurological fluid regulation disorder, causing heart and brain blood circulation disorder and induce stroke.
3, Qigong therapy
When the elderly have risk factors for cerebral thrombosis, before the stroke, qigong prevention can be taken. The following several methods are available for reference: lifting and adjusting the work, guiding the work of the stroke, guiding the sit-sitting work, and improving the brain function. , Shujin Huoxue.
Complication
Cerebral thrombosis complications Complication
Cerebral thrombosis can be complicated by pulmonary infection, upper gastrointestinal bleeding, hemorrhoids, depression and anxiety.
1. Pulmonary infection: Pulmonary infection is one of the main complications. Patients with severe bedridden often have pulmonary infection.
2, upper gastrointestinal bleeding: is one of the serious complications of cerebrovascular disease, that is, the mechanism of stress ulcer is caused by the inferior colliculus and brain stem lesions, and now it is considered that the anterior posterior part of the hypothalamic gray nodules and In the medullary vagus nucleus, the autonomic nerve center is in the lower part of the hypothalamus, but its high-level center is in the hippocampus and marginal system of the frontal lobe, and the mechanism of gastrointestinal bleeding is related to the primary or secondary lesions in the above site.
3, hemorrhoids: mainly because the body does not change the body position for a long time, causing local skin and tissue to be pressed for too long, and a series of manifestations of ischemic necrosis. Patients with cerebrovascular disease have more elderly patients, and the limbs are inconvenient for long-term bed rest. It is easy to pressure local tissue ischemia and hypoxia for bone bulging and other parts.
4, post-cerebral vascular disease depression and anxiety response: post-cerebral vascular disease depression is a common emotional disorder of cerebrovascular disease should be highly valued.
Symptom
Symptoms of cerebral thrombosis Common symptoms Sensory disorder Deafness, dystonia, dystonia, dysuria, toe, numbness, hemiplegic, swallowing, high blood pressure, high blood pressure
(A) general symptoms: the disease is more common in the elderly with atherosclerosis 50 to 60 years old, some have a history of diabetes, often in quiet or sleep, the symptoms gradually reach peak in 1 to 3 days, some patients before the disease There have been one or more transient ischemic attacks. Except for severe cases, the symptoms gradually reach a peak within 1 to 3 days. The consciousness is clear, and the intracranial pressure is not obvious.
(B) localized neurological symptoms of the brain: large variations, related to the degree of vascular occlusion, occlusion of blood vessels, location and collateral circulation.
1. Internal carotid artery system
(1) internal carotid artery system: partial hemiplegia, partial sensory disturbance, hemianopia, trigeminal signs and psychiatric symptoms are common. The main side semi-lesions still have different degrees of aphasia, misuse and loss of recognition, and the presence of the lesion side. Primary optic atrophy, characteristic pathological blindness with contralateral hemiplegia, black sacral paralysis, Horner's sign, oculomotor nerve palsy, and decreased retinal arterial pressure.
(2) middle cerebral artery: the most common, there are three partial signs when the trunk is occluded, and the main hemisphere lesions have aphasia.
(3) anterior cerebral artery: due to the anterior communicating artery providing collateral circulation, the proximal occlusion can be asymptomatic. When the surrounding branches are affected, the inside of the frontal lobe is often invaded, and the lower limbs are heavy, which may be accompanied by cortical sensory disturbances of the lower limbs and dysuria. Deep perforation obstruction, affecting the anterior branch of the internal capsule, often occurs in the central facial sputum and upper limb palsy, bilateral cerebral anterior artery occlusion can appear mental symptoms with bilateral paralysis.
2. Vertebral-basal artery system
(1) Inferior cerebellar artery syndrome: causes dorsolateral medulla obstruction, vertigo, nystagmus, focal pharynx, vagus nerve palsy, cerebellar ataxia and Hroner sign, contralateral side of the lesion, limb sensation Or disappear.
(2) The paramedian central artery: very rare.
(3) anterior inferior cerebellar artery: dizziness, nystagmus, gaze to the opposite side of the lesion, tinnitus on the lesion side, deafness, Horner's sign and cerebellar ataxia, and the side and contralateral limbs of the lesion are reduced or disappeared.
(4) basilar artery: high fever, coma, needle-like pupil, soft limbs of the extremities and medullary paralysis, acute complete occlusion can quickly endanger the patient's life, individual patients present with atresia syndrome.
(5) posterior cerebral artery: manifested as occipital lobe syndrome, with hemianopia and transient visual impairment such as black sputum, etc., in addition to body image disorders, loss of recognition, misuse and so on.
Examine
Cerebral thrombosis examination
1, blood routine:
There is no special change in the early stage of cerebral thrombosis. White blood cells are not high, which is different from cerebral hemorrhage. When combined infections, such as respiratory or urinary tract infections, white blood cells increase.
2, urine routine:
Cerebral thrombosis has no effect on urine routine. When the patient has cochlear arteriosclerosis, the urine routine may be abnormal. Male patients with chronic prostatitis may have pus and protein in the urine. Urine sugar examination can find diabetic patients with previous symptoms.
3, stool routine:
Generally no change, the purpose of examining stool in patients with cerebral thrombosis is to find parasites and other intestinal diseases. Fecal occult blood to find bleeding in the gastrointestinal tract.
4. Blood glucose measurement and glucose tolerance test:
Diabetes patients and sugar can be found to invite low patients. Diabetes is closely related to atherosclerosis and is a risk factor for cerebrovascular disease. The study found that in the acute phase of cerebrovascular disease, regardless of hemorrhagic or ischemic, there are moderate patients with low glucose tolerance. Ischemic cerebrovascular disease often has impaired glucose tolerance during transient ischemic attack, acute phase and recovery phase, and it persists. In patients with cerebral vascular disease with low glucose tolerance, factor VIII-associated antigen, fibrinogen, and triglyceride are significantly higher than normal, and the blood is hypercoagulable, which is one of the causes of cerebrovascular disease.
5, cerebral angiography can confirm the embolization site, but the negative can not rule out the disease.
6, CT examination often helps to confirm the diagnosis, but also can be found cerebral edema and the presence or absence of ventricular compression, displacement and cerebral palsy.
Diagnosis
Diagnosis of cerebral thrombosis
diagnosis
Diagnosis can be based on the cause, symptoms and related tests.
Differential diagnosis
The disease needs to be differentiated from acute cerebrovascular diseases such as atherosclerotic cerebral infarction and cerebral hemorrhage. Brain CT scan helps to distinguish between hemorrhagic and ischemic cerebrovascular disease. After excluding hemorrhagic cerebrovascular disease, it is mainly identified with atherosclerotic cerebral infarction.
1. Atherosclerotic cerebral infarction: more often after middle age, due to stenosis or occlusion caused by cerebral vascular autologous atherosclerosis caused by ischemia, necrosis, softening of the brain tissue of the corresponding vascular supply area, and hemiplegia, aphasia and other neurological functions Defective symptoms, slow onset, often in a quiet or sleep state, there may be aura before the onset, such as transient ischemic attack, etc., more with hypertension, diabetes, coronary heart disease and arteriosclerosis, brain CT scan It is not easy to distinguish from cerebral embolism, but the performance of cerebral embolism is more likely to be associated with bleeding.
2, cerebral hemorrhage: cerebral hemorrhage often has a history of hypertension, aneurysm, arteriovenous malformation, usually in the emotional or strenuous activities of the onset, the disease progresses rapidly, can appear headache, vomiting and other symptoms of cranial hypertension and meningeal irritation Wait. A high-density hemorrhagic foci can be seen on the CT scan of the brain, which can be distinguished from ischemic cerebrovascular disease.
