Stroke Pathophysiology - Document Transcript

1. PATHOPHYSIOLOGY Precipitating Factors: Hypertension Predisposing Factors:

Hyperlipidemia Life style (sedentary) Diabetes Mellitus VASOCONSTRICTION Vices
(Alcohol, smoke) Heart Diseases Age Atherosclerosis Diet Arteriosclerosis Sex
Thrombosis Heredity Severe dehydration Self-medication Blockage of the blood vessel
Embolism Lack of oxygen & High blood pressure, smoking, heart Ischemic diseases,
diabetes, narrowing of nutrients supply arteries supplying the brain, high Stroke
cholesterol and an unhealthy lifestyle. Cerebral Ischemia Hypoxia High blood pressure,
smoking, and a Subarachnoid family history of burst aneurysms. Hemorrhage - Cell death
Altered cerebral - Decreased metabolism Severe dehydration, severe infection in Oxygen
level the sinuses of the head and medical or Venous genetic conditions that increase a
Stroke person’s tendency to form blood clots. Intracerebral Decreased hemorrhage
cerebral perfusion Large Artery Hypertension, diabetes, smoking and Strokes high
cholesterol levels. Local P Acidosis A Transient R Ischemic Same with Ischemic stroke
Attack A Cytotoxic L Edema Y Small Artery Hypertension, diabetes and S Aneurysm
Stroke smoking. I Rupture S Irregular heart beat (atrial fibrillation), a Embolic heart
attack (myocardial infarction), strokes heart failure or a small hole in the heart called a
PFO (Patent Foramen Ovale). Brain tissue Necrosis A stroke is caused by a blocked or
bleeding artery in the brain. Most strokes are due to blocked arteries that supply blood to
the brain and are called DEATH Severe Cases
2. ischemic strokes. Strokes due to bursting of brain blood vessels are called hemorrhagic
strokes. Intracerebral hemorrhage is caused by bleeding into the brain itself, while
subarachnoid hemorrhage is due to bleeding around the base of the brain. A TIA
(transient ischemic attack) is caused by a temporary blockage of blood flow to a blood
vessel to the brain lasting less than 24 hours. Another, rarer, form of stroke can occur
when a vein (that drains blood out of the brain) is blocked. This is called a venous stroke.
Ischemic Stroke This type of stroke is caused by blockage of a blood vessel (artery)
supplying the brain. Brain tissue that no longer receives its blood supply can die within a
few hours unless something is done to stop the damage. The blockage of arteries can
occur in large arteries in the neck or the base of the brain, or in small arteries inside the
brain itself. A blood clot can form in the brain or it can form elsewhere and be carried to
the brain by an artery and after having an ischemic stroke and the majority of survivors
have some long term disability. There are many conditions that increase a person's risk of
ischemic stroke. These include high blood pressure, smoking, heart diseases, diabetes,
narrowing of arteries supplying the brain, high cholesterol and an unhealthy lifestyle.
Treating these conditions can decrease stroke risk. Intracerebral Hemorrhage This type of
stroke is caused by the bleeding of a blood vessel within the brain. As a result of the
bleeding a blood clot forms in the brain, which puts pressure on the brain and damages it.
Although intracerebral hemorrhage is less common than ischemic stroke and it is more
serious. The most common cause of intracerebral hemorrhage is high blood pressure.
Another cause, especially in younger people with intracerebral hemorrhages, is
abnormally formed blood vessels in the brain (vascular malformations or aneurysms).
Subarachnoid Hemorrhage Subarachnoid hemorrhage results from the bleeding of an
artery around the base of the brain. It is the least common stroke type, accounting for
about 5%
3. of all strokes. The most frequent cause of subarachnoid hemorrhage is bleeding from an
aneurysm. An aneurysm is a weakening and ballooning of a short portion of an artery
(similar to a bubble on the side of an old hose). The factors that can increase a person’s
risk of this type of stroke include high blood pressure, smoking, and a family history of
burst aneurysms. TIA (Transient Ischemic Attack) A TIA is like a temporary ischemic
stroke. An artery is temporarily blocked, preventing blood from reaching a part of the
brain. This lack of blood flow causes that part of the brain to stop functioning. The
symptoms of a TIA are the same as symptoms of an ischemic stroke. In a TIA, the blood
vessel opens up again, before any permanent injury to the brain occurs and the patient
recovers completely. Most TIA symptoms last less than 30 minutes. People who suffer
TIA’s are at HIGH RISK OF STROKE soon thereafter. A TIA should lead to immediate
medical evaluation to determine its cause and a treatment plan to prevent a stroke from
following soon after. Venous Stroke Venous stroke is caused by a blood clot blocking the
veins that allow blood to drain out of the brain. (All other strokes are caused by
abnormalities of arteries carrying blood to the brain). Venous stroke causes a “back
pressure” effect that leads to the stroke. These strokes can be either ischemic or
hemorrhagic. Some causes of venous stroke include severe dehydration, severe infection
in the sinuses of the head and medical or genetic conditions that increase a person’s
tendency to form blood clots.