Defintion

• Sudden impairment of blood circulation to the brain affecting

neurologic function.
• Classified as hemorrhagic or Ischemic (thrombotic or emobolic)
• Most common cause of neurologic disability.
• Recurrences are possible within weeks, months, or years
• Also known as Cerebrovascular Accident(CVA), brain attack, or brain
infarct.
 Causes
Cerebral Thrombosis
• Most common cause of stroke
• Obstruction of a blood vessel in the extracerebral vessel
• Atherosclerosis
• Dissection
 Causes
Cerebral Embolism
• 2nd common cause of stroke
• Cardiac arrythmias (Atrial fibrillation, atrial flutter)
• Endocarditis
• Hx. Of rheumatic heart disease
• Myocardial infarction
• Open heart surgery
• Posttraumatic valvular disease
• Congestive heart failure
• Dilated cardiomyopathy
 Causes
Cerebral Hemorrhage
• Third most common cause of stroke
• Arteriovenous malformation
• Cerebral aneurysm
• Chronic hypertension
• Brain trauma
• Bleeding diatheses
• Illicit drug use
Risk Factors
• Age over 65 * • Cardiac arrhythmias, especially atrial
• Male gender* fibrillation
• Hx. Of transient ischemic attack or • Diabetes mellitus
previous stroke* • Postmenopausal hormone therapy
• Hpn • High red blood cell count
• Migraine headaches with aura • Elevated cholesterol and triglyceride levels
• Smoking * • Use of illegal drugs
• Familial hx of cerebrovascular disease* • Brain trauma
• Inactive lifestyle • Carotid stenosis
• Poor dietary habits • Sickle cell disease
• Obesity • Heart Disease including valvular disease,
• Chronic alcohol use* heart failure, structure anomalies allowing
right-to-left shunting, or atrial or
ventricular enlargement.
 Sign and
Symptoms
Sign and Symptoms
• Other than fast these are the other signs and symptoms
• Sudden NUMBNESS or weakness of face, arm, or leg, especially on
one side of the body
• Sudden CONFUSION, trouble speaking or understanding speech
• Sudden TROUBLE SEEING in one or both eyes
• Sudden TROUBLE WALKING, dizziness, loss of balance or
coordination
• Sudden SEVERE HEADACHE with no known cause
Sign and Symptoms
• Warning Signs in Posterior Circulation Strokes
• Vertigo, like the room, is spinning.
• Imbalance
• One-sided arm or leg weakness.
• Slurred speech or dysarthria
• Double vision or other vision problems
• A headache
• Nausea and or vomiting
Pathophysiology
O2 supply to the brai is interrupted or
diminished
S and Sx.

Ischemic Hemorrhagic

Thrombus Embolus
Focal areas of ischemia occur

partially or completely
occludes cerebral blood flow Infarction to the vascular territory
to an area of the brain
Neurons die from lack of o2
Cellular hypoxia & cell membrane
Leads to influx of sodium and calcium
permeability & cell depolarization
ions and water
are affected
edema
Decrease blood flow
 Pathophysiology
Hemorrhagic Stroke Compromise brain function

Blood leaks from a blood Impaired cerebral perfusion

vessel or hemorrhage into the
brain
Infarction
Edema

Compression of brain tissue and

spasm of adjacent blood vessels

Intracranial hemorrhage become occupying lession

Increase
ICP