Medical Conditions | Uncategorized

Brain infarct

Circulatory disturbance in the brain (stroke) resulting in brain tissue death through oxygen deficiency, occurring particularly in later life. An important cause is narrowing of the blood vessels and possible clot formation as a result of atherosclerosis. Clots formed in the blood vessels of the neck, for example, can be released and enter the brain, where they can block a blood vessel. Certain heart conditions also produce clots there. Other possible causes are constriction by inflammation or convulsion of blood vessels, and blockage the of veins that carry blood away from the brain. There is increased danger of stroke in patients with diabetes mellitus and probably also in smokers. Sufferers have often had previous symptoms such as short-term failure of faculties lasting for minutes or hours – confusion for example, or speech difficulties. In such cases the circulatory problem was not enough to cause an infarction. Symptoms of a stroke depend on the part of the brain affected. Unilateral paralysis may occur, often with reduced feeling in the opposite half of the body. With infarction of the left-hand side of the brain aphasia and apraxia often occur. Urination, which is also controlled by the brain, can be difficult, or the patient may urinate involuntarily (incontinence). Infarction in the rearmost areas causes anopia or agnosia. In major strokes there is so much tissue death that consciousness is lowered and the patient can even die. Infarction in the cerebellum causes coordination problems. Diagnosis is from the pattern of symptoms; if blood vessels are constricted a sound can be heard in the neHc. A cerebral CAT scan can exclude haemorrhage or tumour. An X-ray with contrast medium of the blood vessels (angiogram) identifies the precise location. Treatment is with anticoagulants; if the cause is other than atherosclerosis, the underlying condition must be treated. The patient recovers most in the first six weeks, when excessive fluid has been removed from the area of the blockage, although he will continue to do so for at least two years. Rehabilitation by physiotherapy is an important aid to recovery. Patients who have had occasional symptoms may benefit from surgery to remove vessels affected by atherosclerosis and thus reduce the risk of infarction.

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