Cerebral infarction (stroke)

A cerebral infarction, or ischemic stroke, occurs when a blood clot or narrowing cuts off blood flow to part of the brain, and neurons begin to die within minutes. In Mexico City, whether treatment can help depends on when the person was last well and whether the blocked vessel is large. This page does not provide care for an acute event: if a sudden deficit occurs, call 911 or go to the emergency department.

In Mexico, a simple reminder is used: face drooping, a weak hand, speech trouble, and act fast. Sudden vision loss, imbalance that makes it impossible to walk, and an unusual headache also matter, especially when they occur with other signs. Note the time the person was last well. “It went away in the car” does not make the warning go away: a transient episode can signal a larger stroke and should also be evaluated in the emergency department.

Intravenous thrombolysis aims to dissolve the clot. In usual practice, it is considered within the first few hours after the person was last seen well—often up to four and a half hours—and only if there is no bleeding or other contraindication. Mechanical thrombectomy removes the clot with a catheter when a large blood vessel is blocked and imaging shows tissue that may still be saved. At centers with a protocol, some selected patients may be evaluated beyond that initial window, sometimes up to a day later; this is never a rule for everyone. A brain hemorrhage is not treated with these drugs: that is why a CT scan comes first.

At the hospital, blood glucose, blood pressure, and blood clotting are checked. The airway is protected if the patient is drowsy, and doctors look for the cause: atrial fibrillation, a narrowed carotid artery, a dissection, or a clot of uncertain origin. Opening the vessel in time may reduce disability. It does not guarantee a return to “the way things were before.” The size of the infarct, the area affected, and preexisting conditions matter more than enthusiasm for the transfer.

Follow-up aims to prevent another event: heart rhythm, blood pressure, cholesterol, glucose, tobacco use, and the antithrombotic medication appropriate for the cause. Rehabilitation for walking, hand function, and speech begins when the medical team considers it safe. A neurosurgeon becomes involved if there is swelling that causes compression, a space-occupying hemorrhagic transformation, or an underlying vascular lesion—aneurysm, dissection, or malformation—that should be treated separately from the clot. Most strokes are not treated with surgery.

Should I give them aspirin at home? No, not if the symptoms have just started. It could be bleeding, and whether to use an antiplatelet medication is decided after the CT scan.

If we arrive late, is there nothing left to do? After the reperfusion window has passed, there is still work to do: address the cause, prevent another event, manage swelling, and provide rehabilitation. What is lost is that specific opportunity to open the vessel, not all care.

Is a stroke in a young person different? It can be: dissection, a patent foramen ovale, drugs, or vasculitis may be considered in the diagnosis. It still needs to be addressed first in the emergency department, not through a message.

If the stroke has already been treated and you want to review the vascular cause or an angiography finding, message +52 55 2193 8191. If someone is losing their speech or strength now, call 911 or go to the emergency room. This page is not the 911.