Cerebral infarction, also known as ischemic stroke, is also commonly referred to as cerebral infarction, the disease is a sudden onset of cerebral blood circulation disorders, with high morbidity, disability, mortality and recurrence rate of high "four high" characteristics, in the process of clinical treatment to remind us to pay attention to the following issues:

I. Due to the narrow time window for treatment of acute ischemic stroke, it is crucial to assess the condition and make a diagnosis in a timely manner. Therefore, as soon as you suspect that the patient may be suffering from a cerebral infarction, you should send the patient to a nearby hospital with the necessary conditions as soon as possible (which should include the ability to perform an emergency CT examination in 24h and the availability of thrombolysis), remembering that time is life. For ischemic stroke patients, up to 4.5 hours or 6 hours after onset is your optimal treatment window. Studies have shown that ischemic stroke patients with large vessel occlusion in the brain will lose an average of 1.9 million neurons per minute without prompt treatment, and over 7-8 hours, patients will lose 800-900 million neurons. Therefore, recognizing the signs and symptoms of stroke onset so as to activate the resuscitation system in a timely manner and open a green channel for stroke is extremely important for acute stroke resuscitation and improving the long-term survival quality of patients.

Second, for patients who have already been cured of stroke, active search for the cause of the disease and control of intervening risk factors to prevent and reduce the risk of recurrence of stroke also need special attention. The risk of recurrent stroke in patients with this disease is nine times higher than in the general population. Therefore attention must be paid to active secondary prevention. The three cornerstones of secondary prevention of ischemic stroke are antihypertensive drugs, statin lipid-lowering drugs and antiplatelet agents, which should be taken for a long period of time, even for life.

Third, it is important to note that there must be a healthy lifestyle, which is the basis of any kind of drug treatment. First of all, quit smoking: avoid active or passive smoking; Secondly, to control weight: moderate physical exercise at least 30 minutes a day, you can walk, swim, jogging, tai chi, etc., it is best to choose the afternoon hours, 5 minutes to warm up and then 20 minutes of exercise, then 5 minutes of recovery and relaxation, the intensity of the exercise should be gradual and progressive, in order not to feel tired to the extent that (the highest safe heart rate = 170 - age); Finally, to a reasonable Diet: eat at least 5 kinds of fruits and vegetables every day, to "four low, two high" low salt, low sugar, low fat, low calorie, high vitamin, high fiber, eat more meals, the whole body good state of recovery, for the success of the treatment to lay a solid foundation.

Fourth, for patients with cerebral infarction must pay attention to the importance of rehabilitation. According to statistics, 90% of patients with early stroke rehabilitation training can resume walking and 30% can resume hand function, while only 60% of patients without rehabilitation can resume walking and 5% can resume hand function. Modern medicine has proved that through effective rehabilitation training after stroke, the brain tissue in the resting state can be mobilized to replace the necrotic brain tissue to play the corresponding function, thus reducing the disability or dysfunction. It can be seen that rehabilitation intervention or not, and whether it can be intervened at an early stage is crucial to the functional recovery and quality of life of patients.

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Cerebral infarction is called stroke or stroke in Chinese medicine, at present in medicine, it is customary to categorize cerebral infarction into cerebral thrombosis, cerebral embolism and cavernous cerebral infarction and other major types according to different pathogenic mechanisms. Cerebral infarction is a more serious disease, so what should patients pay more attention to in life?

Cerebral infarction belongs to a kind of emergency disease, so the principle of treatment of this disease is super early treatment, within 4 to 5 hours of the onset of the disease, patients should receive intravenous thrombolytic therapy as far as possible at this time, and preferably according to the patient's own risk factors and the extent of the disease, etc., to adopt the corresponding targeted treatment, in order to maximize the therapeutic effect and improve the prognosis.

In normal life, patients should consciously quit smoking and limit alcohol, and adjust some bad lifestyle and diet. Generally speaking, patients should do as much as possible to eat a light diet, eat more fruits and vegetables in order to facilitate the alleviation of hyperlipidemia. It is best to choose medicines reasonably under the guidance of the attending doctor in order to improve the symptoms of the body.

If necessary, you can also cooperate with traditional Chinese medicine and acupuncture buried line treatment, in order to better adjust and improve the body's symptoms, and ultimately better assist in the recovery of the body's condition, as far as possible to avoid the risk of the 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, working in the ICU often results in patients who have had a stroke (stroke is a collective term for brain hemorrhage and cerebral infarction).

As shown in the figure below, the brain has a very rich blood vessels, large and small blood vessels winding into a network of blood vessels supplying our brain nutrients and take away the brain metabolism produced by the waste. Each of these blood vessels is relatively independent of the metabolism responsible for a region of our brain, although the peripheral capillary network has interconnecting traffic to form a network of blood vessels, but if the key trunk of the large blood vessels blocked off will still cause a response to insufficient blood supply to the brain to form a region of brain death.

