Brain Infarction

A brain infarction, or cerebral infarction, involves brain tissue death caused by blockage of the arteries or limiting blood and oxygen supply to a part of the brain. The restricted blood and oxygen supply can cause an ischemic stroke and lead to necrotic tissue if the blood flow is not quickly restored. Narrowing of the arteries can be caused by a buildup of plaque (atheromatous stenosis), blood clot (thrombus), or other blockage (embolus). 

Any disruption to the blood and oxygen supply to the brain can cause damage in a short amount of time. The longer the disruption the more extensive the damage can be and the longer it takes to address the blockage the more likely the damage will be permanent, or even cause death. 

Brain Infarction and Effects on the Central Nervous System

The brain requires a regular supply of oxygen to operate. Oxygen is fed to the brain through the circulatory system. Any limit of oxygen through a blockage in the arteries can begin to cause damage to the brain. Without oxygen, the brain tissue around the blockage can begin to die, or become necrotic. 

Limited blood supply leading to infarction can be caused by a buildup of plaque in the arteries, blood clot, or other blockage. In a blood clot or other embolic infarct, the neurological deficits may appear immediately. A buildup of plaque in the arteries, or atheromatous stenosis, the blood supply is slowed and the effects can appear over time. This may be preceded by transient ischemic attacks (TIAs), which may be temporary and resolve on their own. 

Ischemia, or limited blood supply to the brain, can cause severe damage, referred to as an infarct. Over time, the infarcted tissue can cause swelling or a buildup of fluid in the brain, which can shift the brain and lead to a buildup of intracranial pressure (ICP). The shifting brain and pressure on the brain can compress neurons and arteries, leading to ischemia, brain damage, and eventually death. 

Immediate restoration of blood supply to the penumbra can restore function and slow down cerebral edema. However, even after infarction, the damage caused at the core of total ischemia may be permanent. The area around the core of infarction, or ischemic penumbra, may be able to be restored. There is only a short amount of time to restore perfusion to the ischemic area after a cerebral infarct, generally within about 3 hours. 

Causes of Brain Infarction

There are a number of possible causes and risk factors for ischemic infarction. Embolic or thrombotic infarction is caused by a clot of blood, fat deposits, or even an air bubble that blocks an artery. A blood clot or other blockage and can be caused by: 

• Recovery from injury or surgery
• Blood clotting medication
• Deep vein thrombosis (DVT)
• Heart problems
• COVID-19
• Obesity
• Smoking
• Prolonged sitting or bed rest
• High cholesterol
• Diabetes
• High blood pressure 
• Long-term heavy alcohol use

Signs and Symptoms of a Brain Infarction

The signs and symptoms of a brain infarction are the same kinds of symptoms associated with a stroke or other injury to the brain. In diagnosing brain infarction, tests may include computed tomography (CT) and MRI scans to look at damaged areas of the brain. Brain scans can also rule out other causes of cerebral edema, such as a tumor of subdural hematoma. Symptoms may be based on the area of the brain that may be damaged, can include: 

• Contralateral hemiparesis, which affects the opposite side of the body to the side of the brain where the damage occurs
• Weakness
• Loss of sensation 
• Abnormal pupil dilation
• Slurred speech
• Confusion
• Headache
• Trouble with balance
• Dizziness 
• Reduced reflexes
• Reduced light reaction and eye movement
• Drooping of half of the face

Medical Intervention and Treatment for Brain Infarction

Immediate intervention will give the patient the best chance for recovery. Treatment also depends on the type of blockage, whether a blood clot or arterial blockage. Emergency treatment may begin with IV medication, such as tissue plasminogen activator (tPA) or alteplase, to break up any blood clots and restore blood flow to the brain. 

Endovascular therapy may clear or open blocked blood vessels. This can be done through medication directly to where the blockage is occurring, or using a stent retriever to remove the blood clot.  

After the blood supply is restored in the short term, procedures to open up blocked arteries may reduce the risk of a future ischemic attack, including carotid endarterectomy or angioplasty and stents.

Depending on the extent of the brain tissue damage, the patient may have to go through recovery and rehabilitation. Physical, speech, and psychological rehabilitation may help a patient recover and learn to adapt to the damage caused by a stroke or brain infarction.

Do Medical Errors Cause a Brain Infarction?

Many patients take blood thinners to treat issues like DVT or other heart issues. When these patients go in for surgery, the doctor may take them off blood thinners, which could increase the risk of blood clots including clots that block the blood supply to the brain. Doctors need to be on the lookout for possible clotting. Failure to identify a potential ischemic attack or brain infarction may be a breach of a doctor’s duty of care. 

Even if a doctor does not cause a blood clot, failure to timely diagnose the early stages of ischemia, stroke, or brain infarction can increase the risk of permanent damage, or even death. If a doctor fails to properly document, monitor, or treat cerebral infarctions or edema, the doctor could be responsible for the patient suffering permanent brain damage or death. 

If a family member died because of failure to timely treat a stroke or brain infarction, the family members may be able to hold the negligent healthcare industry responsible through filing a medical malpractice wrongful death lawsuit. The lawsuit can also help the family recover damages to pay for medical expenses, burial costs, and restore the support lost through the death of a loved one. 

Brain Injury Attorneys

If a loved one suffered a brain infarction due to an accident or medical malpractice, talk to an experienced attorney about your options for recovery. Do not hesitate to contact Gilman & Bedigian today for a free consultation.