STROKE

: Presented by
Dr. Emad Ibrahim Osman
Med Reg
Dr. Alafandi Unit
What is Stroke?
 Stroke is defined as an acute neurological deficit
lasting more than 24 hours and caused by
cerebrovascular aetiology. It is subdivided into
ischaemic stroke (caused by vascular occlusion or
stenosis) and haemorrhagic stroke (caused by
vascular rupture, resulting in intra-parenchymal
and/or subarachnoid haemorrhage). Ischaemic
stroke accounts for 87% of all stroke cases,
haemorrhagic stroke for 10%, and subarachnoid
haemorrhage for 3%. [1]

[ 1 ] American Heart association report 2018
Transient ischaemic attack (TIA)
TIA should be suspected in anyone who presents with
sudden-onset, focal neurological deficit that has
completely resolved within 24 hours of onset and cannot
be explained by another condition such as
hypoglycaemia. TIAs have considerable risk of early
recurrent cerebral ischaemic events. [2] Strong risk
factors include atrial fibrillation, valvular heart disease,
congestive heart failure, hypertension, diabetes mellitus,
carotid stenosis, other significant illnesses (such as a
hypercoagulable state or vasculitis such as temporal
arteritis), cigarette smoking, alcohol-use disorder, and
older age.
 Evaluation and initiation of secondary prevention
should occur rapidly.
Intracerebral haemorrhage is caused by
vascular rupture with bleeding into the brain
parenchyma, resulting in a primary mechanical
injury to the brain tissue. In 2017, the global
prevalence of intracerebral haemorrhage (ICH) was
17.9 million people. [25] Strong risk factors include
hypertension, older age, family history of ICH,
haemophilia, cerebral amyloid angiopathy,
anticoagulation, use of illicit sympathomimetic
drugs, vascular malformations, and Moyamoya
syndrome.
Moyamoya is a rare condition in which the blood vessels (internal carotid arteries)
that supply blood to the brain become narrowed. Court commonly in children &
young adult, especially east Asian.
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