Man Suffers Stroke at 45—Could Long-Term Smoking Be the Cause?
Smoking has long been linked to a variety of serious health conditions, including heart disease and lung cancer. However, many people are unaware of its significant impact on brain health. In this case, a 45-year-old man was diagnosed with cerebral infarction—an ischemic stroke—linked to a long history of tobacco use. Despite experiencing early warning signs, he delayed seeking medical attention, leading to a more severe condition. His successful treatment and recovery highlight the importance of early detection and lifestyle changes.
Case Overview
The patient, a 45-year-old male, was admitted to Beijing Tiantan Hospital in August 2021 with worsening symptoms of left limb weakness. He had a nearly 20-year smoking history but no prior diagnosis of hypertension or diabetes. Initial CT scans led to a diagnosis of cerebral infarction. After a series of specialized tests, the medical team recommended interventional surgery followed by a course of medication and outpatient follow-up for six months. His condition improved significantly after treatment and showed no signs of recurrence during follow-up.
Treatment Summary
- Hospital: Beijing Tiantan Hospital
- Date: August 2021
- Diagnosis: Cerebral Infarction
- Procedure: Percutaneous Super-Selective Cerebral Angiography and Balloon Angioplasty of the Right Middle Cerebral Artery
- Medications: Aspirin, Clopidogrel Bisulfate, Pantoprazole Sodium Enteric-Coated Tablets, and Pitavastatin Calcium Tablets
- Recovery Time: Two weeks of inpatient care followed by six months of outpatient monitoring
- Outcome: Full resolution of pre-treatment symptoms with no recurrence
Initial Consultation and Symptoms
The patient reported sudden, unexplained weakness in his left limb. Although he experienced difficulty lifting heavy objects and felt unstable while walking, he initially dismissed the symptoms as fatigue. Since there were no accompanying headaches, dizziness, speech impairment, or swallowing issues, he delayed medical care. Eventually, as symptoms worsened, he sought treatment at our hospital.
Upon detailed evaluation, it was discovered that although he had no history of hypertension or diabetes, he was a long-term smoker. A CT scan of the head revealed signs consistent with cerebral infarction. Further diagnostic testing was strongly recommended, and the patient agreed to hospitalization for a comprehensive assessment.
Diagnostic and Treatment Process
Detailed tests were conducted upon admission, including assessments of liver and kidney function, electrolyte levels, homocysteine levels, lipid profile, coagulation time, cardiac ultrasound, and Holter monitoring. The results showed plaque formation in the left carotid artery and severe stenosis in the right middle cerebral artery.
After confirming there were no contraindications, the patient underwent general anesthesia for percutaneous super-selective cerebral angiography and balloon angioplasty of the right middle cerebral artery. The procedure was successful. Postoperative care included dual antiplatelet therapy with aspirin and clopidogrel, along with pantoprazole and pitavastatin for symptom management. Significant improvement in limb strength was observed shortly after surgery, indicating a positive response to treatment.
Recovery and Follow-Up
By the end of the first day post-surgery, the patient's symptoms had already begun to improve. Over the next two weeks, his recovery progressed steadily. Upon discharge, he demonstrated strong grip strength in his left hand and a stable gait. His vital signs were within normal ranges: blood pressure at 125/77 mmHg, body temperature at 36.7°C, and a heart rate of 70 beats per minute with regular rhythm.
At the six-month follow-up, laboratory tests and clinical evaluations showed no signs of disease recurrence. The patient was considered fully recovered, reinforcing the effectiveness of the chosen treatment strategy when combined with postoperative care and lifestyle modifications.
Post-Treatment Recommendations
While the patient's outcome was positive, long-term health maintenance remains crucial. The following lifestyle adjustments are strongly advised:
- Diet: Adopt a low-salt, low-fat diet. Avoid spicy and irritating foods. Increase intake of fruits and vegetables rich in antioxidants and vitamins.
- Lifestyle: Quit smoking and limit alcohol consumption. Maintain a regular sleep schedule, avoid overeating, and incorporate moderate physical activity into daily routines to improve overall health and immunity.
Clinical Insights and Final Thoughts
Cerebral infarction, also known as ischemic stroke, occurs when blood flow to the brain is obstructed, leading to tissue damage due to lack of oxygen and nutrients. Treatment must be tailored to each patient's specific condition, including the severity of the blockage and individual risk factors. In this case, timely intervention and adherence to postoperative care played a key role in recovery.
While the surgical outcome was excellent, ongoing lifestyle changes and medical management are essential to prevent recurrence. Smoking cessation, regular check-ups, and proper medication adherence are critical components of long-term stroke prevention and overall brain health.