Treatment Options for Intravenous Medications in Cerebral Infarction

Cerebral infarction, commonly known as ischemic stroke, requires prompt medical intervention to minimize brain damage and improve recovery outcomes. During the acute phase of cerebral infarction, intravenous medications play a crucial role in restoring blood flow and protecting brain tissue. These medications often include agents that promote blood circulation, reduce blood viscosity, and improve microcirculation in the brain. Commonly used intravenous drugs include Xueshuantong (hemostatic and blood-activating agent), Vincamine (a derivative of Vinca minor used to enhance cerebral blood flow), Alprostadil (a prostaglandin with vasodilatory properties), and traditional Chinese medicine injections such as Danshen Chuanxiongqin and Danhong. However, the choice of medication should always be tailored to the patient's specific condition and underlying causes.

Thrombolytic Therapy Within the Treatment Window

For patients who arrive at the hospital within the recommended time window—typically within 4.5 hours of symptom onset—intravenous thrombolytic therapy may be initiated. If the patient meets the criteria for thrombolysis, medications such as recombinant tissue plasminogen activator (rt-PA) or urokinase may be administered. These drugs work by dissolving the blood clot responsible for the blockage, thereby restoring blood flow to the affected area of the brain. Timely administration of thrombolytics has been shown to significantly improve functional outcomes and reduce long-term disability.

Anticoagulation for Atrial Fibrillation-Related Stroke

If the patient has a history of atrial fibrillation or other cardioembolic sources, and is not eligible for thrombolytic therapy, anticoagulation may be considered. In such cases, Argatroban—a direct thrombin inhibitor—can be used to prevent further clot formation. Argatroban is particularly useful in patients with contraindications to heparin or those with impaired liver function. Anticoagulant therapy should be closely monitored to balance the risk of bleeding with the potential benefits of clot prevention.

Managing Hyperfibrinogenemia

In patients with elevated fibrinogen levels, known as hyperfibrinogenemia, the administration of Batroxobin—a fibrinogen-reducing enzyme—can be beneficial. Batroxobin helps decrease blood viscosity and prevents the formation of additional clots. This treatment is especially relevant in patients with increased clotting tendency, as it supports improved cerebral perfusion and reduces the risk of recurrent stroke.

Antiplatelet Therapy for Lacunar Infarcts

For patients diagnosed with small-vessel, lacunar-type cerebral infarcts, antiplatelet therapy is often the cornerstone of treatment. Medications such as aspirin or clopidogrel (Plavix) are commonly prescribed to inhibit platelet aggregation and prevent secondary clot formation. Additionally, Edaravone—an antioxidant and free radical scavenger—may be administered intravenously to support neuroprotection and enhance neurological recovery. Clinical evidence suggests that Edaravone can help reduce oxidative stress and promote better functional outcomes when used in the early stages of stroke.

Ultimately, the selection of intravenous medications for cerebral infarction should be guided by a comprehensive evaluation of the patient's clinical status, underlying etiology, and individual risk factors. A multidisciplinary approach involving neurologists, emergency physicians, and pharmacists ensures optimal treatment strategies and improved patient outcomes.