Stroke Infarct Definition, Reason, Symptoms, Treatment & Prevention
Understanding
A stroke is a medical condition when blood circulation in the brain is suddenly interrupted. Well, stroke is divided into infarct (ischemic) stroke and hemorrhagic stroke. In this paper, we will focus more on stroke infarcts.
A stroke infarct is a condition when a blood clot blocks or narrows the arteries that supply blood and oxygen to the brain.
As a result, the brain gets too little (or none at all) for the organ to be permanently damaged. Most cases of stroke are stroke infarcts.
Stroke-infarct sufferers can feel symptoms of paralysis, dizziness, or double vision.
These complaints will disappear when the blood clot is released again and the blocked part of the brain returns to get blood rich in oxygen and nutrients.
Stroke Infarct Symptoms
Stroke is a very dangerous disease and can cause death. If symptoms appear, the patient should be taken to the hospital immediately.
Symptoms of a stroke infarct usually include:
- Paralysis or numbness of the face, arms or legs
- Face drooping ( facial drop ) on one side
- Speak pelo or unclear
- Sudden weakness of one side of the body (hemiparesis)
- Difficult to walk
- Headache
- Fall for no reason
- Confused or unable to understand what other people are saying
- Visual impairment
- Severe headache for no apparent reason
Stroke Infarct Reason
The cause of stroke infarct is lack of blood flow to part of the brain (ischemia). This can occur due to two conditions, namely atherosclerosis and blood clots.
Atherosclerosis is the accumulation of fat or plaque in the blood vessels. Over time, plaque can cause a complete blockage of blood vessels. Blood flow to that part of the brain is stopped and causes a stroke infarct.
Blood clots can also move in blood vessels and cause blockages.
Blockages in these blood vessels are not only in the brain but also in other parts of the body.
For example, the carotid vessels in the neck. When there is a blockage – either by plaque or a blood clot – in the carotid artery, an ischemic stroke can also occur.
In addition, several recent studies have shown that COVID-19 infection can increase the risk of ischemic stroke. However, this still requires more research.
Risk Factors
The risk of stroke infarct is greater if you have the following conditions:
- High blood pressure or hypertension
- Diabetes mellitus
- Atherosclerosis or carotid artery disease
- Atrial fibrillation
- LDL cholesterol levels are high and HDL cholesterol is low
- Sedentary lifestyle
- Overweight or obesity
- An unhealthy diet such as eating foods high in fat, cholesterol, salt and sugar
- Smoking
- Age over 55 years
- History of having a transient ischemic attack (TIA) or mild stroke
- African-Americans and Hispanics have a higher risk of stroke than people of other races or ethnicities
- Male sex has a higher risk of stroke than women
- Use of birth control pills or hormone therapy that includes estrogen increases the risk
A mild stroke has similar symptoms to a stroke infarct but only lasts for less than five minutes.
A mild stroke does not cause permanent damage. However, nearly a third of people who have a mild stroke will have a more severe stroke within one year.
Diagnosis
Usually, doctors can suspect a stroke based on symptoms and physical examination.
Blood tests are done to find out possible causes of stroke, such as:
1. Physical examination
The doctor will usually do a number of tests, such as listening to the heartbeat and checking blood pressure.
The patient will also undergo a neurological or neurological examination to see how the potential for stroke affects the nervous system.
2. Blood test
The patient may have several blood tests, including tests to check for blood clotting, blood sugar, and the presence of infection.
3. CT (Computerized Tomography) Scan
The CT scan procedure uses X-rays to get detailed pictures of the brain.
A CT scan can show if there is bleeding in the brain, tumors, ischemic stroke, or other conditions.
4. Magnetic Resonance Imaging atau MRI
This method uses strong radio waves and a magnetic field to get detailed brain images.
With an MRI, doctors can detect brain tissue damaged by ischemic strokes and also brain bleeding.
5. Carotid ultrasound
In this test, sound waves provide detailed images of the inside of the carotid arteries. Carotid ultrasound can show the presence of fat deposits as well as blood flow in the carotid arteries.
6. Angiogram cerebral
In this rarely used test, the doctor inserts a thin, flexible tube (catheter) through a small incision, usually in the groin area.
The catheter is guided through the main artery, then into the carotid or vertebral artery. Then the doctor injects a dye into the vein to make it visible under X-ray imaging.
The procedure provides detailed images of the arteries in the brain and neck.
7. Echocardiogram
This examination uses sound waves to produce detailed pictures of the heart.
This method can help find the source of the clot in the heart, which may have moved to the brain to cause a stroke.
Stroke Infarct Treatment
Stroke treatment must be done immediately. A blockage that lasts only a few minutes can cause brain cell damage and death.