A cerebral infarction, as the name suggests, is a blockage of one of the blood vessels in the brain. The brain is no reserve energy, the brain's usual energy needs are taken from the blood as needed, if the blood vessels supplying this area of the brain are suddenly blocked off immediately after the blood vessels supplying the area of the brain tissue in a few hours because of the lack of oxygen, lack of nutrients, metabolic wastes can not be transported away from the edema, necrosis. The brain is responsible for controlling all our activities and sensations and all kinds of consciousness, each part of the brain are respectively controlling a part of our body area, if the control of our arm strength of the brain area of the blood vessels blocked off infarction, there will be arm hemiplegia, if responsible for the speech of the area of infarction will appear aphasia can not speak. (Think of it as the water mains supplying a neighborhood suddenly clogging up, and the water from other neighborhoods not being available in time, so the people in that neighborhood would probably not last more than a week before they died from lack of water).

So back to the question above: what do you look for after a cerebral infarction?

If it is an acute brain infarction, then of course it is the fastest way to go to the hospital, to see if there is a chance to use drugs to open up the blocked blood vessels. Anyway, the earlier you find out the earlier you go to the hospital, the more likely it is that the brain cells that haven't died yet will be rescued (usually within 3-4 hours is the best).

If after this time, it is still necessary to go to the hospital, because after a cerebral infarction (especially large cerebral infarction) cerebral tissue ischemia, hypoxia, resulting in cerebral tissue edema, necrosis and softening will form intracranial hypertension, will oppress the normal not necrotic cerebral tissue like the condition of the further aggravation of the disease, so you need to go to the hospital to reduce the cranial hypertension infusion.

Most patients with cerebral infarction will suffer from urinary incontinence or urinary retention (having to urinate, but not being able to poop out), choking on food and drink, or even coma. This is also the time to go to the hospital need catheterization, insertion of gastric tube, intravenous bottles of nutritional support therapy.

Second question: how do you recover from a cerebral infarction?

If the patient survives after the acute stage, he or she is often accompanied by hemiparesis, aphasia (either he or she cannot speak at all, or he or she can speak but does not understand what is being said, or he or she understands what we are saying but does not know how to answer), choking and coughing on food and drink, and urinary retention, etc., which all require good care by family members, and more specifically, the supervising doctor will explain what to do if there is a patient discharged from hospital with such a condition in his or her family. For example, if the patient is choking on his food, he needs to be fed through the gastric tube, and if he has urinary retention, he needs to have a catheter inserted to assist him in urination, and so on.

Regarding hemiplegia, if the patient is unable to turn over on his/her own, he/she needs regular assistance from family members to turn over and pat the stool. Otherwise, decubitus ulcers will easily form and subsequent treatment will be very troublesome.

Family economic conditions allow can be taken to a large hospital physical therapy rehabilitation department for rehabilitation training, you can observe how the rehabilitation hospital to help limb rehabilitation training, home can learn to help do their own rehabilitation training, rehabilitation training for hemiplegic limbs is a very big role in the recovery. To be persistent, work a few years, I have seen a few filial family members to help completely hemiplegic parents through one or two years of physical rehabilitation training miraculously through the crutches and can walk again.

Of course, patients with cerebral infarction need lifelong medication to prevent reoccurrence of infarction, and what medication they need can be prescribed by their supervising physician on an individualized basis.

Cerebral infarction, for the higher rate of disability and death disease, in fact, the principle is similar to myocardial infarction, are due to plaque or thrombus caused by narrowing of blood vessels, part of the brain cells ischemic necrosis, a series of clinical symptoms of the disease.

The cause of cerebral infarction, in addition to atherosclerosis, is atrial fibrillation stroke.

And what do patients with cerebral infarction need to be aware of?

1, first of all, the golden treatment period of cerebral infarction for the onset of 4 hours, 4 hours can be emergency thrombolytic therapy, 6 hours can be thrombolytic therapy to minimize the time of cerebral infarction of vascular blockage, save brain cells, so, find yourself with half limb numbness, slurred speech, severe dizziness, limb activity uncoordinated, etc. need to consult a doctor in a timely manner.

2, if the treatment is over, it is recommended to continue long-term oral medication, cerebral infarction is not recommended within 7 days of the acute stage of blood pressure is too low, to ensure cerebral perfusion, reduce the infarct area. And after the acute stage, it is recommended to continue to take oral antiplatelet or anticoagulant drugs, as well as statin, adjust blood pressure and other therapeutic drugs. And dynamic review.

3, no sequelae of the patient, it is recommended to continue to take medication, maintain a healthy state of life, maintain a healthy diet, quit smoking, quit drinking, low-salt, low-fat, low-sugar diet, to ensure that meat, eggs, milk and other nutrients into a balanced input to avoid overeating, and adhere to the aerobic exercise 2-3 times a week, no time more than half an hour.

