Control of hypertension prevention of cerebral infarction

Keywords: prevention of cerebral infarction

        Usual to patients with hypertension, headaches, dizziness, insomnia, emotional instability, anxiety, memory loss, numbness of the limbs, transient aphasia, mistaken for high blood pressure or cervical spondylosis performance. As medical medical science and technology development, high-resolution CT and magnetic resonance imaging in clinical use, found that hypertensive patients appear above the performance of approximately 16% to 32% of patients with lacunar infarcts.

    The clinical is now confirmed that high blood pressure is one of the most dangerous factors of lacunar infarction. Patients if not treated in time, the general will lead to damage of the heart, brain and blood vessels, and aggravate the development of atherosclerosis better its pathogenesis is that: to the middle-aged, due to changes in the machine (such as red blood cells deformability, platelet aggregation force enhancements, increased blood viscosity, dyslipidemia change), the blood is hypercoagulable state, the blood flow slowed down, resulting in a decrease in cerebral blood flow. In cerebral atherosclerosis based on lacunar infarction associated with hypertension, occurs.

    Lacunar infarction, 15 to 20 mm in diameter, fresh or the old deep brain infarction. Damaged blood vessels of the middle cerebral artery and the basilar artery deep perforating branches, often occur in the basal ganglia, thalamus, internal capsule, pons, basal ganglia and white matter, and other parts, often confused with symptoms of high blood pressure, CT and MRI can be used to confirm the diagnosis.

    Middle age, disease, the majority of long-term history of hypertension, it is called hypertension lacunar attack caused by hypertension tiny artery lesions, but also seen in patients with normal blood pressure. Clinical manifestations: 1. Pure sensory stroke; pure motor stroke; Masonic hemiparesis change tonality; dysarthria – clumsy hand syndrome; 5. Lacunar state.

    Diagnosis: clinical diagnosis of lacunar infarction according to the following points: 1. Before the onset (usually before the onset within 48h) is almost always transient ischemic attack, and some even attack several times. After the onset of clinical neurological signs isolated nature. The illness often progressive, formed in a few hours or a few days. Almost all cases the headache and disturbance of consciousness, all patients with neurological symptoms and signs, almost all can be fully restored. Small artery lesions infringement, cerebral angiography without exception; CSF examination the isotope scan X-ray and computer off scan showed no abnormality. 6. Lacunar infarction diagnosed pathological examination can find cavities.

    Lacunar infarction patients, the short-term treatment is entirely possible rehabilitation. First, should actively prevent and control high blood pressure, people over the age of 40 should be regularly measured blood pressure, for early detection and early treatment. Found that high blood pressure should be checked regularly to the heart, blood vessels, retinal and lipids, and dynamically observe the changes of hemorheology. Daily life avoid emotional fatigue, to satiation Baoyin and constipation. In addition, it should be a quiet rest, and selection of rutin, vitamin C, nicotinic acid, dipyridamole, enteric-coated aspirin, venoruton, nimodipine, Brain Essentials piperazine, piracetam, West Billings and other drugs. The choice of Chinese medicine Salvia, Chuanxiong.

Cerebral infarction prognosis to be anti recurrence

Keywords: cerebral infarction needs anti-relapse

        Patients Sex: Male patient’s age: 65

        ● Detailed conditions and consultation purposes: a good doctor, my father left in 2000 after cerebral infarction sequelae of hemiplegia, also uncovers gallstones. I would like to inquire about the need to take drugs to prevent stroke recurrence, long-term medication will have side effects. Previously been eating Naoxintong step. “Thank you, doctor

        ● The incidence and duration: 2000 stroke

        ● general: Other Fortunately, some constipation, get up in the morning there will be sputum; physical strength is not good. About blood pressure 70,110

        ● history: 1995, 2000 slight MI, stroke

        A: multifaceted comprehensive regulation.

        Focuses on the prevention of blood pressure fluctuations, and to pay more attention to some dietary factors that may cause atherosclerosis. Need to take aspirin and other preventive drugs, shall be subject to the checks after under the guidance of a doctor taking drugs. To pay attention to the problem of your father constipation, avoid excessive straining at stool and adverse consequences.

The elderly, hot days Note cerebral infarction

Keywords:

        Ten days of June to the sustained high temperatures, the cerebral infarction incidence and an upward trend. According to the neurological director of the Central Hospital Kyi less first professor said, there are more than 100 cases by hospital CT diagnosis of patients.

