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For patients who have had one cerebral infarction and are likely to have a second one, it is indeed very important to do a good job of secondary prevention of cerebral infarction. The specific methods are as follows.

1. Dietary changes, recommended low-salt and low-fat diets, control of total food calories, more fresh vegetables, fruits, nuts, beans, deep-sea fish and whole grains.

2. Management of hypertension, if hypertension is present, it is recommended that the blood pressure be controlled above 140/90 mmHg and below 130/80 mmHg if not associated with severe carotid stenosis.

3. Management of dyslipidemia, especially LDL cholesterol, is recommended to be controlled below 1.8 mmol/L or a 50% reduction from the original level. Triglycerides can be controlled at normal levels.

4. Management of blood glucose, should regularly monitor pre-meal and post-meal blood glucose, control blood glucose in the ideal range, recommended glycated hemoglobin <7%, the ideal value is 6% or less.

5. Hyperhomocysteine, if a cerebral infarction occurs, homocysteine values should be measured, and if they are above normal, oral folic acid, vitamins B6 and B12 should be taken.

6. Obesity, all patients who have had a cerebral infarction should pay attention to the body mass index (BMI), it is recommended to control below 25, and at the same time pay attention to the abdominal circumference, China's standard is less than 90cm for men and less than 80cm for women.

7. Smoking, have had cerebrovascular disease, must quit smoking.

8. Alcohol consumption, it is recommended to abstain from alcohol, if you can not abstain from alcohol, it is recommended that no more than one glass at a time (beer 375ml, red wine 150ml, white wine 45ml), no more than 5 times a week.

9. Antiplatelet drugs, aspirin or clopidogrel. Having had a non-cardiac cerebral infarction, it is recommended to start long-term antiplatelet drugs orally.

10. Anticoagulation. For cardiac stroke, it is recommended to start long-term oral anticoagulation for secondary prevention.

11. Statin, LDL cholesterol >2.6mmol/L, long-term statin is recommended to lower blood lipids while synergistically preventing recurrent cerebral infarction.

12. If there is heart disease such as atrial fibrillation or patent foramen ovale, treat the primary cause.

13. Carotid artery stenosis, if the stenosis is 70% or more, along with a recent cerebral infarction or transient ischemia, stenting or carotid endarterectomy is recommended.

14. Other special cases, such as arterial entrapment, anticoagulation or stenting; revascularization for smog disease; sickle cell anemia suggesting regular transfusions to correct anemia and hypercoagulability. Other causes of hypercoagulability are treated symptomatically.

For secondary prevention of cerebral infarction, lifestyle improvement is the foundation, risk factor control is the key, and antiplatelet medications and statins are adjuncts. Active prevention will definitely reduce the chance of recurrence!

The prevention of second recurrence of cerebral infarction has always been an important and difficult clinical issue. First of all, the probability of having a second cerebral infarction, a third cerebral infarction or multiple cerebral infarctions after a cerebral infarction is very high (of course, it is mainly the second cerebral infarction because few patients can survive to the third cerebral infarction after suffering two cerebral infarctions), how high is this probability? Almost fifty percent of patients with cerebral infarction will have another cerebral infarction after a cerebral infarction, and the risk of morbidity is much higher than that of normal people.

Why is this happening?

This is because the occurrence of a cerebral infarction is usually associated with underlying diseases, such as atrial fibrillation, hypertension, diabetes, hyperlipidemia, and so on. These diseases exist for a long time, causing the patient's blood vessels (and other aspects) to become diseased and far less healthy than normal, so it is easy to have another cerebral infarction

How can I prevent it?

1. Active treatment of underlying diseases

For example, patients with atrial fibrillation (which tends to produce emboli in the heart that dislodge and block cerebral blood vessels causing cerebral infarction) need to take anticoagulant medications (warfarin), etc. If patients with high blood lipid, they need to take lipid-lowering drugs such as atorvastatin. If you have high blood pressure, you need to take antihypertensive drugs.

2. Use of aspirin

Aspirin is of great significance in preventing secondary infarctions in patients after a cerebral infarction, and recent studies have also found that aspirin can also fight cancer. Good Medicine

3. Change bad habits

It's a cliché to stop smoking, drinking and eating less grease. Avoid staying up late

4. Exercise appropriately and do rehabilitation exercises

Some patients with mild cerebral infarction may not have obvious sequelae, then there should be moderate exercise every day. For serious sequelae, such as paralyzed in bed, then the family should do a good job of care, rehabilitation exercises (passive exercise, such as massage, help the patient to move their arms and legs, and conditions can be utilized rehabilitation equipment), long-term bedridden, blood reflux is impeded, it is also very easy to form blood clots.

