What Is an Ischemic Foot?

Ischemic stroke is a general term for necrosis of the brain tissue due to stenosis or occlusion of the blood supply arteries (carotid and vertebral arteries) of the brain and insufficient blood supply to the brain. There are four types of cerebral ischemia: transient ischemic attack (TIA); reversible neurological dysfunction (RIND); progressive stroke (SIE); and complete stroke (CS). TIA has no cerebral infarction, and RIND, SIE, and CS have different degrees of cerebral infarction.

Basic Information

nickname

Cerebral infarction

English name

Cerebral ischemic stroke

English alias

cerebral infarction

Visiting department

cardiology

Common causes

Middle cerebral artery embolism; extracranial internal carotid or vertebral artery stenosis, occlusion or thrombosis, etc.

Common symptoms

Sudden numbness of the contralateral limb, weakness, sensory disturbance, monocular blackness, dizziness, diplopia, binocular blackness, ataxia, etc.

Causes of ischemic stroke

According to the scope of ischemia, cerebral ischemia can be divided into local cerebral ischemia and diffuse cerebral ischemia. The causes of local cerebral ischemia are: middle cerebral artery embolism; extracranial internal carotid or vertebral artery stenosis, occlusion or thrombosis; cerebral arterial spasm. The causes of diffuse cerebral ischemia are: cardiac arrest, hypotension, anemia, hypoglycemia, etc.

Clinical manifestations of ischemic stroke

Different types of cerebral ischemia have different clinical manifestations.

1. Transient ischemic attack (TIA)

The main manifestations are transient, transient localized neurological dysfunction, the duration does not exceed 24 hours, the symptoms resolve on their own, and no positive signs of the nervous system are left. TIA can occur repeatedly with irregular intervals.

(1) Contralateral limb numbness, weak strength, sensory disturbance, and monocular blackness in carotid TIA , such as aphasia in the dominant hemisphere;

(2) Vertebral artery TIA sudden dizziness, diplopia, dark eyes, ataxia, dysphonia, and difficulty swallowing, may have concentric blindness, the location of each paresis is not constant, and it is often accompanied by occipital headache .

2. Reversible Neurological Dysfunction (RIND)

The onset of stroke is similar to the clinical manifestations of TIA, but the neurological dysfunction lasts for more than 24 hours and usually returns to normal in about a week. A CT or MR scan of the skull reveals small infarcts in the brain.

3. Progressive stroke (SIE)

Neurological dysfunction gradually develops and becomes step-like aggravated. It takes more than 6 hours for the disease to develop to a high level. The main cause is the internal carotid artery and middle cerebral artery plug.

4. Complete Stroke (CS)

Sudden emergence of localized neurological dysfunction of more than moderate degree, and the development of the condition reached a peak within 6 hours. Later, neurological dysfunction persisted and rarely recovered. The main manifestations are hemiplegia, blindness, aphasia, sensory disturbances, and often conscious disturbances.

Diagnosis of ischemic stroke

1. Skull CT and MRI scans

The importance of a head CT scan at the beginning of the onset is to exclude cerebral hemorrhage. However, no abnormal CT findings were found in the early stages of cerebral infarction. The infarcted area showed a significant low-density change 24 to 28 hours after the onset of onset, with no placeholder effect. MRI can be diagnosed 4 hours after the onset.

2. Cerebrovascular examination

Digital subtraction angiography DSA, CT or MR angiography can show the lesion location and nature of aorta in the brain. Shows the location and extent of cerebral artery stenosis, occlusion, or distortion.

3. Transcranial Doppler (TCD)

This is a non-invasive method for examining the changes in cerebral hemodynamics. Based on the flow velocity and direction of the blood flow, the presence or absence of stenosis and occlusion of the cerebral vessels can be determined.

Ischemic stroke treatment

Patients with cerebral ischemia at the beginning of the onset of the disease should be given active medical treatment to prevent further development of cerebral ischemia. Reduce brain damage. Treatment should be determined according to the patient's different etiology, pathogenesis, clinical type, onset time and other conditions, and individualized treatment should be given.