    Lesions of cerebral infarction is a cerebral vascular accident, due to summer sweat more, more body water loss, increased blood viscosity, the continued expansion of blood vessels, vasodilation and contraction regulate function deterioration, coupled with sleep and activities of the elderly reduced, especially for the elderly love smoking and drinking, the incidence of cerebral infarction chance is much higher.

    In general, cerebral infarction, mostly unexpected, but a small number of older people will slow onset. If you feel dizzy, headache, the hemisensory obstacles, barriers to physical activity and aphasia, should raise the alarm. Most of the elderly onset unclear consciousness or drowsiness, mental So, if the above symptoms should promptly go to the hospital of neurology treatment, CT scan of the head can be diagnosed.

    Hot days, the elderly should pay special attention to the prevention of cerebral infarction. First of all, it should be done daily monitoring of blood pressure, hypertensive patients should be timely and regular use of antihypertensive drugs. Second, pay attention to rest, The housework and entertainment reasonable arrangements to prevent fatigue, tension and mood swings, to ensure that the sleep time. To adequate drinking water. Fourth, the use of low-salt, low-fat diet to prevent overeating. Taking low-dose aspirin and other preventive drugs. Finally, the habit of smoking, drinking elderly should pay attention to control.

Limitations of cerebral infarction laboratory examination

Keyword: the limitations of cerebral infarction

        (A) CT in cerebral infarction onset within 4 to 6 hours, and some cases can be seen slightly ill-low-density lesions. But early CT examination to exclude cerebral hemorrhage, subdural hematoma, intracranial tumors, cerebral infarction-like disease. Most cases occur in the 24 hours after the border was clear low density lesions (Figure 24-3). About one week, there may be a strengthening of the infarct uneven. CT advantages for convenient, quick, applicable to critically ill patients, uncooperative patients. Can be found in the the infarct peripheral edema, brain mass effect and whether converted to hemorrhagic infarction. But less than 5mm infarction and posterior fossa infarct appeared difficult for CT. Cortical surface of the infarct is often not perceived by CT.

    (B) magnetic resonance imaging (MRI) MRI of the high magnetic field (1.5Tesla), in one hour of the onset may show cortical surface and infarction of the posterior fossa. Six hours after the onset of infarction can almost MRI showed performance for the T1-weighted low signal and T2-weighted high signal. The disadvantage of MRI is the high price of imaging a long time, does not apply to patients with critical illness, substandard authors and equipped metal dentures and ECG, pacemaker patients.

    (C) The non-invasive vascular screening duplex ultrasound (duplexsonography) can be used for assessment of extracranial carotid artery disease and the degree of stenosis. Transcranial Doppler (transcranial Doppler, TCD) can detect the base of the brain artery flow velocity, found the middle cerebral artery, the distal segment of the vertebral artery and the basilar artery stenosis or blocked, the assessment of collateral circulation. The TCD instrument of the recent development of bifocal probe, dual-channel or four-channel TCD instrument can be used for the detection cardiogenic of of asymptomatic emboli and vertebral measured emboli or arterial origin. Magnetic resonance angiography (MRI angiography) can be used to check for extracranial and intracranial the brain large artery lesions.

    (D) arteriography selective cerebral arteriography and several less angiography (DSA) applicable to ultrasound found severe stenosis of the internal carotid artery considered for carotid endarterectomy patients or clinical manifestations unusual suspect artery layered or arteritis those. This is an invasive examination, 2% to 12% of the subjects may be complicated the artery layered or embolic stroke.

    (E) blood tests should be routinely measured blood count, Classification, platelets, prothrombin time, partial thromboplastin time, blood glucose, electrolytes, creatinine. On the part of the patient based on the clinical situation, the selective determination of protein C, protein S, antithrombin III (AT III), fibrinogen, anticardiolipin antibodies, plasminogen activator inhibitor factor (PAI), syphilis serology test and so on. It should be measured after the acute phase of stroke onset to affect lipid levels.

    (VI) in cerebrospinal fluid in clinical suspicion of infectious diseases or by imaging and other tests can not determine the diagnosis before considering lumbar puncture.

    (Vii) Other ECG is essential. Also should be as routine chest X-ray to rule out tumor thrombus, can serve as a comparison of aspiration pneumonia occurred later.

