Cerebral ischemia

The ischaemia is a disease or event that occurs in the blood vessels , when for some precise cause blood flow thus killing brain cells dependent on the supply is cut off. In this way, it has become one of the most studied and feared phenomena by the medical profession, because although its causes are determined, the consequences can be permanent or fatal.

Ischemia can affect any part of the body, cerebral ischemia only occurs in the blood vessels that reach the brain, which precisely become increasingly thin and prone to suffer from this type of blockage, that is why it is the most common ischemia of all.

What is cerebral ischemia?

It is also known as cerebrovascular accident and is specifically produced by the blockage, interruption or plug in the vessels of the brain that leads to permanent neuronal damage . The inability of the blood vessel to transport the necessary nutrients and oxygen produces an accelerated degeneration of the sensitive tissue, the cells die and with them some capacities of the organism.

The severity of ischemia will be determined by the type that occurs, as well as the length of time in which these neurons do not receive oxygen and irrigation. The symptoms are evident but there are no immediate palliative that can stop the consequences.

Symptoms of cerebral ischemia

The symptoms will always be associated with the place in the brain where the accident occurs. Each space or cluster of neurons and tissue has a particular function that will be affected by lack of blood supply or tissue death.

Despite this, the symptoms can be similar and easy to detect due to their similarity to Stroke (CVA) and bleeding.

The most common and obvious are:

• Loss of consciousness for long periods of time.
• Sudden loss of motor skills or numbness of the limbs.
• Difficulty articulating words, coordinating ideas, and expressing themselves clearly.
• Facial paralysis in one half of the face.
• Dizziness and momentary hallucinations.
• Inability to understand conversations, words and also to emit them.
• Hypotonia, muscular affection.

Depending on the blocked blood vessel, the severity of the consequences will be determined. Generally, everything that happens in the left hemisphere of the brain is reflected in the right side of the body and vice versa . Doctors will know how to determine which area was affected by an MRI.

Causes of cerebral ischemia

Ischemia itself is a blood clot, which somehow prevents the normal passage of blood through a major vessel or artery. This clot can occur elsewhere in the body and travel to the brain vessels that are narrower and more delicate.

The main reasons why the passage in the bloodstream is interrupted are accumulations of fat within the arteries due to high cholesterol or lipids . These blockages meet with clots and hinder the transmission of nutrients for a short period of time. If it is resolved naturally, it will be a focal ischemia, otherwise it will be a globalized one and therefore much more dangerous, even fatal.

Types of cerebral ischemia

This classification aims to identify the type of ischemia that a patient has suffered according to the place where it occurs and also the causes that may have caused it, without neglecting its severity, which becomes another factor for identification, diagnosis and analysis.

Focal ischemia

When the obstruction is in a specific blood vessel supplying only a specific area of ​​the brain, the symptoms and consequences are focused. It is still an important event but the damages can be attended to precisely; Within the types of severity, this is usually the least harmful of all.

Global ischemia

In contrast to focused ischemia, there is global ischemia that occurs when the interruption of blood flow occurs in a larger area or throughout the brain. When the obstruction is in a main artery the consequences are much more devastating, this associated with the time that the clot lasts in the blood can be the cause of permanent consequences and even brain death.

Thrombotic ischemia

If the cause of the blockage is specifically a blood clot that has coincided with an obstruction by cholesterol plaques, it is already in the presence of thrombotic ischemia. If there is no such clot and there is only an important total or partial blockage by the cholesterol plaques, it is also considered thrombotic ischemia.

Embolic ischemia

This happens outside the brain and is the consequence of some clot that has formed in another part of the body but which, as a result of the displacement of blood, empties into the cerebral vessels or arteries. This embolus is much larger than the arteries located in the soft organ and when arriving there it temporarily or permanently obstructs the passage of blood. You can determine the place where it arose and the displacement it had within the body.

Lacunar stroke

It is a minor event that happens in one of the arterial branches of the brain. The consequences of this phenomenon can be much less than those of a stroke or global ischemia, however depending on the area it can become more or less dangerous. This stroke affects the brain or a smaller portion of it.

Transient ischemic attack

In some cases, the bloodstream is capable of reversing the effects of a brain blockage or ischemia. It does not matter if it is an embolic or thrombotic ischemia, the blood with its force manages to displace or destroy the blockage, making the interruption very brief.

The consequences of this event are considerably less, the recovery is almost complete even though said patient already has risk factors to suffer another similar event again. It is also associated with the small, almost imperceptible strokes that a human being can suffer throughout his life before presenting a major or more dangerous event such as a stroke.