5. Many times celery and onion

I have already described these two foods in my previous answer as being good for preventing brain attacks, so I won't repeat them here.

6. Regular review to assess physical condition

Six months or a year is usually recommended.

Any patient who has had a cerebral infarction has a significantly increased risk of having a second cerebral infarction!

Cerebral infarction is an ischemic disease of the cerebral vessels, and vascular diseases are systemic, you think about the blood flow in the blood vessels, the blood vessels are a closed circulation, and the cause of vascular damage, and not just damage to only this part of the blood vessels of the brain. Then this pathologic basis can not be completely removed, and the possibility of reoccurrence of vascular disease is higher.

Clinically, we also always encounter patients with recurrent cerebral infarction.

The general principles of prevention are: abstain from smoking and alcohol, take medication regularly, monitor three highs, exercise appropriately, have a regular routine, and eat a healthy diet.

For the prevention of the second occurrence of cerebral infarction, we first clarify the cause of cerebral infarction, the current common cause of cerebral infarction is atherosclerosis, one is atrial fibrillation thrombus dislodgement.

First, for strokes caused by atrial fibrillation, which account for almost about 20% of all strokes, our prevention program is relatively simple but poorly implemented. Prevention of thrombotic events in atrial fibrillation:Anticoagulation therapy, including warfarin, and now the new drugs dabigatran and rivaroxaban. Warfarin is inconvenient to take the drug needs frequent blood tests, easy to invalid or blood, need to monitor the INR between 2-3, many people are reluctant to choose, there are many people eat eat on their own stop using. Dabigatran and rivaroxaban, on the contrary, do not always need to check the blood, but the cost is higher.

Of course, radiofrequency ablation can theoretically be used to eradicate AF, but it is more expensive and has a lower success rate; left ear blockade has also been gradually applied in recent years, but it is still not widely available.

Second, for atherosclerosis formation of cerebral infarction, the root cause is the three high, smoking, obesity, not exercise such high-risk factors accelerate the progress of atherosclerosis. Prevention of secondary infarction, is to take aspirin plus statin on time, anti-platelet aggregation, anti-inflammatory, stabilize plaque. At the same time actively control the three high, quit smoking and drinking, lose weight, exercise, and regular review.

Third, dietary attention.

Low-salt, low-fat, low-sugar diet with grains and fresh vegetables and fruits, vegetable oils, appropriate fish supplements, white meat, small amounts of nuts, and other healthy diets. You can check out Dr. Wang's Shakeology.

Cerebral infarction brings great pain to patients, especially the sequelae seriously reduce the quality of life of patients and hinder their family life.

Therefore, the prevention of cerebral infarction should not only prevent the occurrence of second cerebral infarction, but also prevent cerebral infarction from the foundation.

Cerebral infarction not only has a high incidence rate, a high death and disability rate, but also a high recurrence rate. It is not uncommon to see patients with second or even third recurrence in the hospital. When treating the patients, we should tell them how to prevent recurrence at the same time.

Adhere to preventive medications, aspirin, statins, antiplatelet aggregation, lipid lowering to stabilize plaque. If there is atrial fibrillation patients must go to the cardiology department for anticoagulation. Timely supplementation of folic acid, vitamin B5, vitamin B12. At the same time, 'three high' patients should be controlled, especially hypertensive patients, usually not only on time to take medication every day to monitor the blood pressure, the mood should also be controlled.

Low salt and low fat diabetic diet in your daily diet and lifestyle. Eat a light diet, fried, fatty meat, offal, high-calorie food and so on to avoid eating. Quit smoking and drinking, don't stay up late and don't get emotional. Exercise every day, because patients with cerebral infarction will be left with limb dysfunction, must be early, continuous and persistent exercise. And activities can also promote blood circulation, improve blood supply insufficiency.

Prevention of second recurrence of cerebral infarction requires not only the efforts of the patient himself, but also the care and help of his family. A favorable environment is also very important.

I'm Dr. Lee from the Rehabilitation Department. Click the upper right corner to follow me, stay away from sub-health and enjoy a healthy life.

For patients with cerebral infarction, the recurrence of the disease is undoubtedly a huge blow. So what should patients pay more attention to in their daily life in order to better prevent the recurrence of the disease?