Cerebral infarction laboratory tests

Keywords: cerebral infarction laboratory tests

        Laboratory tests

    (1) electrocardiogram, echocardiogram, chest X-ray radiography and monitoring blood pressure, the primary signs of disease, such as hypertension and different types of heart disease.

    (2) skull X-ray radiography and sometimes can be found in the internal carotid artery siphon calcification; the infarct broader incidence 2-3 future shift midline waves, for about two weeks.

    (3) Cerebral angiography can be found in the arterial occlusion or stenosis of the site, cerebral edema caused by vascular compression, displacement and collateral circulation.

    (4) The brain CT and MRI can show cerebral infarction location, size, and its surrounding brain edema and signs of the presence or absence of bleeding, is the most reliable non-invasive diagnostic tool.

The cerebral hemorrhage family emergency treatment

Keywords: cerebral hemorrhage

    Cerebral hemorrhage (cerebral haemorrhage) refers to bleeding in the brain parenchyma, due to the bleeding site can be divided into internal capsule, pons, cerebellum, and intraventricular hemorrhage. Often induced by exertion, mental stress and other factors, about half of the patients died of cerebral hernia within one week after the illness.

    [Cause]

    (1) hypertension, cerebral arteriosclerosis as the most common cause.

    (2) cerebral vascular malformations, brain aneurysm rupture.

    (3) intracranial tumor hemorrhage, such as the primary tumor (glioblastoma multiforme), or secondary tumors (human chorionic epithelioma).

    (4) cerebral paragonimiasis.

    Clinical manifestations

    (1) internal capsule bleeding (capsula interna haemorrhage)

    Acute onset, rapid emergence of severe headache, dizziness, vomiting, coma, the contralateral limb completely flaccid paralysis, often accompanied by bleeding lesions of head and eyes turned to the side, was “gaze lesions-like symptoms and three partial, ie hemiplegia hemisensory obstacles and hemianopia, called the internal capsule damage three partial syndrome, another disease side dilated pupils.

    (2) pontine hemorrhage

    Acute onset of consciousness quickly loss was a deep coma, vomiting, fever, lesions side muscle of peripheral paralysis, contralateral limb was central paralysis, head toward the lesion side, bilateral pathological reflex positive bilateral pupil is extremely narrow, was “needle-like".

    (3) cerebellar hemorrhage (cerebellum haemorrhage)

    Acute onset, the patient suddenly appeared occipital pain, often accompanied by dizziness, frequent vomiting and ataxia, and positive signs of meningeal irritation and soon went into a coma.

    (4) intraventricular hemorrhage (ventricular hemorrhage)

    Often restless, coma gradually deepened, uneven breathing, body temperature high and low, flexion both upper limbs, lower limbs straight, the trunk can be presented opisthotonus, sometimes limb twitching and miosis.

    [Diagnosis]

    (1) is more common in the elderly, the general incidence in the non-rest position.

    (2) disease often have high blood pressure, a history of cerebral arteriosclerosis.

    (3) before the onset of headache, limb tingling and other symptoms of a pioneer.

    (4) the incidence of acute internal capsule, pons, cerebellum or intraventricular hemorrhage various manifestations and signs.

    (5) fundus examination there are retina arteriosclerosis signs.

    (6) high blood pressure or normal.

    (7) often stiff neck and Kernig’s sign positive signs.

    (8) cerebrospinal fluid examination may have increased cerebrospinal fluid pressure, mostly bloody.

    (9) CT brain scan can show the image of the high-density lesion.

    (10) cerebral angiography to determine aneurysm or arteriovenous malformation lesions.

    Differential diagnosis

    (1) subarachnoid hemorrhage

    Rapid onset, more common in young people, often unconscious, stiff neck, and positive signs of Klinefelter can oculomotor nerve paralysis, cerebrospinal fluid pressure, was bloody, and cerebral angiography aneurysm, can help diagnosis.

    (2) cerebral embolism

    Rapid onset, more common in patients with rheumatic heart disease, sudden loss of consciousness, but recovered rapidly and cerebrospinal fluid examination was normal CT brain scan showed low density, the data can be identified.

    (3) cerebral thrombosis

    Slower onset, more common in the elderly, often atherosclerotic history, generally occurs at rest or during sleep, often unconscious barriers onset beginning, cerebrospinal fluid pressure is not high, transparent, CT brain scan showed low density, can help identification.

    (4) brain tumor

    Slow onset, often have headaches, vomiting and progressive increase symptoms, physical examination papilledema and focal neurological signs can help identify.

