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Abstract: A 50-year-old female patient felt very anxious due to the refinement of cranial magnetic resonance examination suggesting lacunar cerebral infarction after the organization of physical examination in the unit, indicating symptoms such as panic, chest tightness, palpitations and dizziness, which the patient considered to be a very serious disease, and came to our outpatient clinic to complete relevant examinations, which did not reveal high-risk factors for cerebrovascular disease, and after giving medication, the patient’s condition was stable and her discomfort was relieved.
Basic information】Female, 50 years old
Disease Type】Lacunar cerebral infarction
Hospital】Shandong Provincial Third Hospital
Date of consultation】April 2022
Treatment plan】Oral medication (Ginkgo biloba + Tongtian oral liquid) + diet control
Treatment period】15 days of home treatment, followed by 1 month of outpatient follow-up
Treatment effect】Stable condition, relief of discomfort symptoms
I. Initial consultation
The patient, a 50-year-old female, was very anxious when she came to the outpatient clinic. She said that since the discovery of lacunar cerebral infarction during the unit checkup, she could not sleep all night and felt that her condition was very serious, and she had symptoms such as panic, chest tightness, palpitations and dizziness at the same time. No significant abnormality was seen on perfect neurological examination, but the patient’s cranial magnetic resonance examination results clearly diagnosed lacunar cerebral infarction. Further improvement of relevant tests is needed to screen for high-risk factors of cerebrovascular disease.
It is suggested that the patient should improve blood tests such as routine blood tests, liver and kidney functions, ion, lipids, blood glucose, cardiac enzymes and glycosylated hemoglobin. And improve the ambulatory electrocardiogram examination, cardiac ultrasound, carotid ultrasound.
II. Treatment history
The above tests were completed from the outpatient clinic, and the results showed no significant abnormalities except for high blood lipids. The patient indicated that he had no previous history of specific diseases, usually had poor sleep and was prone to anxiety. At present, the patient was considered to have lacunar cerebral infarction caused by chronic blood supply deficiency in the brain, but the infarct area was small and there were no clinical symptoms. Ginkgo biloba and Tongtian Oral Liquid were given as oral treatment to improve blood circulation in the brain, lower blood lipids and nourish brain cells. The patient was advised to pay attention to relaxation, avoid anxiety, ensure good sleep, and recommended to follow up in 15 days at the outpatient clinic.
III. Treatment effect
After 15 days of standardized medication, the patient indicated that the symptoms of panic, chest tightness, palpitations and dizziness were significantly improved, but the outpatient screening suggested that the blood lipids were high, so the patient was advised to actively control the blood lipids, reduce the intake of high-fat and high-cholesterol diet, and have a low-sugar diet to avoid the aggravation of cerebrovascular lesions, and continue to take the above drugs orally to improve cerebral blood vessels and nourish brain cells, which can help improve brain metabolism. 1 month later Follow-up visit, the patient’s lipids have been controlled to normal range. The patient was advised to review the cranial MRI once a year to assess the vascular condition in the brain.
IV. Precautions
The patient had lacunar cerebral infarction, but fortunately after treatment, the infarct was small in extent and did not cause serious consequences. It is recommended that the patient should develop good living habits, avoid staying up late and straining, eat a light diet, quit smoking and drinking, and have a low-salt and low-fat diet. If symptoms such as dizziness, numbness of limbs, weakness of limbs and slurred speech occur, they should actively go to the hospital, improve the cranial magnetic resonance examination and take standardized treatment methods for the symptoms in time.
V. Personal insight
The patient in this article is too anxious about the condition, in fact, lacunar cerebral infarction is not terrible, and with the growth of age, cerebrovascular atherosclerosis will gradually appear after the age of 50, mainly related to insufficient perfusion. It is recommended that we should develop the habit of regular medical checkups, and once the phenomenon of lacunar infarction occurs, we should actively pay attention to our own health and assess whether there are any high-risk factors that lead to the aggravation of cerebrovascular lesions. If high-risk factors leading to cerebrovascular lesions are found, they should be actively controlled. At the same time, good lifestyle habits, control of high-risk factors, and avoidance of atherosclerosis can effectively prevent lacunar cerebral infarction.