Fadila Padmarini / 2AD4

P27220021111
STROKE

A. Brain’s part
 Cerebrum has 4 hemisphere. Each has cortex, and each cortex has 4 lobes. Cerebrum
consist of :
o Frontal Lobe
Control movement and has crucial job as executive function.
o Parietal Lobe
Control sensory info and our sense ability.
o Occipital Lobe
Has control our vision
o Temporal Lobe
Control hearing ability, memory, smell ability, languages, and our facial
recognition.
 Cerebellum
The cerebellum part control muscle coordination and balance.
 Brainstem
Brainstem has function as conjunction between brain and spinal. It has control at
heart rate, blood pressure, breathing, GI function, and consciousness.
 The left brain control our left of body part. And so on the right part one. We can call
it ‘Vice Versa’ law.
 Brain consist of various artery that also has various size. It connected each other. The
main connection of the arteries call ‘Circle of Willis’.
B. Ischemic Stroke
 An ischemic stroke occurs when blood clots or other particles block the blood vessels
to the brain. Fatty deposits called plaque can also cause blockages by building up in
the blood vessels.
 Common than other type.
 The damage of this stroke depends on Location and time.
  The self-resolved in 24 hours one is transient ischemical attack, it has minimal long-
term damage.
 The Circle of Willis part make our brain could keep get need of blood from the
circulation when the blockade happened, so the blockade can resolved.
 Circle of Willis offers alternative way for blood to get around obstructive.
 The endothelial cell disfunction also can cause ischemic stroke. The blood vessel
which get inflammation damage from other harsh chemical (like tar, nicotine,
alcohol). It call endothelium part. The damaged part call atherosclerosis and fall out.
It calls plaque. The plaque can call cheese texture thing and can cause blockade to.
 The blockade of blood flow can cause embolism at the part which isolated. The
condition when the blood clot form the stagnant blood.
 The lacunar stroke is the most common form of ischemic stroke that cause when the
damaged part of the brain forms cysts and look like lakes. It happen because the
hyaline atherosclerosis form from hypertension and diabetes condition.
 The shock condition happened when reduction in blood flow throughout the body.
Tissues furthest downstream and affected most. When the blood flow from any
direction, it cause damage.
 The symptoms show depends on the place where affected.
 The symptoms of worst and to prevent the long-term damage, we can see as the sign
condition like facial drooping, arm weakness, speech difficulty, and the time that we
have to help.
C. Hemorrhagic Stroke
 A hemorrhagic stroke happens when an artery in the brain leaks blood or ruptures
(breaks open). The leaked blood puts too much pressure on brain cells, which
damages them.
 It can caused by :
o Atherosclerosis
o Thrombus
o Embolus
o Global reduction of blood flow
 o
D. Screening and Treatment
 Screening
o The screening session can see from angiography (we can see where is the block)
o Flair Sequence MRI (can distinguish from old)
 Treatment can do to reestablished blood flow :
o Thrombolytic enzyme
Like TPA (Tissue Plasminogen Activator) to activated body’s clot busting
mechanism. But it has time limit for usage.
o Aspirin
Prevents more clots
o Surgery
To remove clot physically use mechanical embolus removal in cerebral ischemia
(MERCI) using wire and the lot pulled out. Use suction removal of clot to suck
the embolism out.