Patient: Description (onset time, main symptoms, hospital visited, etc.): cerebral cT report lacunar infarction, currently no symptoms, blood pressure (high pressure 160, low pressure 100) Now taking antihypertensive drugs nifedipine and enteric aspirin, alginate disodium for three days temporarily did not see the effect. How to treat in the future
Wei Lin, Department of Neurosurgery, Shandong Qianfo Mountain Hospital.
Lacunar cerebral infarction is named after the pathological diagnosis, which is a general term for fresh or old small deep cerebral infarcts with a diameter of 15-20 mm or less. The occlusion of these small arteries can cause multiple foci of cerebral softening of different sizes, eventually forming large and small lacunae. Depending on the infarcted vessels, they often show different neurological symptoms, the most common ones clinically are headache, dizziness, insomnia, amnesia, numbness of limbs, movement disorders, dysphonia – dumb hand syndrome, and in severe cases, dementia, hemiparesis, aphasia, etc.
Wei Lin, Department of Neurosurgery, Shandong Qianfo Mountain Hospital
This disease is a serious health hazard for middle-aged and elderly people. In the past, the diagnosis could not be confirmed clinically by purely relying on neurological examination as well as EEG, cerebral angiography and cerebrospinal fluid examination. In recent years, with the wide application of CT and MRI, the diagnosis rate of lacunar cerebral infarction has been greatly improved.
How does lacunar cerebral infarction occur? Currently, it is mostly thought to be due to hypertension and cerebral atherosclerosis. Long-term hypertension can cause small artery sclerosis and hyaline degeneration, thus producing vascular occlusion; coupled with changes in the body in middle and old age, such as increased blood viscosity, enhanced platelet aggregation, reduced red blood cell deformability, and increased lipids, which put blood in a hypercoagulable state, slow blood flow, and reduced cerebral blood flow, it is more likely to lead to small artery occlusion, and lacunar cerebral infarction occurs.
So, how to prevent lacunar cerebral infarction? First of all, we should actively prevent and treat hypertension. For middle-aged and elderly people over 40 years old, we should measure blood pressure regularly for early detection of hypertension and reasonable treatment. At the same time, regular blood rheological examination should be made to observe the dynamic changes of blood viscosity, and hyperlipidemia and hyperviscosity should be actively treated. Secondly, we should pay high attention to the anterior symptoms of cerebrovascular disease and effectively control transient cerebral ischemic attacks. Since this disease is not easily detected without special examination, once the middle-aged and elderly people have symptoms such as unexplained personality change or dizziness, memory loss, movement disorder and slurred speech, they should pay high attention to them and should not be ignored. Besides paying attention to reasonable diet, suitable exercise, good mind and sufficient regular rest, you should also ask your doctor for active and effective treatment.
If you have any questions, please feel free to contact me, I will be in clinic all day on Friday, and you can come to the hospital directly for face-to-face consultation when you have time.