Biomedical Engineering Reference
In-Depth Information
Key Facts about Brain Infarction
1. Brain infarction can be classii ed by the mechanism of ischemia:
hemodynamic, thromboembolic and the pathology of the vascular lesion:
atherosclerotic, lacunar, cardioembolic, or undetermined.
2. h e mechanism for stroke in atherothrombus is initially contributed to
perfusion failure distal to the site of severe stenosis or occlusion of the
large vessel.
3. Lacunar infarction and cerebral white matter lesions are caused by small-
vessel disease.
4. Although the pathophysiology of cerebral small-vessel disease is still
unclear, aging and hypertension are considered the main risk factors.
5. In elderly people, atrial i brillation and ischemic heart disease are the most
common causes of cardioembolic stroke.
6. Approved treatment for acute brain infarction is limited to intravenous
thrombolysis with recombinant tissue plasminogen activator within 3 hr
at er CT-based exclusion of intracerebral hemorrhage or to aspirin within
48 hr.
7. h e benei t of antiplatelet therapy for secondary stroke prevention in
patients with a previous ischemic stroke or TIA is well established.
However, there is no evidence that antiplatelet agents reduce the risk of
primary stroke in the general population.
Definitions of Key Terms
Carotid plaque:
Carotid plaques usually develop at the bifurcation of the common carotid
artery and echolucent plaques detected by ultrasound are associated with increased risk
for cerebrovascular events.
Cerebral large-vessel disease:
Ischemic stroke due to large-vessel disease may be caused by
atheroma on the extracranial and intracranial arterial stenosis.
Cerebral small-vessel disease:
Although the pathophysiology of cerebral SVD is still unclear,
aging and hypertension are considered the main risk factors, small vessel occlusion is
associated with thickening or hyaline deposition of small perforating arterioles.
Silent brain infarction:
Asymptomatic lesions detected in the basal ganglia, thalamus, brain
stem, or subcortical white matter on brain MRI, these lesions are commonly lacunar
infarctions.
White matter lesions:
Periventricular or subcortical ischemic lesions, which are
pathologically neuronal loss, ischemic demyelination, and gliosis.
