Our brain is the central system of our body which controls the whole human system. The loss of blood flow into the brain stem leads to brainstem infarction. An adequate amount of blood flow is essential for the normal functioning of each organ of our body. When an organ is deprived of blood by a blocked or damaged artery, the tissues may die, causing the organ to fail or suffer permanent damage.

There are two types of brain infarction, based on the location of destruction. The deficiency of blood occurs in the cerebral cortex due to damage of the carotid arteries. The lower part of the brain receives most of its blood from vertebral arteries, leading to a brain stem infarction when blood supply is choked off. Both types of infarction can lead to serious complications such as brain damage or even death. The blocked arteries are a significant factor for the stroke or brain infarction. That is why older population are at high risk zone for brain stroke as the artery function typically decreases with age.

The major types of brain infarction are as follows:-
• Ischemic stroke: The block usually caused by a blood clot that gets stuck in a narrow blood vessel stops the blood flow into the brain. This is the most common form of brain stroke.
• Hemorrhagic stroke: in this case, the blood vessel in the brain bursts due to the weak wall or clogging of blood clot. Blood then flows out of the vessel and damages brain tissue.

The signs and symptoms of the condition are as mentioned below:
• Dizziness, loss of balance, nausea, or vomiting.
• Slurred speech, or trouble in speaking or swallowing.
• Blurred vision.
• Numbness and weakness on any of the side of body or face.
• Drowsiness or unconsciousness.
• Sudden headache or hearing loss.
• Absence of flow void in the vessels leading to the infarcted area in the white matter.

The CT scan or MRI scan will help in the diagnosis of brain infarction. The anatomic image of the brain will show the bleeding or damage in the specific regions of brain.

There are several treatment methods available for the patient. The treatment methods basically depend on the mode of infarction.
• Drugs are introduced to improve your blood's ability to clot and stop the bleeding.
• Rehabilitation: Rehabilitation (rehab) is an important part of the treatment. The physical therapists help strengthen your arms, legs, and hands through some exercises to improve your balance and movement to decrease your risk of falling
• Ventilator is provided to maintain the balance of oxygen in the body
• Surgical operation of the brain to stop the bleeding and remove the leaked blood.

The condition is generally common with a man of at least 55 years old. The genetic inheritance also plays an important role in the occurrence of the disease. If the disease is common in the family history then this might be an alarming sign.

The several imaging techniques are performed for the diagnosis of the disease. MRI scanning is done after brief neurological examinations and tests of cognitive function like, MMSE (Mini Mental State Examination), CDR (Clinical Dementia Ratio). MRIs are read centrally for the presence of an infarct lesion which is more than 3 mm in diameter or smaller infarct like lesions.

MRI (Magnetic Resonance Imaging) evidence of brain infarction is common in older men and women without a clinical history of stroke. Their strong associations with impaired cognition and neurological deficits suggest that they are neither silent nor innocuous. At MRI detection of infarction usually occurs earlier than with both SE sequences and in particular with diffusion-weighted images. Angiography is also performed to detect the occluded vessel, extra- or intracranially or any collateral circulation.

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Geetanjali Murari
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