    (5) other causes of coma, such as drug intoxication, hypoglycemia, and Japanese encephalitis have their case characteristics to generally distinguish between coma and brain hemorrhage.

    [Family emergency treatment]

    (1) the patient supine, to keep quiet, to minimize moving to prevent re-bleeding.

    (2) agitation may be given a sedative drugs, such as intramuscular or feeding 10mg stability and other drugs.

    Placed in the head, neck, armpits, groin and popliteal, etc. (3) high fever, an ice pack or cold water wet compress physical cooling methods to reduce the cerebral metabolic rate and oxygen consumption, increased cerebral hypoxia tolerance reduce intracranial pressure.

    (4) high blood pressure, generally in no hurry to take the first high-pin low diastolic blood pressure higher than 13.3KPa (100mmHg), (the head end of the foot of the bed elevated 30 degrees) with blood pressure lowering drugs; diastolic blood pressure below 13.3KPa when , take Trendelenburg (foot end of the foot of the bed elevated 30 degrees).

    (5) to maintain airway patency, vomiting patient taken supine and fasting.

    (6) If there is a shock, heart failure and cardiac arrest, should that emergency treatment, taken to hospital for emergency treatment.

    (7) due to the critical condition, and a higher mortality after the onset should sent to hospital.

Cerebral thrombosis and cerebral hemorrhage

Keywords: cerebral thrombosis cerebral hemorrhage

    Cerebral thrombosis (ischemic stroke) and cerebral hemorrhage (hemorrhagic stroke) are cerebrovascular disease, there are many similarities in performance between the two, as mostly seen in people over the age of 50, as well as varying degrees of hemiplegia, paralysis side shallow nasolabial fold, drooping mouth, feeling paralyzed side bust diminish or disappear, may appear the discourse unclear or aphasia. However, there are many differences both in the treatment. Therefore, in the early onset of such can make a preliminary identification, is very useful for the treatment of the patient.

    Cerebral thrombosis is usually secondary to cerebral atherosclerosis, vascular thrombosis, blood flow is blocked, resulting in brain tissue ischemia, necrosis. Cerebral hemorrhage is usually on the basis of long-term hypertension and vascular lesions, caused due to a sudden increase in blood pressure and the incidence of cerebrovascular rupture.

    Cerebral thrombosis in the elderly threat, this is not only that it is a high incidence of symptoms and longer duration, recovery slow and good recurrence in people, and often to rest, at rest or sleep onset unwittingly. This brought some difficulties to the prevention and timely detection.

    However, as long as careful observation of the patient prior to the onset of the performance, it was able to seize some clues, summarized clinical data at home and abroad, the following seven categories of abnormal performance as the the cerebral thrombosis important signal.

        ① recent numbness or weakness, whose hand things suddenly landing;
        The ② sudden temporary blindness or blurred vision;
        ③ sudden aphasia, or spit Yu unclear or difficult to speak, but “knew" clear consciousness, and will soon return to normal, without leaving any traces;
        ④ often dizziness, sometimes suddenly collapsed to the ground, but can quickly wake up;
        ⑤ recent memory impairment, especially in recent memory was significantly impaired, and even completely forgotten;
        ⑥ unexplained mental deterioration, concentration, thinking feel effortless, reducing efficiency;
        ⑦ by check eyes to check out cerebral arteriosclerosis or high blood pressure, or lipids, blood viscosity, Rheoencephalogram insufficiency change is more likely to occur cerebral thrombosis.

    The emergence of these phenomena should not be negligent, should be carefully treated, but do not panic. Shall immediately request the physician diagnosis and treatment immediately rest stops working, keep quiet living environment, the prescribed medication cerebral thrombosis multi incidence in a quiet state, often symptoms when you woke up, the slow progress of the disease, of hemiplegia symptoms in a few hours to within a few days more and more obvious, the consciousness often keep clear. Brain hemorrhage due to emotional and mental strain, straining to defecate, hard lifting heavy objects, prompting a sudden jump in blood pressure and sudden onset, the patient felt a sudden headache accompanied by nausea, vomiting, and development conditions are often in a few minutes to tens of minutes to climax occur immediately hemiplegia and confusion or coma, coma patient breathing deep with snoring. Some patients with clinical manifestations in between, relying on clinical manifestations is difficult to identify needed to be done, the vertebral biopsy, if necessary, can be checked by computer X-ray tomography (CT). In addition, the occurrence of cerebral thrombosis, the patient needs to be applied to the cerebral vasodilators. Thrombolytic agent and anticoagulant therapy. Cerebral hemorrhage patients need to be quiet, to minimize moving, the best place for medical treatment to prevent bleeding heavier available hemostatic agents, discretionary use of antihypertensive drugs.