1) The mention of hypertensive disorders is not unfamiliar to many people. However, most people do not know that the presence of hypertension can promote the formation of atherosclerotic plaques in the organism. In addition, according to research findings, as the body's blood pressure rises, the patient's cardiovascular disease mortality rate will also increase. Once the stroke is stabilized, appropriate antihypertensive treatment can reduce the chance of recurrent stroke.

2) Smoking, studies have shown that the risk of stroke increases dramatically in patients who smoke compared to those who have never smoked. In addition, if a person smokes for many years, the risk of carotid artery stenosis increases dramatically. The carotid artery is the main pathway for oxygen supply to the brain, and if there is an abnormality in the carotid artery, the normal function of the brain will be affected.

3) Dyslipidemia, it is important to note that there is a strong correlation between the development of cholesterol and carotid atherosclerosis, according to the study found that the elevation of cholesterol and LDL is associated with an increased risk of ischemic stroke disease.

Instructor: Chen Yufei, Attending Physician, Department of Neurosurgery, General Hospital of Tongxiang Group Company.

He has been engaged in neurosurgery for more than ten years and has rich clinical experience, specializing in the treatment of craniocerebral trauma, as well as hypertensive cerebral hemorrhage and other diseases.

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Thanks for the invitation! There are actually a lot of preventive measures for cerebral infarction, such as the most basic ones are controlling blood pressure, stabilizing blood glucose, and lowering blood lipids, but instead of emphasizing some of the Chase sets, I'm going to emphasize a few details here.

The first detail is to adhere to, there are a lot of people ultimately fail to fail to adhere to, they say quite good, can actively take medication on time, control blood pressure, stabilize blood glucose, reduce blood lipids, but insist on a week after forgetting to take medication this matter, but also forget to actively control the diet, is still big fish and meat, smoking and drinking live quite happy, then like this, is bound to be within a certain period of time Again relapse. So like some of the methods, the Internet a search a big, a variety of know-how tips can be said to be a variety of, but really able to adhere to and adhere to the correct direction of the people, and can have a few? So there are many cases is not the method is not good, but you have not reached a certain time, there is no certain experience, then you are bound to fail. This can also be applied to the aspect of success, the method of earning money, in fact, so few, but can you stick to it, then you can make yourself a million dollars?

The second is the degree of change of the indicators, can you do daily record, regular daily measurements, according to the actual situation to adjust the dosage of medication, although many people are not a doctor, can not adjust the dosage of medication, but can you put their own indicators for regular monitoring, regular record, the original high blood pressure, now can recall their own two days before the morning of the measured What was the state of the first blood pressure? The vast majority of people have no way to recall, and some even forget what their blood pressure was this morning. So people like this, even if you actively go to the hospital for review, but when the doctor to ask you how the relevant indicators of change today, he certainly can not say, and as a doctor can not be based on some nebulous things on the change of a variety of drugs, so there are a lot of times the review is a formality, and confused to do some routine checks and treatments, but there is no fundamental change to the point. The change to the point. So what I really hope is that, similar to blood pressure, it can be measured at least twice a day, once in the morning and once in the afternoon at around 5:00 p.m. to record the value and draw a curve, so that the dosage of medication can be adjusted according to the actual situation. Similarly, blood glucose should be measured every day, including fasting and after three meals, and the corresponding curve should be drawn, so that the dosage can be adjusted according to the actual situation.

The third to find the root cause, many of the causes of cerebral infarction can not find the root cause, especially in the vast countryside or villages and towns have a lot of cerebral infarction, their level of understanding can only be said to think that he is a vascular disease, can only be treated by internal medicine. And do not know really where his root is, and will not be treated by surgical way. So there are a lot of times, people's understanding of it is to take some medicine to endure, and in the end is really too heavy, then give up the treatment. So there are many times for cerebral infarction, especially recurrent cerebral infarction, must be timely to identify the cause of the blood vessels, because the vast majority of cerebral infarction is caused by narrowing of the blood vessels, can be through stent implantation surgery or endothelial stripping surgery as well as vascular bypass surgery and other types of ways for further treatment, in this way there can be a better treatment, and even some of them do not affect daily life expectancy, to a very good degree. So it's also very important in this regard.

So there are many times some of the measures he is a formality, to you to print two leaflets, sent to their hands, see and do not see are the same thing, not to mention do and do not do, so it is more important to be based on the actual situation, you can decide exactly what kind of situation you are, after all, the disease are on their own, only the fundamental form of the solution to be more favorable!

