Triple bias
Introduction
Introduction "Tri-biased" disease: the clinical manifestations of cerebral infarction, cerebral artery occlusion of the middle cerebral artery can cause "three-biased" symptoms; the contralateral central facial lingual palpebral and hemiplegia, partial sensation of the sensation and hemianopia or quadrant blindness. Simple is to say: hemianopia, partial spread, and hemp. Cerebral infarction, also known as ischemic stroke, refers to the softening and necrosis of local brain tissue due to blood circulation disorder, ischemia and hypoxia. The infarct size of cerebral infarction was the most in lacunar infarction. The clinical manifestations are: subacute onset, dizziness, dizziness, gait instability, limb weakness, a small amount of drinking water and cough, dysphagia can also have a partial hemiplegic sensation, some patients have no local signs.
Cause
Cause
Cerebral infarction is mainly caused by atherosclerosis and thrombosis in the arteries supplying blood in the brain, which makes the lumen narrow or even occluded, leading to focal acute brain cerebral insufficiency; there are also abnormal objects (solid, liquid, gas) along the blood. Cycling into the cerebral artery or supplying the cerebral blood circulation of the neck artery, causing blood flow blockage or sudden decrease in blood flow to produce softened necrosis of the brain tissue in the corresponding dominant area. The former is called arteriosclerotic thrombotic cerebral infarction, accounting for 40% to 60% of the disease, and the latter is called cerebral embolism, which accounts for 15% to 20% of the disease. In addition, there is a lacunar infarction, a microinfarction caused by deep occlusion of the brain artery caused by hypertensive arteriosclerosis, and some people believe that a small number of cases can be caused by atherosclerotic plaque detachment caused by microembolism Caused by the popularization and application of CT and MRI, it is reported that the incidence rate is quite high, accounting for 20% to 30% of cerebral infarction. Cerebral infarction is the most common cerebrovascular disease, accounting for about 75%, the average mortality rate is 10% to 15%, the disability rate is extremely high, and it is easy to relapse. The mortality of recurrent stroke is greatly increased.
Examine
an examination
Related inspection
EEG examination of brain MRI for brain function imaging
1. CT examination
CT showed that the infarct was low-density, and the location, shape and size of the lesion could be confirmed. The larger infarction could cause pressure, deformation and midline structure displacement of the ventricle, but only 4-6 hours after the onset of cerebral infarction, only some cases A slightly lower density lesion with unclear borders can be seen, and most cases can show a low-density lesion with a clear boundary after 24 hours, and an infarct less than 5 mm. The posterior cranial infarction is not easy to be seen by CT, and the infarction on the cortical surface is also Often not detected by CT. Enhanced scanning can improve the detection rate and qualitative diagnosis rate of lesions. The CT of hemorrhagic infarction showed irregular high-density areas with large patches in the low-density area. The difference between the hematoma and the cerebral hematoma was that the low-density area was wider and the hemorrhagic lesions were scattered in small pieces.
2. MRI examination
MRI is extremely sensitive to the detection of cerebral infarction. The detection of ischemic brain damage is superior to CT, and it can detect early ischemic damage, which can be seen within 1 hour of ischemia. After 6 hours of onset, the large infarct was almost always shown by MRI, which showed a T1-weighted low-signal T2-weighted high signal.
3. Regular inspection
Blood, urine, stool routine and liver function, kidney function, blood coagulation function, blood sugar, blood lipids, electrocardiogram, etc. are routinely examined, and those with conditions can perform dynamic blood pressure examination. Chest X-ray should be used as a routine to rule out cancerous thrombus, and can be used as a basis for the diagnosis of inhalation pneumonia.
4. Special inspection
Transcranial Doppler (TCD), carotid color B ultrasound, magnetic resonance angiography (MRA), digital subtraction cerebral angiography (DSA), carotid angiography, can be confirmed whether there is carotid stenosis or occlusion.
Diagnosis
Differential diagnosis
Stroke (apoplexy) is a disease that suddenly faints, is unconscious, has a skewed mouth, is unfavorable in language, is not paralyzed, or is not clinically ill. Due to the rapid onset of the disease, the symptoms are very versatile, and the condition changes rapidly. It is similar to the characteristics of the wind and the good behavior, so it is called stroke and stroke. The incidence and mortality of this disease are high, and often have sequelae; in recent years, the incidence rate is increasing, and the age of onset is also becoming younger. Therefore, it is a major disease that threatens human life and quality of life.
Western medical acute cerebrovascular diseases, such as cerebral infarction, cerebral hemorrhage, cerebral embolism, subarachnoid hemorrhage, etc. belong to the category of this disease. Western medicine divides the disease into hemorrhagic and ischemic, hypertension, arteriosclerosis, cerebral vascular malformation, cerebral aneurysms often lead to hemorrhagic stroke; rheumatic heart disease, atrial fibrillation, bacterial heart Membrane inflammation often forms an ischemic stroke. In addition, hyperglycemia, hyperlipidemia, abnormal blood rheology and abnormal mood fluctuations are closely related to the occurrence of this disease. Head CT, MRI can confirm the diagnosis.
Cerebral infarction (CI), also known as cerebral ischemic stroke (CIS), refers to the softening and necrosis of local brain tissue due to blood circulation disorder, ischemia and hypoxia. Mainly due to atherosclerosis and thrombosis in the arteries supplying blood in the brain, narrowing or even occlusion of the lumen, leading to focal acute brain cerebral insufficiency; also due to abnormal objects (solid, liquid, gas) entering the blood circulation The cerebral arteries or the cervical arteries that supply cerebral blood circulation cause blood flow blockage or sudden decrease in blood flow to produce softened necrosis of brain tissue in the corresponding dominant area. The former is called atherothrombotic brain infarction (ABI), which accounts for 40% to 60% of the disease. The latter is called cerebral embolism (CE), which accounts for 15% to 20% of the disease. . In addition, there is a lacunar infarction, which is a microinfarction caused by deep occlusion of the brain artery caused by hypertensive arteriosclerosis. It is also believed that a small number of cases can be disintegrated by atherosclerotic plaque. Caused by microembolism, due to the widespread use of CT and MRI, it is reported that the incidence rate is quite high, accounting for about 20% to 30% of cerebral infarction. Cerebral infarction is the most common cerebrovascular disease, accounting for 75%, the average mortality rate is 10% to 15%, the disability rate is extremely high, and it is easy to relapse. The mortality of recurrent stroke is greatly increased.
