Can cerebral ischemia be prevented?

A transient ischemic attack or cerebral ischemia is a cerebral vascular event in which blood flow is reduced or stopped in a specific region of the brain for a period of time, generally short, leading to cellular stress that leads to temporary malfunction of neurons in the affected area.

Differences between cerebral ischemia and stroke

Unlike a cerebrovascular accident, the symptoms of a mini-stroke – as transient cerebral ischemia is also called – usually last from one to two hours, and its immediate effects never exceed 24 hours in duration.

Transient cerebral ischemia can be due to multiple causes, from genetic-hereditary origins, underlying causes of lifestyle, to those derived from previous injuries -permanent or transitory, as a consequence of suffering from any disease.

A transient ischemic attack It is different from a cerebrovascular accident because, after transient cerebral ischemia, the blockage in the blood flow dissolves and reverses quickly. not producing the death of neurons in the non-irrigated area. On the contrary, in a stroke -thrombotic or due to effusion- the blood flow is completely interrupted, generating neuronal death in the affected area, with prolonged, and sometimes profound and permanent sequelae. An important fact to take into account is that transient cerebral ischemia makes the person more prone to later having a stroke.

Next, we will review those causes that lead to transient cerebral ischemia and the medical recommendations to prevent it.

Causes of transient cerebral ischemia

Disruption of blood flow to the brain may be due to:

• Formation of a blood clot in a cerebral artery.
• Formation of a clot in another region of the body, frequently in the heart, which travels through the bloodstream, being retained in a cerebral blood vessel.
• Previous event of stroke.
• Injuries to arteries and blood vessels.
• Carotid obstruction disorders.
• Arteriosclerosis; especially in the area whose flow leads to the brain.
• Atrial fibrillation events.
• Heart failure or defects, and myocarditis.
• Peripheral arterial disease.

Preventing transient cerebral ischemia

The likelihood of transient cerebral ischemia can be dramatically reduced by following important lifestyle changes. Some of these conditions may be accompanied by drug treatments to control cardiovascular disorders and injuries, especially the hypertension and hypercholesterolemia.

Among the recommendations to follow, by way of prevention, are:

• Avoid obesity, maintaining body mass indexes at maximum values ​​of 25.
• Control of hypertension, since values ​​above 140/90 increase the chances of suffering a cerebral ischemic event five times.
• Control of hypercholesterolemia, making use of statins and other therapeutic resources, such as a balanced diet with adequate dietary fiber content.
• Frequent physical exercise, which protects and strengthens the cardiovascular system and its cerebral blood supply. It is recommended to develop daily physical activities for a minimum of 25 minutes, in a moderate way.
• Control and prevention of diabetes, which is achieved through the maintenance of adequate body weight and balanced consumption of carbohydrates, especially sugars and refined flours related to sweets, sweets and soft drinks.
• Smoking control. The habit of smoking greatly multiplies the risk of suffering from vascular and brain disorders.
• Moderate alcohol consumption. Like tobacco, alcohol in excess greatly multiplies the chances of damage to the cardiovascular system and proper irrigation and oxygenation of the brain.
• Control of the use of hormonal contraceptives, as there are combinations that make women more prone to forming blood clots, which can eventually travel to the brain and cause transitory cerebral ischemia. Its use should be medically supervised, especially in those over 30 years of age, smokers, and in those who are overweight or obese.
• Consume a cup of coffee, or four of green tea a day; even better if both are combined.

Symptoms of transient cerebral ischemia

The physical signs of a transient ischemic event begin and progress rapidly, last for short periods of time – between 1 and 2 hours – and their effects disappear in less than 24 hours, and can be repeated a short time later, on some occasions.

Transient cerebral ischemia can lead to a subsequent event of ischemic stroke, which is why it is necessary to attend to its evolution and go quickly to primary medical care.

Symptoms that indicate the development of transient cerebral ischemia are similar to those of cerebrovascular accident; among them are:

• Modification of the lucid state of mind, starting with a state of confusion, dizziness, and can lead to drowsiness or even fainting.
• Changes in sensory perception, such as loss of visual acuity, hearing restrictions, or lack of sensation in smell, taste and touch.
• Changes in mental acuity, such as momentary mental confusion, Difficulty expressing or understanding what others are saying, difficulty reading and writing, and temporary memory loss.
• Muscle alterations, in the coordination Y sense of balance, which lead to difficulty walking, standing up, swallowing, or even loss of toilet training, and also weakness or lack of strength to perform physical actions.
• Circulation failure and nervous response, which are reflected in numbness of the limbs or other parts of the body, and a tingling sensation on the skin. This includes, sometimes, the inability to stick out the tongue, or that the tongue and the mouth appear crooked, so that it is not possible to speak clearly, drink or smile.
• Sudden, severe headache, especially if it is very localized.

Risk factors to consider

• Family history of stroke.
• High blood homocysteine ​​levels.
• Hypertension.
• Hypercholesterolemia
• Diabetes.
• Overweight and obesity.
• Being a man, they are more prone to these events; and being a woman, since its effects are more harmful.
• Age over 55 years.
• Smoking
• Moderate alcohol consumption.
• Consumption of illicit drugs.
• Use of hormonal contraceptives.
• Ethnic origin; African Americans, Native Americans, Mexicans, Hawaiians, and some other Asian groups have a higher risk rate for transient cerebral ischemia.