What is the most important treatment after a brain attack? It is the prevention of recurrent cerebral infarction through medication! Cerebral infarction is also called ischemic stroke, cerebral infarction is the most common type of stroke, accounting for about 70~80%, due to the cerebral blood vessel plugging can cause blood dysfunction of brain tissue, triggering corresponding neurological deficits, the disability rate and death rate are relatively high.

So what are the risk factors for recurrent brain infarcts that need to be prevented?

Cerebral infarction is closely related to atherosclerosis, so it is important to control the risk factors for atherosclerosis, which include high blood pressure, diabetes mellitus, smoking, and dyslipidemia. In the United States, a study found that patients with two or more risk factors had a significantly higher risk of having a second stroke!

1) hypertension, it is clear that everyone recognizes this disease, but many people do not know is that high blood pressure can promote atherosclerotic plaque formation, in the United States through epidemiological studies found that with the rise in blood pressure and cardiovascular disease mortality rate increases, once the stroke is in a stable, then antihypertensive treatment is able to reduce the incidence of recurrent stroke.

2) Smoking, studies have shown that patients who smoke have a substantially increased risk of stroke compared to those who have never smoked; the Framingham Heart Study found that years of smoking also substantially increased the risk of carotid artery stenosis; and it is well known that the carotid arteries provide blood oxygen to the brain;

3) Diabetes, people with diabetes have twice the risk of ischemic stroke than the normal population!

4) Dyslipidemia, cholesterol and carotid atherosclerosis are strongly correlated, and some studies have found that elevated cholesterol and LDL are associated with an increased risk of ischemic stroke.

Other risk factors include heavy alcohol consumption, heart disease (e.g., myocardial infarction, left heart insufficiency, heart valve disease, left ventricular thrombus, atrial septal defect, etc.), hypercoagulable state of the blood, hyperhomocysteinemia, infections, obesity, physical inactivity, and radiation therapy, among others.

With the risk factors described above, what are the common causes of ischemic stroke?

The most common include atrial fibrillation and carotid artery stenosis, and the most serious complication of atrial fibrillation is the ischemic strokes that can be caused by the dislodgment of a heart embolus from the left atrium and embolization of the blood flow into the cerebral vessels. The carotid artery, as mentioned earlier, provides oxygen to the brain tissue.

So what can be done to prevent it?

This includes regulating blood pressure, controlling blood glucose, antithrombotic, applying statins to lower lipids, and changing poor lifestyles.

I think that being able to recognize this problem shows that a lot of progress has been made, and it's not too late to mend.

Let me analyze how one cerebral infarction is already worse than death, how can it happen a second time?

The first main reason, is the heart of this disease is not enough to recognize, do not know that cerebral infarction is an old man's vascular degenerative changes caused by degenerative changes, what is the meaning of degenerative changes, that is, people to a certain age will slowly occur in the case of cerebral infarction high-risk factors have not been lifted, and always think that they are almost good, there should be no problem. Therefore, they stop taking the medication hastily, and after stopping the medication, they may not have regular checkups. As a result, cerebral infarction occurs again. In this case, the prevention is to ask the doctor before stopping the medication.

The second reason I think is that the patient long-term medication, the patient will always be worried about often take medication, is a drug three poisons, worried about the toxic side effects of the drug, so intentionally or unintentionally stopped taking the drug, in fact, the toxic side effects of the drug do not have to worry about it at all, because this drug since you have eaten for a long time, that is to say, you can eat the drug, and that is the drug is mainly in the normal application of normal dosage, will not appear too many side effects. Side effects, of course, regular review of the appropriate examination, such as lipid drugs liver function damage, regular review of liver function, liver function is normal on it.

The third reason, you can't blame the patient, you can only blame the characteristics of the drug, such as antiplatelet drugs, aspirin, a very small number of people can have aspirin resistance, the drug is taken for a period of time because of some reasons, the drug does not work, how to do this? Now there is a test called thromboelastography, which can determine the function of platelets and whether aspirin is still effective.

The fourth reason is that some people have medical conditions, do not pay attention to their diet and life, and do not avoid high-risk factors.

Throwing in the towel and welcoming criticism.

How's it going?You think this article is helpful to you, please do not forget to click on the word "attention" and then "like" ah!I am an interventionalist specializing in neurosurgery! I specialize in neurosurgery and interventional medicine, and will be able to provide you with more information about cerebrovascular disease and its health benefits. Thank you for your time.

