A sudden onslaught of symptoms. Nausea, weakness, shallow breathing, a fast heart rate, low blood pressure, and a headache so intense it can be debilitating. These are all signs of a serious condition known as cerebral embolism.
A cerebral embolism occurs when some blockage travels through the body's vasculature and lodges in the brain, cutting off oxygen flow. This can result in a variety of effects, from a short loss of oxygen to the brain to a full ischemic stroke.
This article examines cerebral emboli, their symptoms, and what to do if someone suspects they or someone else has one. It will also look at ways that may help reduce the risk of embolism and how to adapt after a stroke.
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What is Cerebral Embolism?
A cerebral embolism occurs when a blood clot, air bubble, fat droplet, or other substance travels to the brain, which blocks a cerebral artery, causing an infarct or stroke.
While it is easy to confuse this with thrombosis, they differ because thrombosis originates in the brain, whereas embolism travels to it.
- Cerebral thrombosis is a blood clot in the brain.
- Cerebral embolism is a clot that travels to the brain from somewhere else, often from the heart. It can be secondary to heart blockages or occur during heart surgery.
- Both can cause an ischemic stroke.
There are several types of emboli, including:
- Blood clots
- Air emboli are a type of embolism formed when air travels through the body, disrupting oxygen flow. This is most commonly due to trauma, illegal intravenous drug use, or a complication of pregnancy.
- Fat emboli result from small droplets of fat entering the bloodstream and blocking blood flow. This type of embolism can occur after orthopedic surgery, bone marrow transplants, and liposuction.
Causes of Cerebral Embolism
Cerebral embolisms may result from various underlying conditions and are a common cause of stroke. The causes of cerebral embolism can be broken down into two main categories.
Common Causes
Atrial fibrillation, also known as AFib, is a type of cardiac arrhythmia in which the upper chambers of the atria beat erratically and out of sync with the rest of the heart. These mismatched beats can cause embolisms to form.
Heart valve disorders that can cause an embolism include valvular stenosis, the narrowing of the valve, thus restricting blood flow, and regurgitation, or insufficiency, caused when a leaky valve allows blood to flow backward into the heart.
A valvular prolapse occurs when the valve flaps, bulges, or flops into the wrong chamber.
Rare Causes
- Paradoxical Embolism: An embolus travels from the lower venous system into the upper arterial system, causing a stroke.
- Infective Endocarditis: An infection that impacts the inner lining of the heart and its valves.
Symptoms of Cerebral Embolism
While a cerebral embolism can lead to a stroke, recognizing certain early symptoms may help prompt timely medical care.
They include:
- Severe headache
- Shortness of breath
- Hypoxemia, or low oxygen levels
- Tachypnea, fast but shallow breathing
- Weakness
- Petechiae, rash-like spots on the upper body
- Chest pain
- Tachycardia, or a heart rate over 100
- Fever
- Swelling in a limb
- Seizures
- Vertigo or dizziness
- Nausea and vomiting
- Hypotension, or low blood pressure, less than 90/60 mmHg
Symptoms of a cerebral embolism vary based on severity and may overlap with other conditions. Immediate medical attention is required if stroke-like symptoms occur.
Effects of Embolic (Ischemic) Stroke
A cerebral embolism frequently leads to an ischemic stroke. Because every brain is unique, the impact of a stroke can differ significantly from one person to another. Since the brain governs the body and mind, such an embolism can cause various effects.
There are also different effects based on where the stroke occurs and how much tissue is damaged. However, there are some similarities in stroke effects, and these include:
Physical Effects
- Hemiparesis, or the loss of muscle control on one side of the body
- Blurry vision, double vision, or loss of vision
- Difficulty speaking, slurred speech, or aphasia
- Difficulty swallowing or chewing
- Loss of balance or coordination
- Pain, numbness, or tingling in the affected area
- Extreme fatigue
Emotional Effects
- Depression
- Anxiety
- Mood swings
- Sudden personality changes
- Emotional outbursts
- Withdraw from friends and family
Cognitive Effects
- Memory loss
- Trouble thinking, reasoning, or making judgments
- Inattention or neglect, especially to the affected side of the body
- Trouble reading or writing
Treatment Options
Emergency treatments for cerebral embolism include removing the blockage and restoring oxygenation as rapidly as possible.
Treatments include thrombolytic therapy (tPA), which uses medications to dissolve and remove a blockage within a specific time frame of symptom onset, or a mechanical thrombectomy, a surgical procedure to remove a clot physically.
After the clot is cleared, blood pressure management stabilizes the patient and ensures no more emboli are sent to the brain. Long-term treatment may include anticoagulation medications to help reduce the risk of future clots.
Functional and Integrative Approaches
Some patients explore integrative approaches to support overall well-being. Functional medicine focuses on the patient and looks at ways to support overall health and identify potential contributing factors.
Functional medicine approaches include finding and addressing underlying health issues and ensuring a patient follows proper nutritional guidelines, including supplements, physical and occupational therapy, and mind-body techniques (e.g., meditation, yoga, and mindfulness).
Prevention and Risk Reduction
To lower a patient's risk for a cerebral embolism, healthcare professionals should investigate lifestyle interventions such as controlling high blood pressure (hypertension), controlling diabetes, quitting smoking, and reducing or eliminating alcohol.
Maintaining a balanced, heart-healthy diet is essential for overall well-being and may help reduce the risk of embolism. Diets such as the Dietary Approaches to Stop Hypertension (DASH) or the Mediterranean Diet emphasize soluble fiber and potassium while reducing fat, salt, and sugar intake.
Regular physical activity, entailing at least 150 minutes of cardiovascular exercise each week, weight-bearing exercise for bone and muscle health, and muscular training for stability and blood pressure control, is recommended.
Living with Cerebral Embolism
Cerebral embolism and possible stroke may require lifestyle adjustments and rehabilitation support.
Aside from standard therapy, patients and their families should investigate methods of coping with post-event depression and anxiety, as well as finding support groups to learn about adapting to post-embolism life.
There have been many advances in neurological care. Emerging research suggests that patient mobility and abilities can improve decades after the event using neurodevelopmental therapy and movement that can often be done at home.
Some studies exploring neurodevelopmental learning strategies suggest potential improvements in walking, self-care, balance, strength, and quality of life long after traditional treatments have ended.
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Key Takeaways
- A cerebral embolism is a serious, possibly deadly event in which a clot has traveled from somewhere else in the body to the brain, thus cutting off oxygen. If not treated rapidly, it will often lead to a stroke and possibly death.
- Signs of an embolism include shortness of breath, headache, weakness, chest pain, vertigo or dizziness, nausea, and vomiting.
- The long-term effects can be physical, emotional, and cognitive.
- Strategies to lower the risk of cerebral embolism include proper diet, regular exercise, and smoking cessation.
- Patients and their healthcare teams are encouraged to discuss cerebral embolisms and how to maintain a healthy lifestyle to limit their occurrence and effects.
- Patients may benefit from discussing their condition with their healthcare team and support networks.
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