Risk factor’s

Risk factors are those situations or conditions that can worsen or produce the disease . In this case, that of cerebral ischemia, age plays an important role; eating habits and daily routine as well.

Ischemia is much more frequent in elderly people , so that the older people are, the greater the probability and risk of suffering this phenomenon. High blood pressure is another important factor as well as high cholesterol levels and some types of diabetes . Presenting or having suffered from a heart problem can turn an ischemia picture into a really critical pathology.

External factors also have a considerable influence, these can be vices such as smoking or excessive fat intake that ultimately translates into a higher cholesterol level and generalized arterial blockage.

What to do with a cerebral ischemia. Treatment

The first reaction of those who accompany a patient with cerebral ischemia is to go to a specialist or medical emergency so that they can materially solve the arterial blockage. If it is not a transient ischemia, an operation or the injection of drugs that are able to dissolve the blockage will be required.

The surgery to address ischemia focuses on the location of the obstruction by resonance and localized proceeds to extract and evaluate the state of the tissue that has been without irrigation oxygen and nutrients. Many times, the tissue dies completely and the motor or cognitive functions that depended on it do not recover.

With the flow restored, the general conditions of the patient are evaluated, especially their cognitive and motor capacity. All this after recovering from the intervention. Many patients require psychological help to face the consequences and loss of some faculties.

The occupational therapy can reestablish somehow missed if conditions are associated with memory, speech and communication. Compensation for lost skills also works when the brain area has been so affected that full recovery will ultimately not be achieved. In that case, neuropsychological rehabilitation is applied until a functional balance is achieved.

Complications

Ischemia is a localized event that happens and cannot be stopped, however with early medical attention it is possible to prevent the sequelae from being much more painful. The complications that this phenomenon can bring are associated with risk factors, since a patient who has presented a transient ischemia may suffer a stroke or global ischemia again over the years.

If a patient is not seen immediately, the disruption of blood can kill brain tissue , leading to death or total disability. Brain death is also one of the possible complications that derive from late medical attention or the severity of the ischemic attack.

Physiological consequences of suffering ischemia

An ischemia will always leave sequelae that, depending on the severity, can be resolved at a higher or lower speed. The signals can be divided into two large groups, motor consequences or cognitive consequences.

Motor consequences

Depending on the hemisphere of the brain that has been affected, the consequences can be partial paralysis of the body or extremities, mainly hands and feet. The arms and legs can be difficult at the muscular level, which will make it difficult to walk or hold objects.

The face can be affected by ischemia and sequelae remain, especially when eating or trying to drink liquids, since the strength of the facial muscles has been lost. In these cases, patients ingest liquids with the help of straws or spoons.

Cognitive consequences

They have to do with mental skills such as speaking, learning, and concentration. People who have suffered from severe ischemia may have trouble withholding information or eventually expressing their wishes. Specify ideas, construct sentences and learn new activities.

In this case, occupational therapies are applied that seek to reduce the effects of ischemia , however many of the consequences can be permanent. There may also be loss of memory, of interest in activities that were previously essential such as exercising, sexual activities, sharing with large groups of people, etc.

Can cerebral ischemia be prevented?

Nobody knows for sure when this phenomenon occurs, but if there are living conditions that can be adopted after having suffered a cardiovascular problem and thus reduce the risk of being a victim of such a pathology.

Reducing the consumption of saturated fats, quitting smoking, doing cardiovascular exercises where the blood supply works frequently, and maintaining a constant medical check-up can be of great help to combat a stroke.

By performing cholesterol tests every three or six months, the general conditions of the arteries can be evaluated to locate possible blockages that in the future become clots, heart attacks or global ischemias. There are already medical procedures that focus on destroying the accumulation of cholesterol in the arteries before they bring fatal consequences.

Losing weight should also be a priority for those who want to avoid cardiovascular problems, although an obese person may never have a heart condition, this is percentage less common. A person with the ideal weight and constant physical activity reduces the risk exponentially.

Resume

• Ischemia is a serious disease that occurs in one of the most important organs in the human body.
• It cannot be accurately prevented or predicted and can have definite, life-changing consequences for the patient.
• To prevent it from happening, you can change your eating habits and lifestyle and thus be less vulnerable to the disease.
• Early medical care can mean saving someone’s life when global or dangerous ischemia is developing.
• There are psychological treatments that can return some functions lost due to ischemia or balance the patient’s life so that he can continue with a normal life.