How does cerebral artery stenosis occur? The relationship between cerebral blood vessels, cerebral blood flow and brain tissue is the same as that between the dry channels of rivers, water flow and crops in the field. The pollutants in the water flow will slowly stagnate in the channels causing narrowing of the rivers and eventually slowing down the water flow. Hypertension, hyperglycemia and hyperlipidemia play an important role in plaque formation, and other factors such as high uric acid, homocysteine and smoking all play a role in promoting it. In fact, there are many causes of cerebral vascular stenosis, and it is age-related. People with atherosclerotic stenosis are often middle-aged and elderly people aged 40 to 80 years old, or even older. Fat and cholesterol metabolism malfunction, hypertension, diabetes, obesity, smoking and gender age can all be factors leading to cerebral atherosclerosis. The following conditions in the river are prone to blockage, when there are more solid impurities in the water itself, when the water flow slows down, and at bends or forks; by the same token, when the blood is viscous, the blood flow will naturally slow down, and plaque and stenosis will easily form in branch vessels and bends. How did I get a brain infarction? The first reaction of the patient after the disease is denial, why me? This disease is actually related to our health attitudes and lifestyles. Most of the cerebral infarction has the basis of atherosclerotic stenosis, and some patients have a previous history of TlA attack, which refers to transient ischemic attack, transient blurred eyes, numbness and weakness of limbs, and aphasia, which are all alarm bells ringing to remind me that ignoring them will evolve into serious consequences. If you pay attention to the warning bell, make adjustments to your lifestyle and risk factors, the possibility of such adverse consequences will be much smaller. These symptoms are similar to plaque detachment blocking a branch vessel, which is similar to a section of a river where the water flow is completely blocked by silt and dead branches; another possibility is related to low perfusion after stenosis, which is similar to a river stenosis where crops die of drought due to lack of water supply. Cerebral infarction certainly has certain causative factors. Most cerebral infarction patients develop the disease due to the following reasons: interruption of medication, excessive pressure reduction, overwork or poor rest, irregular life, alcoholism, anger or depression, victimization, high-fat, high-calorie diet, severe vomiting and dehydration caused by diarrhea. Paying attention to the above issues in life can avoid most of the occurrence of cerebral infarction. How to deal with after brain infarction? Then after the occurrence of brain infarction should go to the hospital as soon as possible, how should we deal with it? Then first of all, we should go to do the relevant blood vessel examination and go to the hospital, when indeed time is brain and time is health. Because after the occurrence of cerebral infarction, it is like the crops in the ground do not get normal water supply, and drought death or yield reduction will occur after a long time, and timely water supply can effectively alleviate these above problems. This is similar to the cleaning of a river. The treatment process at the hospital is to perform the appropriate imaging and vascular examinations, and if possible to perform intravenous thrombolysis or arterial thrombolysis, and if necessary, stenting. What does surgery for carotid artery stenosis address? If the examination reveals a large vessel lesion in the neck with significant stenosis and unstable plaque, surgical intervention should be considered. The surgical options are internal carotid artery endarterectomy and internal carotid artery stenting. The aim is both to make the stenotic vessels spacious and to remove the unstable plaque elements under the condition of ensuring an adequate blood supply. The former is an open procedure in which the vessel is cut directly and the subintimal plaque is removed; the latter is a minimally invasive endovascular treatment in which a stent is placed in the stenosis and the plaque is squeezed to the edge while the vessel is dilated. Surgery is a preventive procedure and both carry certain risks, sometimes catastrophic or irreversible. Because there is a natural risk of cerebral infarction in future life, which may be irreversible when it occurs, surgery is the treatment of choice if the risk of surgery is considered to be lower than the natural risk of disease, and non-surgical treatment is the treatment of choice if the natural risk of disease is considered to be lower than the risk of surgery. This is similar to the clearing of a severe river blockage, where the most severely blocked areas of siltation have to be completely cleared to restore the river’s flow again. What are the risks of internal carotid artery stenting? The risks of stenting include: 1. hemorrhagic complications, mostly caused by excessive intracranial perfusion after CAS, which is like when we refill a crop field that has been deprived of water for a long time, the crop cannot accept so much water at once, too much water causes flooding, and after the drought is a flood; 2. ischemic complications, low perfusion caused by thrombosis in the stent and embolism caused by intraoperative plaque dislodgement events. This is like when we clean the river, some residues in the river are not completely salvaged but washed downstream by the river, sometimes they block some small tributaries; 3. Arterial entrapment, arterial spasm, can also cause cerebral ischemia, that is, difficulties in cleaning the river and damage the riverbed as well.