Cerebral infarction can cause mental disorders

  One day at the end of last year, Mr. Yuan suddenly felt inflexible on one side of his hands and feet, and made a fist weak. Later, he was slurred in speech and went to the hospital for examination. The CT and MRI examinations of his head showed cerebral infarction, and his condition improved after treatment. But the good times didn’t last long. Recently, Mr. Yuan suffered from mental abnormalities, talking nonsense during the day and staying up at night. The children quickly took him to the hospital for treatment. After a series of examinations, the doctor diagnosed a mental disorder caused by cerebral infarction.
  Cerebral infarction, also known as ischemic stroke, refers to the ischemic necrosis or softening of the local brain tissue caused by the blood supply of the brain, ischemia, and hypoxia. In addition to cerebral infarction manifested as cataplexy, hemiplegia, speech disorder, mental retardation, some patients also have mental disorders. Clinical statistics show that the incidence of mental disorders secondary to cerebral infarction in the elderly is 32.6%; post-infarction depression accounts for 90.1%, and post-infarction mania accounts for 9.9%.
  Most patients with mental disorders caused by cerebral infarction are accompanied by coronary heart disease, diabetes, dyslipidemia, etc., have a history of hypertension, cerebrovascular accident, about half of the patients have a slow onset, and most of the disease courses show stepwise and fluctuating changes. The stroke worsens, and only a few patients can be relieved. The short course of the disease is about 2 months, and the elderly can reach more than 20 years.
  Mental changes caused by cerebral infarction have different manifestations at different stages of disease progression. Early manifestations include headache, dizziness, tinnitus, sleep disturbance, inattention, fatigue, and emotional fragility (shown as weakened emotional control, susceptibility, irritability, or unreasonable irritability, distress, regret, worry, etc.), It’s easy to make family members mistakenly think that “people are old and bad-tempered”, “retired and feel lost” and ignore them. As the disease progresses, patients may have memory and intellectual disabilities, especially the memory deficits of names and numbers. They can’t remember recent events, but still remember things decades ago; some patients will appear Aphasia (the name of an item was originally called, but now it can’t be called) or apraxia (not using things that have been used all the time, such as not using a key to open the door). In the late stage, it is manifested as forced crying and laughing (referring to sudden outbreaks without external inducements, unable to control the crying and laughing, the patient’s facial expressions are dull, peculiar, and lack of inner experience), emotional indifference, and dementia. After an acute ischemic attack or several transient ischemic attacks, confusion, behavioral disturbances, and delusions such as hypothesis, victimization, jealousy, exaggeration or theft may occur, and occasionally hallucinations. Personality changes can occur after the onset of a stroke or in the later stages of the disease. The patient becomes selfish, profligate, naive, lazy, hypersexual, and even violates morals and laws.
  In addition, the speed of physical function recovery after cerebral infarction is also closely related to the occurrence of mental disorders. At the beginning of cerebral infarction, due to the sudden loss of physical function, it is impossible to participate in normal social and family life, and needs to be taken care of by others, and is worried about whether the physical function can be restored. This kind of worry, expectation, and anxiety can easily cause anxiety and depression; In the late stage of infarction, due to the slow recovery of physical function, a pessimistic and disappointed psychology is produced, and then a feeling of hatred, worthlessness, helplessness and despair occurs. Therefore, necessary psychological treatment and care are of great benefit to patients.
  However, clinically, it is not easy to make a diagnosis of dysfunction in patients with cerebral infarction. Due to the loss of physical, family and social functions in patients with cerebral infarction, symptoms such as loss of appetite, decreased sexual function, sleep disorders, and weight loss are often confused with the clinical features of affective disorders, and some patients are in despair State, to cover up the inner conflict, thereby affecting the diagnosis. Therefore, the focus of careful observation and patient inquiry is the patient’s feelings of unpleasantness, hatred, crying, depression, self-grief, sense of worthlessness, sense of uselessness, helplessness and despair, restlessness, irritability, etc. Symptoms, because these symptoms are important for diagnosis. In recent years, the clinical application of various standardized scales has provided more objective indicators for checking and determining whether there is emotional disorder and its severity.
  Once patients with cerebral infarction are diagnosed with mental disorders, they must be treated symptomatically in internal medicine. Authors with acute ischemia can inject Danshen, Chuanxiong and other injections; those who meet the indications can be treated with surgery; to improve cognitive function, they can take NaoFuKang, NaoFuXin and ribonucleic acid; when mental symptoms are more obvious , Can be combined with a small amount of antipsychotic drugs such as thioridazine and other treatment.