Cerebral Emboli: A Cause of Dementia?

A wandering clot (an embolus) or some other particle that forms away from the brain, usually in the heart, may also cause an ischemic stroke. This is called cerebral embolism. The clot is carried by the bloodstream until it lodges in an artery leading to or in the brain, blocking the flow of blood.

The most common cause of these emboli is blood clots that form during atrial fibrillation (AF). AF is a disorder found in about 2.2 million Americans. It's responsible for 15–20 percent of all strokes. In AF, the heart's two small upper chambers (the atria) quiver like a bowl of jello instead of beating strongly and effectively. Some blood isn't pumped completely out of them when the heart beats, so it pools and clots can form. When a blood clot enters the circulation and lodges in a narrowed artery of the brain, a stroke occurs. This is called a cardioembolic stroke, or a stroke that occurs because of a heart problem.

Causes

Causes of Cerebral Embolism :

•    Neoplasms (ie, breast, pelvic malignancy, stomach)
•    This is  a rare type of embolism that happens when a bubble of air trapped in the blood and causes a blockage.
•    Pregnancy and estrogen use
•    Surgery and/or procedures such as pancreas and lung surgeries
•    Orthopedic, abdominal, and genitourinary procedures
•    ombosis (cerebral thrombosis) is the formation of a clot within a blood vessel of the brain or neck and is usually caused by atherosclerotic plaque build-up.
•    This is when an embolism - usually a blood clot - gets trapped in an artery in the brain i t's one of the most common causes of a stroke.

Symptoms

Symptoms of Cerebral Embolism :

•    pain ;
•    Numbness.
•    Rapid heart beat;
•    Chest pain.
•    Vomiting or severe nausea
•    Tingling;
•    Dimness or loss of vision, particularly in only one eye
•    Coldness;
•    Seizure
•    Mottled or pale skin; and
•    Altered mental state
•    Swallowing abnormality

Treatment

Here is the list of the methods for treating Cerebral Embolism :

•    Treatment of the underlying cause of increased right atrial pressure is intended to reverse the right-to-left shunt, restoring the hemodynamic homeostasis
•    Surgical embolectomy with closure of a PFO or ASD appears to be the best treatment option for patients with an impending PDE, except in fixed pulmonary hypertension, where indefinite anticoagulation is an acceptable option.
•    When brain cells die during a stroke, they release toxic chemicals that can trigger a chain reaction that can injure or kill other nearby cells.
•    Contraindications include intracranial disease, recent surgery, or trauma. An approximate 1% risk of intracranial hemorrhage exists with the use of tPA.
•    If the embolism is caused by a blood clot and it's not causing emergency symptoms, it may be treated with drugs to dissolve the clot, as well as an anticoagulant ( blood thinning) drug to stop more clots forming.
•    Consultation with a pulmonologist and/or intensivist may be useful for patients with PDE and PE with hemodynamic compromise for positive-pressure ventilation and intensive care monitoring.

Article Tags: Blood Clot, Cerebral Embolism

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