Acute cerebral infarction is caused by various reasons leading to vascular wall lesions, narrowing, occlusion, or thrombus formation in the cerebral artery lumen, resulting in reduced or interrupted local blood flow to the brain, causing ischemia, hypoxia, and necrosis of brain tissue, resulting in corresponding neurological symptoms. The thrombus enters the cerebral artery with blood flow, causing acute occlusion of the cerebral artery lumen, resulting in ischemia, necrosis, and corresponding neurological symptoms and signs in the blood supply area of the brain tissue. Thrombosis can occur in any blood vessel in the brain, with the internal carotid artery and middle cerebral artery being more common, followed by the basilar artery and vertebral artery. Most of the patients with acute cerebral infarction are elderly, and there are many basic diseases, leading to a very high incidence rate and disability rate, which brings a heavy burden to the family.
1、 The etiology of acute cerebral infarction
(1) Cardiogenic: This is the most common cause, accounting for 60% to 75% of cerebral infarction, with atrial fibrillation being more common. According to statistics, more than half of cerebral infarction patients suffer from rheumatic mitral stenosis combined with atrial fibrillation. In addition, endocarditis, myocardial infarction, cardiac surgery, cardiac catheterization, atrial myxoma, mitral valve prolapse, etc. can also produce emboli leading to cerebral infarction, which is one of the important indications for heart disease.
（2） Non cardiogenic: It is caused by emboli outside the heart entering the brain with blood flow, leading to embolism and infarction. For example, cancer cell emboli, fat emboli, egg emboli, infectious pus emboli, and gas emboli.
（3） Cerebral atherosclerosis: the most common and basic cause of thrombosis in cerebral infarction. Hypertension is a risk factor of this disease, often coexists with cerebral atherosclerosis, and both affect each other. Diabetes, hyperlipidemia, coronary heart disease, smoking, obesity, less activity will also accelerate the process of cerebral atherosclerosis, which is also a risk factor of this disease.
（4） Cerebral arteritis: lupus erythematosus related arteritis, nodular periarteritis, etc. are also common causes.
2、 The clinical manifestations of cerebral infarction
(1) usually have no obvious cause of onset, and often occur suddenly during activities. The onset process is fast, developing to a peak within seconds to minutes. Most patients have clear consciousness, with a few cases experiencing recurrent episodes, coma, and intracranial hypertension.
（2） Nervous system: The manifestations of the nervous system vary depending on the type of artery that has been occluded or infarcted. The most common symptom is occlusion of the middle cerebral artery. Mainly affecting the blood supply to the internal capsule area, manifested as head and eye gaze towards the lesion side and "three deviations":
1. Hemiplegia: tongue paralysis, facial paralysis, and limb paralysis on the opposite side of the lesion.
2. Misalignment disorder: Abnormal sensation of the lesion on the side and limbs.
3. Skewness: Lesions with ipsilateral hemianopia.
4. Other manifestations: (1) dominant hemisphere involvement, resulting in aphasia. (2) Non dominant hemisphere involvement may result in body image impairment. (3) If specific parts are damaged, situations such as loss of reading, writing, and recognition may occur.
5. Symptoms of vertebral basilar artery occlusion: mainly affecting the function of the brainstem and cerebellum. (1) Symptoms of brainstem damage: dizziness, nausea, vomiting, cross sensory disorders, needle like changes in pupils, diplopia, ophthalmoplegia, articulation disorders, swallowing difficulties, etc. In severe cases, varying degrees of consciousness disorders and limb paralysis may also occur. (2) Symptoms of cerebellar damage: dizziness, nausea, vomiting, nystagmus, ataxia, etc.
（3） Special type of cerebral infarction:
1. Large area cerebral infarction: consciousness disorders may occur, even endangering life.
2. Hemorrhagic cerebral infarction: Blood vessels within the cerebral infarction are damaged, and blood leaks out.
3. Multiple cerebral infarction: Cerebral infarction caused by occlusion of two or more cerebral blood vessels in different blood supply systems.
（4） Most patients have primary manifestations of thrombosis, such as rheumatic heart disease, coronary heart disease, severe arrhythmia, cardiac surgery, metacarpal fractures, etc. Some cases have evidence of embolism in multiple locations outside the brain, such as the skin, conjunctiva, lungs, kidneys, spleen, mesentery, etc.
（5） Disease incidence: It often occurs in a quiet and sleeping state. Some patients have prodromal symptoms such as cerebral ischemia before onset, such as headache, dizziness, limb numbness, and weakness.
（6） Severity of illness: Most patients have clear consciousness and stable vital signs. Intracranial hypertension is relatively rare.
In summary, early treatment after the occurrence of acute cerebral infarction is very important, which can greatly improve the success rate of treatment and reduce the disability rate. Patients with primary diseases must pay attention to taking medication on time and have regular follow-up examinations.