Limitations of cerebral infarction treatment

Keywords: cerebral infarction treatment

        Brain cells can tolerate ischemic damage limited time. Should be made public and medical personnel are aware of the urgency of cerebral infarction treatment organization efficient rescue system. The patient stroke signs via ambulance brigade immediately to community stroke to the nearest medical institution. Establishment of stroke units in order to continuously improve the quality of medical care.

    (A) to prevent and treat a variety of complications prevent complications is extremely important to reduce the mortality rate of stroke, to avoid ischemia brain cells to further damage and recovery and create favorable conditions for the defects of the brain function better.

    To maintain a good heart and lung function, to keep the airway open and not allow oxygen content decreased. Should be alert to the occurrence of arrhythmias, myocardial infarction, heart failure, preferably 24 to 48-hour ECG monitoring. Water, electrolyte and nutritional intake, record and out of fluid volume, and promptly correct hypovolemia, improve cardiac output. The glucose infusion avoid, because high blood sugar will aggravate cerebral infarction damage. Disturbance of consciousness or swallowing dysfunction not eat by mouth, to avoid aspiration pneumonia, nutritional supplements nasogastric tube. Paralysis can not afford the patient should adopt inflatable bedding, changing position regularly, pay attention to skin care and paralyzed limbs remain active, mandatory the hyperventilation or cough to prevent bed sores, joint contractures, atelectasis, deep vein thrombosis and pulmonary embolism occurred . Keep urine clear. To patients spiritual support and encouragement. Occur secondary to give full play to the normal part of the patient’s body and function part of the role is not completely lost.

    1. Blood pressure in the acute phase of stroke patient’s blood pressure is essential. Decided because of cerebral blood flow in cerebral perfusion pressure (the cerebral perfusionpressure CPP) CPP and mean arterial pressure (MAP) and intracranial pressure (ICP) the difference between the positive correlation. Must maintain in order to avoid the aggravation of cerebral ischemia, CPP between 6.67 ~ 20.0kPa (50 to 150mmHg). Stroke and other brain damage, cerebral vascular automatically adjust incapacity passive cerebral blood flow and increase or decrease with MAP. Therefore, should be very careful about the treatment of hypertension in patients with acute cerebral infarction. MAP increased sometimes cerebral hernia harbinger reduce intracranial pressure, blood pressure can be improved. However, the mean arterial blood pressure is too high can increase brain swelling and intracranial pressure. 20.3kPa (220mmHg) or diastolic blood pressure more than 16.0kPa (120mmHg) systolic blood pressure over 15 minutes every 3 consecutive case retest oral captopril (captopril) or nicardipine ( nicardipine) to slowly lower the blood pressure of about 15%. Intravenous labetalol (labetalol) 10mg, necessary to closely monitor the blood pressure cases injected once every 20 to 30 minutes.

    MAP or CPP than premorbid reduced by 1/3 or MAP <9.33kPa (70mmHg) or CPP <6.67kPa (50mmHg) while no hypovolemia should be given to the dopamine or other vasopressors rises slightly lower than the disease before the blood pressure levels. While research hypotension reasons.

    2. The majority of intracranial pressure and cerebral infarction cerebral edema, but usually does not become a problem, especially in elderly patients have different degrees of brain atrophy can adapt to the severe brain swelling. Young patients or brain, large areas of the cerebellar hemisphere infarction, the most the severity in the 2 to 5 days after the onset of brain swelling, increased intracranial pressure due to brain herniation and death. Intracranial pressure higher than 2.67kPa (20mmHg or 270mmH2O) or drowsiness, patients from sober to the side of the pupillary light reaction dull rapid intravenous infusion of mannitol, 20 to 100 g every 2-6 hours to increase the plasma penetration pressure to be higher than 300mosmol / L, the moisture from the brain to the intravascular reduce intracranial pressure by reducing brain volume. Record and out of the fluid volume, diuresis, dehydration treatment 10-14 days until the brain capacity of resistance (compliance) to return to normal. The treatment should be adjusted according to the clinical situation, intracranial pressure, plasma osmolality changes. Mannitol infusion in 10 to 20 since the beginning, you can reduce intracranial pressure, should be fast drops, but the speed is too fast can cause hemolytic reaction.

