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*Accumulation of LDL

particles within arterial

vessel walls
*Presence of Defect on Continued
Stimulation of endothelial congenital / media and force on
cells to adhere to traumatic elastin on the
monocyte to T-cells • Right hemiparesis (face, aneurysm vessel wall weakened
upper extremity, lower • Left hemiparesis
vessel wall
Endothelium produces extremity) • Left sided sensory
chemical messengers • Right-sided sensory loss, loss Initial arc of
signals monocytes and T- motor deficit, decrease • Left homonymous innermost
cells to incorporate within stereognosis, hemianopia hemianopia *Hypertensio Frequent layer
internal layer • Right homonymous • Anosognosia n increase in
Additional growth of hemianopia • Asomatognosia systolic or
Maturation of monocytes lesion through influence • Dysarthia diastolic bp Vulnerability
into macrophages • Loss of prosody of
of inflammatory • Aphasia of vessel
molecules wall to
• Alexia • Flat affect
Potential rupture
LDL particle • Agraphia during
Formation of fibrous vessel
ingestion • Acalculia Right Hemisphere
cover over lipid core rupture
• Apraxia causing Occurrence
Constitution of fatty of Rupture
acid streak on inner
Larger plaque
arterial wall
formation Inadequate glucose
Earliest supply and oxygen to Intracranial
Plaque Hemorrhag
manifestation of brainstem and
rupture e
plaque formation Inadequate blood cerebellum
Temporary Alteration of
Primary Thromboplastin supplying majority Acidosis Compressi
Posterior cerebral Cessation of
Haemostasis released by of both on of
circulation cellular functions
• Platelet Adhesion macrophage hemisphere adjacent
Alteration in pH brain
• Platelet Secondary
Arterial vessel
Activation TIA/RIN vulnerable to Insufficient
rupture caused by Lactic acid ATP
• Coagulation Elevation
Fibrin strand form a ischemia damage production production
Transient of
mesh around activated Cerebral systemic intracrani
Deprivation of O2 al
Cerebral blood flow supply causing Insufficie
Thrombus Partial occlusion mitochondria to shift Neurologi
less than nt blood
of the cerebral from aerobic to c
25mL/100g/min circulatio
artery anaerobic dysfuncti
*Emboli break off Travels to cerebral Emboli lodged in smaller Sufficient arterial Fatal
from other side of arteries via carotid or cerebral blood vessels of blockage progress to Herniatio
body vertebrobasiliar system complete occlusion n

Middle Cerebral Artery Posterior Cerebral Artery Vertebrobasiliar Artery Anterior Cerebral
Ischemia Ischemia Ischemia Artery Ischemia

Impaired Blood Supply to Blood Supply Deprivation to Impaired circulation in the

Frontal lobe and
Cerebrum Occipital Lobe circle of villis
superior medial
parietal lobe blood
- Contralateral Hemiparesis - Perseveration Insufficient blood supply supply deprivation
- Contralateral sensory - Aphasia, amnesia, alexia, towards the brain
deficit agraphia, visual agnosia, - Apraxic gait
- Homonymous ataxia - Headache and vertigo - Memory impairment
hemianopsia - Loss of deep sensation - Coma - Sensory deficit
- Unilateral neglect - Stupor; coma - Memory loss and - Perseveration
- Aphasia, anomia, alexia, confusion - Bladder incontinence
agraphia, aculculia - Flaccid paralysis
Internal Carotid Artery - Contralateral
- Impaired vertical Ischmia - Ataxia hemiparesis
sensation - Cranial nerve
Altered Major blood supply dysfunction
towards the brain - Dysconjugate gaze
- Visual deficits
- Contralateral - Sensory loss, numbness
- Sensory deficit
- Blurred vision
Putamen Thalamus Lobar Brain Stem Cerebellum
• Contralateral • Contralateral Sensory • Contralateral • Quadriparesis • Ataxia
Hemiparesis Loss Hemiparesis • Facial Weakness • Facial weakness
• Contralateral Sensory • Contralateral • Contralateral Conjugate • Decreased level of • Gaze paresis
Loss Hemiparesis gaze paresis consciousness • Skew deviation
• Contralateral conjugate • Gaze paresis • Aphasia • Gaze paresis • Decrease level of
gaze paresis • Homonymous • Neglect • Ocular bobbing consciousness
• Homonymous Hemianopia, aphasia, • Apraxia • Autonomic instability
• Aphasia
• Neglect