AMA Phatophysiology

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II.

PHATOPHYSIOLOGY
Predisposing Factors: 1) Age: 48 y/o 2) Heredity: Mother died because of stroke 3) Sex: Male 4) Prior Stroke, TIA or heart attack Precipitating Factors: 1) Hypertension 2) Cigarette Smoking 3) Atrial Fibrillation 4) Poor diet 5) Alcohol Intake

Atherosclerosis Formation of Plaque deposits Thrombosis Occlusion by major vessel

Hypertensi on

Lysed or moved thrombus from the vessel

Vascular wall becomes weakened and fragile

Leaking of blood from the fragile vessel wall Sx:, headache, unconsciousness, nausea/vomiting, visual disturbances

Cerebral Hemorrhage Mass of blood forms and grows

Vasospasm of tissue and arteries

Sx: dizziness, confusion, headache

CEREBRAL HYPOPERFUSION

Impaired distribution of oxygen and glucose

Blood seeps into th e ventricles Obstruction of CSF passageway

Formation of small and large clots

Impaired distribution of oxygen and glucose

Tissue hypoxia and cellular starvation

Cerebral Ischemia Accumulation of CSF in the ventricles Lodges unto other cerebral arteries

Initiation of ischemic cascade

Ventricles dilate behind the point of obstruction

Increased ICP Unrelieved obstruction

Anaerobic metabolism by mitochondria

Vertebrobasilar System

Damage to the blood vessel endothelium

Transient Ischemic Attack Structural integrity loss of brain tissue and blood vessels Brain sustains an irreversible cerebral damage

Breakdown of the protective Blood Brain Barrier

Cerebral edema

Compression of tissue

Vascular Congestion

Increased intracranial pressure Impaired perfusion and function

Sx: Alternating motor weaknesses, contralateral hemisensory impairments, double vision, homonymous hemianopsia, nystagmus, conjugate gaze, paralysis, dysphagia, coma

Vertebrobasilar System Cerebellum and brain stem

Continued insufficiency of blood flow

Further compression of tissues

Coma

Cerebral Death

Loss of neural feedback mechanisms

Cessation of physiologic functions

Altered body temperature


Systemic Failure

Impaired Gas exchange

Risk for aspiration r/t NGT use

In Severe Cases

DEATH

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