brain stem infarction
Introduction
Introduction to brain stem infarction Brain stem infarction: vertebral basilar artery and its branches have atherosclerosis, or arterial embolism, spasm, inflammation leading to stenosis of the lumen, ischemia caused by circulatory disorders. Cerebral infarction is commonly known as "stroke" or "stroke." "Stroke" is divided into "hemorrhagic stroke" and "ischemic stroke", "ischemic stroke" is cerebral infarction, which includes cerebral thrombosis, cerebral embolism, etc., cerebral infarction accounts for 70% to 80% of all strokes. In recent years, it has increased significantly and has become younger. Some patients are only 27 years old, but most of them are middle-aged and older people over 45 years old. basic knowledge The proportion of illness: 0.003% Susceptible people: most of them are middle-aged and older people over 45 years old. Mode of infection: non-infectious Complications: aspiration pneumonia acne urinary tract infection pulmonary embolism lower extremity deep vein thrombosis dysphagia malnutrition
Cause
Causes of brain stem infarction
Body factor (25%):
Brain stem obstruction is a severe stenosis or occlusion of the brain stem blood vessels, which leads to the blockage of cerebral blood flow and the ischemic necrosis and softening of the brain tissue. The main pathological change is brain softening. More common in middle-aged and elderly, often have a history of hypertension arteriosclerosis or a lack of basilar artery blood supply.
Disease factors (35%):
The most common cause is cerebral arteriosclerosis, often accompanied by high blood pressure, dyslipidemia, and other causes of arteritis. Congenital artery stenosis, polycythemia vera, hypercoagulable state, Moyamoya disease, etc.
Prevention
Brain stem infarction prevention
Limit sodium salt, control weight, avoid alcohol and tobacco. Pay attention to the prevention and treatment of fever, dehydration, diarrhea, sweating and other conditions that easily lead to cerebral infarction. Pay attention to maintain adequate sleep, avoid overwork, pay attention to work and rest, pay attention to the regularity of life.
Cerebral infarction should be treated as soon as possible, although it is not as dangerous as cerebral hemorrhage, but the patient is frail for many years, many chronic diseases are plagued, there are many cautious medications in treatment, and the infarct area can be expanded in a short time, and many will occur. Comorbidity, so the mortality rate of cerebral infarction is also relatively high, and the disability rate is higher than cerebral hemorrhage.
Complication
Brain stem infarction complications Complications aspiration pneumonia acne urinary tract infection pulmonary embolism lower extremity deep vein thrombosis dysphagia malnutrition
Various complications are prone to occur in the acute and recovery stages of cerebral infarction. Aspiration pneumonia, hemorrhoids, urinary tract infections, deep venous thrombosis of the lower extremities, pulmonary embolism, and malnutrition caused by dysphagia can significantly increase the risk of poor prognosis. Therefore, effective prevention and close care of these complications is also a key link in the standardized treatment of cerebral infarction.
Symptom
Brain stem infarction symptoms common symptoms cerebral sulcus widening white matter degeneration brain stem damage signs gait instability dysphagia dysphagia dysfunction limb numbness fever
The main pathological change of cerebral infarction is based on cerebral arteriosclerosis. Blood vessels form thrombus, block blood flow, cause ischemia, hypoxia and necrosis of brain tissue, causing hemiplegia, aphasia, numbness of the limbs, walking. Unstable, incontinence, insanity, dementia, and even vegetative, partial brain stem infarction and large-area cerebral infarction can be fatal.
Examine
Examination of brain stem infarction
ordinary inspection
Platelet aggregation rate, coagulation function, blood sugar, blood lipid level, liver and kidney function, etc.; electrocardiogram, chest radiograph. These tests help to clarify the patient's basic condition, and some of the results also help to determine the cause.
Special inspection
It mainly includes brain structure imaging assessment, cerebrovascular imaging assessment, brain perfusion and functional examination.
(1) Brain structure imaging examination
1. Head CT; 2. Head MRI.
(2) Cerebrovascular imaging
1. Neck vascular ultrasound and transcranial Doppler (TCD); 2. Magnetic resonance angiography (MRA) and computer imaging angiography (CTA|3. Digital subtraction angiography (DSA).
(C) cerebral perfusion examination and evaluation of brain function
1. Commonly used cerebral perfusion examination methods include multimodal MRI/PWI, multimodal CT/CTP, SPECT and PET.
2. Brain function assessment mainly includes functional magnetic resonance, EEG and other methods for examining special brain functions such as cognitive function and emotional state.
Diagnosis
Diagnosis and diagnosis of brain stem infarction
Differential diagnosis
1. Cerebral hemorrhage: The onset is more urgent. Symptoms and signs of focal localization of the nervous system appear within minutes or hours. Symptoms such as headache and vomiting, such as increased intracranial pressure and varying degrees of disturbance of consciousness, are associated with increased blood pressure. However, large areas of cerebral infarction and cerebral hemorrhage, mild cerebral hemorrhage and general cerebral thrombosis symptoms. Feasible head CT for identification.
2. Cerebral embolism: rapid onset, peak symptoms within a few seconds or minutes, often with a history of heart disease, especially atrial fibrillation, bacterial endocarditis, myocardial infarction or other sources of embolism should consider cerebral embolism.
3. Intracranial space: Some subdural hematomas, intracranial tumors, brain abscesses, etc. are also onset faster, and there are symptoms and signs of hemiplegia, which need to be identified with this disease. Possible head CT or MRI identification.