4. If the patient has clear sequelae, it is recommended to have early rehabilitation during hospitalization, and the earlier the rehabilitation is carried out, the better the therapeutic effect will be. This is the importance of rehabilitation in patients with clear sequelae of cerebral infarction, of course, in addition to physical and speech rehabilitation. All of them need to be carried out at the same time.

Cerebral infarction is terrible, the sequelae are terrible, so prevention is never wrong than cure. It is better not to treat a disease than to treat it properly, and it is better to treat it properly than not to get sick. This is the importance of prevention.

What should patients with cerebral infarction pay attention to? Cardiovascular and cerebrovascular are not separate, Dr. Zhang on his own knowledge, say a few words, hope you you can help.

1. Acute stage of cerebral infarction

For those patients with new-onset cerebral infarction, it is important to send them to hospitals that have the ability to save their lives at the first sign of onset. This is because for patients with ischemic stroke, or cerebral infarction as it is called by the common people, 4.5 hours or less than 6 hours after the onset of the disease belongs to the golden time for treatment. If blood flow can be restored in time and treated properly during this time period, a large amount of neuronal damage may be avoided. It can be said that at this stage, early medical treatment, time is brain!

2. Cerebral infarction recovery period

①Adherence to medication

For those who have suffered from cerebral infarction, must pay attention to the late adherence to the use of anticoagulation, antiplatelet drugs, statins and other drugs. That is, the people usually eat warfarin, aspirin, statin and other drugs. Adherence to medication in order to maximize the prevention of cerebral infarction again.

②Regular review

For patients with cerebral infarction, it is important to pay attention to regular review while adhering to the medication because both changes in the condition and monitoring of the side effects of the medication taken need to be reviewed, which is also the essence of chronic disease management.

③Improvement of lifestyle

It is also important for patients who have had a cerebral infarction to pay attention to improving their lifestyle. Lifestyle changes include a low-salt, low-fat, low-sugar diet, cessation of smoking and limiting alcohol, psychological balance, and moderate exercise.

The above are the problems that Dr. Zhang can think of that patients with cerebral infarction need to pay attention to, right as a brick to attract jade, I hope it can help you.

Cerebral infarction patients need to pay attention to is the first time to find out, and then immediately sent to seek medical treatment. Getting to the doctor before 6 hours of the onset of the disease belongs to the golden time, after thrombolysis or thrombolysis treatment can basically restore the function of the limb.

After the onset of cerebral infarction patients stabilized after rescue, the real need for patients to face their own difficulties only began.

First, take your medication on time. The medicines your doctor prescribes for you must be taken on time, don't stop taking them yourself, take more or less. Aspirin, atorvastatin calcium tablets, Chinese patent medicines that activate blood circulation and remove blood stasis, nutritive nerve medicines, antihypertensive and hypoglycemic medicines, and so on. Your doctor will adjust your medication accordingly based on the review results, don't adjust it yourself.

The second is the patient's attitude, many patients with cerebral infarction can not accept the result for a while. Negative attitude, and even have resistance. At this time, family members should encourage and guide them.

Take advantage of the golden recovery period, the first 3 months of our illness are the fastest. This is the time to follow your doctor's program and work hard to regain as much limb function as possible.

Eat a planned diet, not in the sense of gorging yourself on whatever you want. Be sure to eat a light diet, limit salt, limit sugar, and refuse grease. Ensure that your weight is in the standard range to reduce the likelihood of relapse.

Be in a good mood, don't take the bull by the horns, and face the aftermath of the disease openly. You can't let bad moods control you, or they can easily lead to a relapse.

Stick to rehabilitation, rehab is a long term recovery process. Don't lose confidence, try a little bit harder every day, little becomes more, and quantitative changes cause qualitative changes.

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.

The main thing for patients with cerebral infarction is to pay attention to the recurrence of cerebral infarction, mainly from the improvement of lifestyle, reasonable diet, appropriate exercise, smoking cessation and alcohol restriction, as well as the control of related risk factors, etc. The following precautions are common:

Dietary control: pay attention to low-salt, low-fat diet, it is recommended that the daily salt intake should be less than 6g, cholesterol daily intake should be less than 300mg. to eat more fruits and vegetables, you can eat lean meat, fish, milk, etc., and at the same time, to quit smoking and limit the consumption of alcohol.

(b) Appropriate increase in exercise: according to their physical strength, appropriate increase in physical activity.

Third, avoid colds: when the weather changes, pay attention to avoid catching a cold, cold.

Fourth, improve bad habits: daily life to avoid sedentary, especially when watching TV, Internet and so on, pay attention to control the time.

Fifth, disease intervention: active treatment and control can induce or aggravate cerebral infarction related diseases, such as hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, etc., to take the medication for cerebral infarction, not just stop, change, according to the doctor's instructions, and adjust the treatment program appropriately.

Sixth, emotional control: maintain a good emotional stability, try to avoid emotional excitement or bad mood.

VII. Regular medical check-ups: Regular medical check-ups are required every year to keep track of the overall condition of your body.

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