In addition, emergency care for stroke also depends on the type, whether it is an ischemic stroke or a stroke that involves bleeding into the brain (hemorrhagic).
For ischemic stroke, doctors must quickly restore blood flow to the brain. Some ways to treat stroke infarct that can be done are:
1. Emergency Intravenous (IV) Drugs
Administration of drugs that can help break up clots must be given within 4.5 hours of the first symptoms appearing if given intravenously.
The sooner the drug is given, the better the prognosis of therapy will be. Prompt treatment not only increases the patient’s chances of survival but also reduces complications.
Injection of Tissue Plasminogen Activator (TPA), also called alteplase ( activase ) or tenecteplase (TNKase), is the gold standard of treatment for ischemic stroke.
TPA injection is usually given into a vein in the arm within the first 3 hours. Occasionally, TPA may be injected up to 4.5 hours after stroke symptoms begin.
This drug works to restore blood flow by dissolving blood clots that cause strokes.
By eliminating the cause of the stroke quickly, the patient can recover more completely from the stroke. Doctors also consider certain risks, including the potential for bleeding in the brain, when determining whether TPA is suitable for a patient.
2. Emergency Endovascular Procedures
Endovascular therapy has been shown to significantly improve outcomes and reduce long-term disability after ischemic stroke. The endovascular method should be performed as soon as possible.
In this procedure, doctors treat ischemic stroke directly to the blocked blood vessel. Here are the steps.
- Drugs are delivered directly to the brain. The doctor threads a long thin tube through an artery in the groin area and guides it to the brain to send TPA directly to where the stroke occurred
- Removing a clot with a stent retriever. Doctors can use a device attached to a catheter to directly remove a blood clot from a blocked blood vessel in the brain
- This procedure is especially beneficial for people with large clots that cannot completely dissolve with TPA. This procedure is often done in combination with injectable TPA
- Doctors can perform perfusion imaging tests (performed by CT or MRI) to help determine how likely it is that a person will benefit from endovascular therapy.
- Drugs. Clot-dissolving drugs must be given within 4 hours of the onset of stroke symptoms
- The drug is tissue plasminogen activator (tPA) and is administered through a vein in the arm. The sooner tPA is given, the better the prognosis
Prevention
Stroke is better prevented than treated. Everyone should take precautions against stroke, especially those who are at high risk.
Here are some ways you can do this.
- Live a healthy lifestyle by maintaining a healthy heart diet and exercising regularly
- Maintain ideal body weight or lose weight for those who are overweight and obese
- Undergo routine medical examinations especially blood pressure, cholesterol, and sugar
- Avoid smoking and secondhand smoke
- Overcome stress and get enough rest
- Consuming drugs for stroke-related diseases, such as high blood pressure, diabetes, and hyperlipidemia
- For those who are at high risk, daily medication may be needed, namely low-dose aspirin to prevent stroke. However, not everyone can take the aspirin drug. Therefore, it is important to consult a doctor first
Complications
A stroke infarct can cause temporary or even permanent disability. This depends on how long the brain has been deprived of blood flow and which part of the brain is affected.
Complications of a stroke infarct may include:
- Paralysis or loss of control over muscle movements. The patient may become paralyzed on one side of the body or lose control of certain muscles, for example the muscles on one side of the face or one arm
- Difficulty speaking or swallowing. Strokes can also affect control over the muscles in the mouth and throat. The patient becomes difficult to speak clearly, swallow and eat.
- Patients may have difficulty with language, including understanding speech, speaking, reading, and writing
- Trouble thinking and memory loss. Many stroke survivors experience some memory loss. They tend to have difficulty thinking, reasoning, making judgments, and understanding concepts
- Emotional problems. Stroke survivors may find it more difficult to control their emotions, or even become depressed
- Numbness, pain, or other uncomfortable sensations may occur in the body part affected by the stroke. For example, if a stroke causes loss of feeling in your left arm, you may experience an uncomfortable tingling sensation in that arm
- Changes in behavior. People who have had a stroke may be more socially withdrawn. In addition, they may also need assistance with self-care and daily activities
When to See a Doctor?
Seek immediate medical attention if you notice signs or symptoms of a stroke. Some of the signs below can be noticed, namely:
- Face (face). Facial paralysis on one side or drooping eyes
- Arms (arms). The arm experiences weakness, making it difficult to lift, tingling, or numb
- Speech (talk). Difficulty speaking or appearing slurred, and unusually sluggish under normal circumstances
- Time (time). If you or a close relative experience the three things above, seek emergency medical assistance immediately. Every minute counts, because the longer a stroke goes untreated, the greater the potential for brain damage and disability