    Furosemide (furosemide) and acetazolamide (acetazolamide) can be used either individually or combined to reduce cerebral edema.

    Hyperventilation for the effective treatment of increased intracranial pressure. PaCO2 from 5.33kPa (40mmHg) dropped 3.33kPa (25mmHg) reduces cerebral blood flow of 25%. By reducing cerebral blood flow and cerebral blood volume in order to reduce the intracranial pressure. But some cranial hypertension patients may have relatively lower cerebral blood flow exists, hyperventilation caused by ischemic damage.

    3. Blood sugar low blood sugar or high blood sugar will aggravate ischemic brain damage, should be discovered and corrected in a timely manner. Glucose above 150mg/dl should be given insulin.

    4. The body temperature lower the body temperature can be reduced the experimental infarct volume, increased body temperature, increase the scope of damage. A considerable part of the stroke patients with a history of infection before the onset of stroke and then often complicated by lung infections. Therefore, close monitoring of body temperature, active control infection and fever, and hypothermia.

    (B) of the ischemic damage prevention mechanism based on the occurrence of cerebral ischemic damage some treatment, their efficacy, safety, and adapt to the object, dose, method of administration, have yet to be determined.

    1. Fibrinolytic fibrinolytic treatment of acute stroke four international multi-center study enrolled 328 to 622 patients in the phase of analysis, due to cerebral hemorrhage treatment group was significantly higher conversion rate (about 3-4 times) and suspended in 1995. MAST-1 study group found that severe neurologic deficits, and lacunar infarction were the risk factors for cerebral hemorrhage. The ASK Study Group stop accepted the onset three hours or longer patient. Moreover, there again thrombus after thrombolysis.

    2. The anticoagulant heparin prevents blood clots expansion inhibit vascular smooth muscle cell proliferation and platelet aggregation. VA can be used for the acute blockage to prevent the extension to the BA, also can be used for heart bolt cerebral infarction. Large cerebral infarction of the internal carotid artery system should not be used, is likely complicated by the infarct risk of bleeding, and there was no problem to prevent further thrombus extension. In order to avoid excessive anticoagulation, usually a rate of 800 per hour to 1200 units of heparin intravenous titration, prolong the activated partial thromboplastin time, PTT, 1 to 1.5 times. Change warfarin oral maintenance.

    The heart bolt cerebral infarction often bleeding, anticoagulation will increase the bleeding should be over 2 to 4 days after stroke warfarin therapy, the prothrombin time (PT) 1.2 to 1.5 times longer than the control.

    Exclude hemorrhage before treatment imaging studies, patients had no bleeding tendency during treatment follow-up imaging studies.

    The recent advent of low-molecular-weight heparin only daily subcutaneous injections of 1 or 2 times, does not increase the risk of bleeding and simplifies laboratory monitoring. A set of random, double-blind, controlled study, the treatment group within 48 hours after the onset of 6 months when the prognosis is better than the control group.

    3. The experimental study of the anti-platelet, platelet activation and peanut arachidonic acid metabolites may exacerbate ischemic damage. Low-dose aspirin inhibition of platelet production can promote platelet aggregation and vasoconstriction of thromboxane A2 (thromboxane A2). Ticlopidine (ticlopidine) inhibition of platelet and fibrin $ binding. The ongoing multi-center study of aspirin treatment of acute cerebral infarction.

    4. Hemodilution therapy the Greek can reduce blood viscosity to increase cerebral blood flow. Applicable to patients with high blood viscosity, caused due to hemodynamic factors of cerebral infarction, lacunar infarction. Large artery atherosclerotic artery infarction NA. Isovolumic dilution (intravenous dextran and phlebotomy phlebotomy) has proved to be 12 to 24 hours after the onset of the patient is not valid. Does not apply to patients with increased intracranial pressure, acute myocardial infarction, congestive heart failure, arrhythmias, severe hypertension and hematocrit hematocrit (Hct) is not high (<36%). If Hct is higher than 46%, confirmed that dehydration should complement the crystal. Hypovolemia should be to add volume. Individual very early patients, Hct increased rather than caused by dehydration nor contraindications careful intravenous dextran. The Swan-Ganz catheter is inserted to maintain pulmonary capillary wedge pressure 1.60kPa (12mmHg) to prevent pulmonary edema, congestive heart failure, dextran can still provoke allergic reactions, kidney failure.

