Are "cavitary infarction" and "cerebral infarction" the same thing? There are differences in the medications used for the two, so don't over-treat them

An elderly friend told Huazi that he had a head CT scan and found several lacunar cerebral infarction lesions. Is this a cerebral infarction? Will he suffer from hemiplegia in the future? Huazi asked him if he felt anything abnormal now. He said he didn't feel anything and his arms and legs were moving normally. Someone told him that he needed to take statins and aspirin. Should he take them?

Huazi told him that he didn't need to worry about hemiplegia now, but he needed to pay attention to prevention in the future, live a healthy lifestyle, and actively control chronic diseases. But as for preventive medicine, it depends on the degree of danger to decide what to use, and don't over-treat.

1. Is “lacunar infarction” the same as “cerebral infarction”? Regarding lacunar infarction (lacunar infarction), the mainstream medical opinion is that it is a type of cerebral infarction, but the lesion is very small and the affected area is not in the functional area, so most patients will not have any symptoms. If you do not undergo imaging examinations such as CT and MRI of the head, you may not discover it in your lifetime.

Another way of saying it is that "lacunar infarction" is a radiological description, which refers to the discovery of tiny "cavities" in the brain during imaging examinations, just like the holes left behind after brain cell death caused by cerebral infarction, so it is called lacunar infarction.

There are different opinions on the cause of lacunar infarction. The mainstream opinion is that under the influence of factors such as hypertension, diabetes, hyperlipidemia, and smoking, atherosclerosis occurs in the arteries in the brain, leading to vascular stenosis and occlusion, causing the death of brain nerve cells, which are then liquefied and absorbed, leaving behind cavities.

Another way of saying it is that as we age, blood vessels will undergo degenerative changes. The tiny blood vessels at the distal end will degenerate, the brain tissue will tend to atrophy, and the gap between the brain tissue and blood vessels will increase, which will show the characteristics of "cavity infarction" during imaging examinations.

2. The medications for "cavitary infarction" and "cerebral infarction" are different. After cerebral infarction is discovered, long-term medication is needed for prevention. The main drugs used are statins and antiplatelet drugs represented by aspirin. Statins can lower cholesterol, fight against atherosclerosis, delay the progression of hardened plaques, reinforce plaques, and prevent plaque rupture.

Aspirin can inhibit platelets, and when plaques rupture, it can prevent platelets from aggregating and forming blood clots to block blood vessels. These two drugs are core drugs for preventing cerebral infarction, and they need to be taken for a long time to play a better role.

However, drugs have certain adverse reactions. For example, statins can affect liver function, cause muscle damage, and cause new diabetes. Aspirin can increase the risk of bleeding, damage the gastrointestinal mucosa, and other adverse reactions. In other words, when taking medication, the benefits of drug efficacy coexist with the risks of adverse reactions, so a balance must be made. Only when the benefits far outweigh the risks can the drug be used.

For lacunar infarction, the risk is significantly lower than that of true cerebral infarction, so the medication cannot be generalized. The focus of medication is on the regulation of blood pressure, blood lipids, and blood sugar. If you smoke, you need to quit smoking. If the low-density lipoprotein cholesterol (LDL-C) level is too high, statins can be used to reduce it to 1.8~2.6mmol/L according to the size of the risk factors, while aspirin needs to be taken when there are clearer danger indications.

3. How to prevent and treat basic diseases:

Patients with hypertension should control their blood pressure below 140/90 mmHg, and it is best to control it at 130/80 mmHg.

Diabetic patients should control fasting blood sugar below 6.1mmol/L and blood sugar below 7.8mmol/L two hours after a meal.

People with hyperlipidemia should control their low-density lipoprotein cholesterol below 2.6mmol/L, and it would be best if it could be controlled at 1.8mmol/L.

Improve your healthy lifestyle:

Quit smoking, limit alcohol intake (no more than 25 grams of alcohol per day), eat a low-salt (6 grams per day) and low-fat (25 grams per day) diet, combine meat and vegetables, replace one-third of the staple food with whole grains and beans, eat more vegetables, maintain regular three meals a day, and avoid overeating. Insist on moderate exercise and ensure good sleep.

In summary, "cavitary infarction" and "cerebral infarction" may overlap with each other, but the degree of danger is very different. The two have different focuses in terms of medication. Medication should be used according to the dangerous situation. It cannot be used in the way of treating cerebral infarction. Otherwise, there may be overtreatment and unnecessary adverse drug reactions. Specific medication should be taken under the guidance of a doctor. If you have any questions about medication, please consult a doctor or pharmacist in time. I am pharmacist Huazi, welcome to follow me and share more health knowledge.