Stroke

Pathophysiology

We have two kinds of strokes: hemorrhagic and ischemic

For the hemorrhagic stroke:

 Blood vessels leak/bleed

Nangyayari siya kapag merong leak or nagbleed na blood vessels sa brain.

 The occurrence of stress in the brain results in internal injury. Pwedeng dahil sa stress,
nagkakaron ng internal injury yung brain, or yung blood vessels nga na located doon because
syempre kapag stressed yung tao, lumalakas ung blood pressure. And overtime, nawiweaken
nito ung ating mga blood vessels, which may eventually lead to rupture. So dahil nasira ung
blood vessels, ung dugo, nag-aaccumulate lang siya doon and syempre, nagproproduce ito ng
toxic effect sa brain natin na maaaring maglead into infarction or tissue death dahil nga hindi
na enough ung oxygen supply sa utak.
o So meron tayong 2 klaseng hemorrhagic stroke which are:
o Intracerebral hemorrhage
o Yung blood vessels na nagrupture is located within the brain itself, so nagkakaron ng
blood clots or accumulation doon mismo sa loob.
o Subarachnoid hemorrhage
o Kapag kay subarachnoid hemorrhage naman, ung accumulation ng dugo is within the
subarachnoid space or ung space na nakapalibot sa utak. Usually dahil ito sa aneurysm
kaya nangyayari siya.

Moving to the ischemic stroke:

 Insufficient oxygen and blood supply to the brain. So nangyayari ito dahil insufficient ung
oxygen supply na nakakarating sa utak. So it simply means na, unlike kay hemorrhagic stroke
na sa utak mismo nanggagaling ung rupturing, dito naman ang natatamaan is ung artery na
nagsusupply ng oxygen pupunta sa brain. Commonly ito ung middle cerebral artery.
 Thrombotic and embolic conditions. So if kay hemorrhagic stroke, intracerebral and
subarachnoid. Dito naman yung 2 yan. So yung difference nila is kapag thrombotic, blood clot
sa artery ung reason while kay embolic naman is foreign na substance or object, or pwede ring
blood clot pero galing sa ibang parte ng katawan. Kumbaga, itong 2 conditions ay nabloblock
ung supposed passageway kaya hindi narireach ng supply ung brain.
 Due to plaque build-up, this will cause constriction of the vascular chambers which may form
clots. Dahil nagkakaron ng occlusions sa vascular chambers, syempre eventually, pati ung dugo
na nagfloflow don, dahil masikip ung daanan, magaaccumulate sila or magcloclot which will
then result to thrombosis.
 Atherosclerosis narrows blood vessels. Which is again, since narrow ung daanan,
magaaaccumulate nanaman ng dugo, and will also again lead to thrombosis.
 insufficient blood flow to the brain = necrosis. So syempre kapag hindi nagkakaron ng sufficient
oxygenation ung tissues, magkakaron ng severe stress ung cells doon and eventually,
maglilead yan sa necrosis.
 If necrosis happens, three occurrences will happen
o plasma membrane disruption
o organelles will swell
o neuronal function loss