    5. Nimodipine given nimodipine artery occlusion animal brain infarct volume is less than the control group. The oral drugs on the onset of 12 to 24 hours after the patient is invalid. Can onset early trial, 30mg, once every 6 hours. Or intravenous infusion, first 3 days later converted to oral. The need for timely detection and lower blood pressure and to the correction of.

    6. Pentoxifylline (pentoxifylline, PTX) can improve the ability of red blood cell deformability, reducing whole blood and plasma viscosity, inhibit the aggregation of red blood cells and platelets, increasing tissue oxygenation. Group treated within 12 hours after the onset of a randomized, double-blind, controlled study, intravenous infusion PTX72 hour during the progress of neurological symptoms was significantly better than the control group, 2-group difference that is not converted after oral administration.

    The brain defect function (c) the treatment of stroke treatment goal is to avoid individual or brain cell death and promote the recovery of the defects of the brain function. The former is the key of the acute phase, short therapeutic window. The latter should also be the acute phase, the therapeutic window may be quite long. The limb should begin as soon as possible passive activities, active sports and various functional activities, carry out targeted rehabilitation of movement, speech, cognitive impairment of brain function. Mobilize patient initiative, the enthusiasm of the family and society, adhere to long-term, and gradually increase the difficulty of the functional exercise. Acupuncture, massage, physical therapy, physical therapy, qigong, neuropsychological therapy, occupational medicine and speech therapy according to the disease and objective conditions. We had eight cases of cerebrovascular disease hemianopia have been more than six months (mean 40 months) patients the directional dynamic color light stimulation to six weeks, seven cases of visibility and significantly expanded significantly improved visual function. 99mTc-HMPAO brain SPECT rCBF examination findings the lesion side occipital lobe and midbrain radioactive defect, rCBF was significantly increased the visual progress after treatment, 7 cases. The clinical progress no change. There is a considerable time after stroke brain function defects, there is still the prospect of improvement.

    (D) preventive treatment during some very cerebral ischemic damage may contribute to the diagnosis and treatment measures (carotid surgery or intubation, etc.) before the short-range applications nimodipine equality cerebral protective agent through the dangerous phase, more and similar to the experimental cerebral ischemia, the effect should be better than ischemia after the start of the administration. Patients with cerebrovascular disease risk factors in climate unfavorable season could be considered a long time to take brain protection agents.

The correct prevention of cerebral infarction

Keywords: cerebral infarction correct prevention

        Blood pressure control at a reasonable level. Easy to make because the blood pressure is too high, the the brain microcirculation tumor and a small artery atherosclerosis bleeding; hypotension, cerebral insufficiency microcirculation stasis, easy to form the cerebral infarction.

        2, pay attention to the psychological health, many stroke onset, with emotional.

        3, weight loss, obesity is one of the recognized risk factors for stroke,

        4, scientific and reasonable diet, mainly to the low-fat, low-calorie, low-salt diet, and to have enough high-quality protein, vitamins, cellulose, and trace elements. Diet fed is not conducive to health. Moldy food, salted fish, cold food, do not meet the requirements of food hygiene, to fast.

        5, climate change and human health, the relationship is very close. When the sudden change in temperature, air pressure, temperature significantly, in the elderly, especially the frail and sick, mostly suited to illness, especially in the cold and the height of summer when the elderly adaptability, reduced immunity, morbidity and mortality are higher than usual, so be especially careful.

        6, timely treatment of diabetes, coronary heart disease, liver and kidney dysfunction and other diseases.

        7, moderate physical activity is good for health.

        8, emphasis on the precursor to stroke.

Hot water rub neck prevention of cerebral infarction

Keywords: hot water rub neck prevention of cerebral infarction

        Prevention of cerebral infarction in addition to adhere to a low fat, more vegetables, avoid animal offal, egg yolks, fish roe containing cholesterol diet, and adhere to the morning and evening, regular exercise, and insist on taking low-dose aspirin, also in the morning and evening bath on the occasion, 50 ℃ hot water scrub, massage neck around, reddening of the skin, the degree fever. Long-term adherence to hot water neck rub, make the the neck vascular smooth muscle relaxation, to improve the nutrition of the blood vessels, hardening of the blood vessels gradually soften and restore its elasticity