The basic cause of cerebral infarction is high blood pressure, high blood fat, high blood viscosity and arteriosclerosis. So in the prevention is mainly control blood pressure, blood fat, blood viscosity, keep a happy mood, avoid emotional fluctuations, in the change of season can also be preventive infusion, which are more effective practices. It is recommended that you pay attention to low-salt, low-fat, light, do not eat salty, eat less greasy fried food, but also moderate exercise to enhance physical fitness.

1、It is best to lower blood pressure to <140/90mmHg if the patient can tolerate it. 2、Strictly control blood glucose level, fasting blood glucose should be <6.0mmol 3、Systematic treatment of heart disease. 4, Quit smoking and drinking. 5、Regularly do neurological examination and necessary auxiliary examination and laboratory test 6、Reasonable physical exercise: strengthen physical exercise according to one's own condition and pay attention to improve the depression and other emotions after cerebral infarction. 7. Pay attention to the influence of seasonal changes on patients with cerebral infarction: pay attention to the recurrence of cerebral infarction during the change of winter and spring seasons and the change of fall and winter seasons. 8, the use of drug therapy: the current commonly used drugs for aspirin, but aspirin to prevent the recurrence of cerebral infarction of the pharmacological effect of a single.

Cerebral infarction, i.e. ischemic stroke, is the most common type of cerebrovascular disease, and nearly 70% of patients with stroke subtypes in China have ischemic stroke. The latest data show that the annual recurrence rate of ischemic stroke in China is as high as 17.7%. Then how to prevent recurrence? Effective secondary prevention is the main means to reduce recurrence and death.

Risk factors for cerebrovascular disease include both preventable and non-preventable categories, and preventable risk factors should be actively controlled to reduce the occurrence and recurrence of cerebrovascular disease. Relevant risk factors can refer to previous guidelines for primary prevention of stroke and secondary prevention. In the following, I will focus on the risk factors that have sufficient evidence in evidence-based medicine, are of high concern, and are amenable to intervention.

1. Hypertension: ischemic stroke patients who have not received prior antihypertensive therapy should initiate antihypertensive therapy if their systolic blood pressure is ≥140 mmHg or diastolic blood pressure is ≥90 mmHg several days after onset.

2. Abnormalities of lipid metabolism: Long-term treatment with high-intensity statins is recommended for patients with noncardiac ischemic stroke, with or without other evidence of atherosclerosis, to reduce the risk of stroke and cardiovascular events. Evidence suggests that secondary prevention is more effective when LDL-C decreases ≥50% or LDL ≤1.8 mmol/L.

3. Abnormal glucose metabolism and diabetes mellitus: diabetes mellitus and pre-diabetes mellitus are independent risk factors for stroke recurrence or death in patients with ischemic stroke, and the recommended target for glycated hemoglobin treatment is <7%.

4. Smoking: Ischemic stroke patients with a history of smoking are advised to quit.

5. Sleep apnea: Encourage medical units that have the conditions to monitor sleep apnea in ischemic stroke patients, and use continuous positive airway pressure (CPAP) to improve the prognosis of stroke patients with combined sleep apnea.

6. Hyperhomocysteinemia: In patients with recent ischemic strokes and mild to moderate increases in blood homocysteine, supplementation with folic acid, vitamin B6, and vitamin B12 may reduce homocysteine levels.

7. Antiplatelet agents: For patients with noncardiogenic embolic ischemic stroke, oral antiplatelet agents rather than anticoagulants are recommended to prevent stroke recurrence and other cardiovascular events.

8. Antithrombotic therapy for cardiogenic embolism: for patients with ischemic stroke accompanied by atrial fibrillation, the use of appropriate doses of oral anticoagulation with warfarin is recommended; new oral anticoagulants can be used as an alternative to warfarin.

Standardized secondary prevention drug therapy for stroke patients can significantly reduce the risk of stroke recurrence and improve clinical prognosis, but whether patients have good drug adherence is the key to whether secondary prevention can be sustained. Observational studies at home and abroad have shown that ischemic stroke patients with good adherence to medication have a better clinical prognosis. Therefore, we remind patients who have already suffered from stroke that in order to prevent recurrence, the above risk factors must be strictly controlled.

Ref: Chinese Medical Association Neurology Branch, Chinese Medical Association Neurology Branch, Cerebrovascular Disease Group. Chinese guidelines for secondary prevention of ischemic stroke and transient ischemic attack 2014[J]. Chinese Journal of Neurology, 2015, 48(4) 258-269.

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