cerebral thrombosis

Medical terminology

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Cerebral thrombosis is called cerebral thrombosis, which is based on cerebral atherosclerosis and plaque. Under the condition of slow blood flow and low blood pressure, the visible components of blood attach to the intima of arteries to form thrombus. Clinically hemiplegia Is primary clinical manifestation 。 Most of them are born after 50 years old, and males are slightly more than females.

TCM disease name: cerebral thrombosis
Multiple population: After 50, there are slightly more males than females

Common location: Cerebrovascular
common symptom: hemiplegia

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pathogeny

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Cerebral thrombosis yes ischemia nature Cerebrovascular It is a kind of disease, mostly seen in middle-aged and elderly people, and is not obvious sex difference It is caused by the pathological changes of the cerebrovascular wall itself. The most common cause of cerebral thrombosis is arteriosclerosis Arteriosclerosis , lumen intima is rough, lumen narrows, and under certain conditions, such as decreased blood pressure, slow blood flow or blood Viscosity Increase platelet Aggregation Under the influence of strengthening and other factors, Coagulation factor Agglutinate into blocks in the lumen to form thrombus, block the blood vessel and interrupt the blood flow, thus causing Brain tissue Ischemia, hypoxia, softening and necrosis. Cerebral thrombosis can occur in any part of the cerebral vessels, but in clinical practice Internal carotid artery 、 Anterior cerebral artery and Middle cerebral artery Thrombosis is more common in the branches of.

clinical manifestation

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Before onset, the patient had numbness in limbs, poor movement, unclear speech vertigo 、 Blurred vision etc. sign 。 It often occurs in sleep or in the morning, and the affected limb is weak or unable to move, and the speech is ambiguous or aphasia , choking when drinking water. Most patients lost consciousness or had mild disorder. facial nerve and Hypoglossal nerve paralysis ， Nystagmus ， Muscular tension And abdominal reflex weakened or enhanced, Pathological reflex Positive, abdominal wall and Testis raising reflex Weaken or disappear.

Mild cerebral thrombosis is manifested as inflexible movement of one side of the limb Insensitivity 、 aphasia , in serious cases, coma incontinence Even death. However, the symptoms of cerebral thrombosis are different due to different locations.

inspect

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one electroencephalogram

Asymmetrical on both sides, the focus is laterally Slow wave 、 amplitude Low and slow Alpha rhythm 。

two Cerebral angiography

It shows arterial stenosis, occlusion and abnormal blood vessels around the lesion.

3. Brain ultrasound

Median line visible 24 hours after disease Wave direction Contralateral displacement.

four CT scanning

The vascular distribution area at the infarct site appears Absorption value Reduced low-density area.

five Hemorheology

Whole blood viscosity increase, platelet Aggregation enhance, Extracorporeal thrombus The length increases.

diagnosis

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The diagnosis can be made according to the etiology, clinical manifestations and relevant examinations.

treatment

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one acute stage

To improve as soon as possible cerebral ischemia Blood circulation of the zone Neurotonic functional recovery Is the principle.

(1) Relieve brain edema For severe patients with large infarction area, it can be used Dehydrating agent or diuretic 。

(2) Improve microcirculation Low molecular dextran can be used to reduce viscosity of blood And improve microcirculation.

(3) Dilute blood ① Isovolumic hemodilution therapy is performed by venous blood letting and replacement of the same amount of liquid. ② High volume hemodilution therapy intravenous injection Liquid without blood to achieve the purpose of volume expansion.

(4) Thrombolysis ① Streptokinase 。② urokinase 。

(5) Anticoagulation It is used to prevent the expansion of thrombus and the occurrence of new thrombus. ① heparin 。② Dicoumarin 。

(6) Vasodilation It is generally believed that the effect of vasodilators is uncertain Intracranial hypertension In the early stage, it is not recommended to use it because it can sometimes aggravate the condition of serious patients.

(7) Others Hyperbaric oxygen therapy can also be used for this disease, External counterpulsation therapy and Light quantum blood therapy Etc.

two convalescence

Continue to strengthen paralyzed limbs Functional exercise And speech Functional training , can be used together with drugs physiotherapy , physical therapy, etc. In addition, it can be taken for a long time platelet aggregation Agents, such as Pan Shengding or aspirin Help prevent recurrence.

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