1.What is stroke?
Stroke is a common disease that threatens human life and health. It is characterized by a sudden onset of symptoms of brain damage. Patients suffer from paralysis, sensory abnormalities, speech impairment, and even coma and death.
Stroke is divided into two categories, one is cerebral vascular rupture and bleeding, usually called cerebral hemorrhage, such as hypertensive cerebral hemorrhage, subarachnoid hemorrhage, etc.; the other category is vascular occlusion leading to cerebral ischemia and brain tissue necrosis, which is usually referred to as cerebral infarction. Currently, cerebral infarction is the most common type of stroke in China, accounting for more than 70%.
2. Stroke imposes a heavy burden on society and families.
Currently, stroke is the third most common cause of death in western industrialized countries after malignant tumors and cardiovascular disease. Since the late last century, the incidence and mortality rate of cerebrovascular disease in western countries have been decreasing year by year due to the gradual improvement of risk factor control. In contrast, due to the rapid economic development in China in the past 30 years, the lifestyle of the people has changed dramatically, and the risk factors of cardiovascular and cerebrovascular diseases are far from being better controlled, so the incidence and prevalence of cerebrovascular diseases have increased year by year and are now the first cause of death.
3.What are the risk factors of stroke?
Stroke, also often referred to as a cerebrovascular accident, is not actually an accident, but a sudden outbreak of multiple risk factors acting over a long period of time. These factors include high blood pressure, heart disease, diabetes, smoking, dyslipidemia, poor lifestyle, etc.
4.What is cerebral artery and extracerebral aortic stenosis? What are the clinical symptoms?
Long-term atherosclerosis can cause stenosis of cerebral arteries and large arteries outside the brain, and these artery stenoses are one of the main causes of cerebral infarction. Atherosclerotic lesions can not only narrow or occlude the arterial lumen, but also form emboli to block the arteries in the brain, causing a stroke.
Some common aura symptoms include: sudden onset of headache, double vision; recurrent episodes of limb immobility, weakness and slurred vomiting; recurrent episodes of dizziness, spinning of vision, blurred vision, unsteady walking, choking on water and hoarseness; recurrent episodes of transient monocular blackness in front of the eyes, etc. If these symptoms appear, it is recommended to go to the hospital in time to avoid missing the early diagnosis and treatment of the disease.
5.What are the diagnostic measures of cerebral artery stenosis?
(1)Neck vascular ultrasound and transcranial Doppler examination are simple and easy to perform, and can be used as a preliminary examination.
(2) Cephalometric imaging (CT or MR), which can provide the status of brain tissue lesions and can also be used to understand cerebral vessels, but its accuracy and specificity need to be further improved.
(3) Cerebral angiography, which is the most direct and accurate means to diagnose cerebral artery stenosis at home and abroad, is used to determine the presence or absence of cerebral artery stenosis, its location and degree, and also to understand the condition of cerebral blood flow collateral circulation. The test results are important for choosing the best treatment plan.
6.What is cerebral angiography? What is neurointerventional treatment and what are its advantages?
A thin catheter is inserted through the femoral artery at the root of the thigh. Under X-ray fluoroscopy, this catheter is sent into the branches of the blood vessels supplying the brain, and images are recorded after contrast is injected. Through these images the doctor can identify various lesions in the cerebral blood vessels and thus develop a targeted treatment plan. Cerebral angiography is currently the most accurate, most commonly used and most mature method of diagnosing cerebrovascular disease, and has been called the “gold standard”. In the same way as above, special advanced technology is used to treat the lesion, i.e. neurointerventional treatment. The biggest advantage is that it can really clarify and treat the lesion, and the effect is sure, safe, minimally traumatic, less painful for the patient, short operation time, and quick recovery after the operation.
7.How is cerebrovascular stenosis treated?
All patients with cerebral artery stenosis should be treated with comprehensive treatment to prevent stroke, which includes.
(1) Diet and lifestyle changes, limiting cholesterol intake, proper exercise, etc;
(2) Pharmacological treatment, including antiplatelet agents, lipid-lowering drugs and blood pressure control drugs;
(3) Surgical treatment: Interventional treatment for eliminating arterial stenosis and reducing emboli dislodgement. Medication and diet therapy are the basis, and the best plan should be made according to the vascular examination results and the systemic condition.
8.What cases of cerebral artery stenosis need stenting
For patients with severe cerebral artery stenosis with a stenosis rate of more than 70%, treatment with drugs is ineffective; treatment with surgery is highly invasive and has a high complication rate. A metal stent can be used to insert a catheter through the femoral artery straight into the neck or skull to prop up the narrowed vessel lumen for the purpose of improving cerebral blood supply and preventing strokes. This inspiring and miraculous technique is the latest technology for stroke prevention – cerebrovascular intervention, which has been hailed by the international medical community as “a major step forward in the prevention and treatment of stroke”. Stenting of the cerebral arteries is a minimally invasive treatment, and this group of patients with severe cerebral artery stenosis can benefit significantly from stenting.