PATHOPHYSIOLOGY

• Patho -physiology of ischemic stroke

1. Local thrombus formation
2. Occlusion of a cerebral artery
3. Decrease cerebral blood flow
4. Ischemia
5. Infarction
• Types
1. Atherosclerotic
2. Cardiogenic
3. Penetrating artery disease
Atherosclerotic
• Plaque
• Rupture
• Collagen, platelet aggregation and thrombus release
• Reach the cerebral circulation
o Hypoperfusion
o Arteriogenic
•Intracranial nerves
•Extracranial nerves

Cardiogenic
• Blood stasis
• Clot from aorta to cerebral circulation
.Atrial fibrillation
.Valvular heart disease
.Prosthetic valves
Penetrating artery disease
Occlusion of the one of the penetrating arteries that provide blood to the brain’s deep
structures.

Patho-physiology of Hemorrhagic stroke

• Hemorrhagic stroke
.Subarachnoid hemorrhage
.Trauma
.Rupture of intracranial aneurysm
.Rupture of an arteriovenous malformation
.Intracerebral Hemorrhage
.Ruptures within the brain parenchyma leading to hematoma
.Uncontrolled high blood pressure
.Sub dural Hematomas
. Collection of blood below the durameter
. Trauma
 Stroke risk factors: Non
modifiable
• Age: >55 risk doubles every decade
• Gender: Male more common, Female higher death rate
• Heredity
• Prior stroke
• Race:
Increased in Hispanic/Asian/Pacific Islander
African –American higher rates than whites
 STROKE RISK FACTORS:
MODIFIABLE
1.Hypertension
2.High cholesterol: Clogs arteries
3.Atrial Fibrillation: Pooling blood promotes clots
4.Diabetes
2/3 die from stroke or heart disease
5.Tobacco
6.Smoke
7.Alcohol
8.Obesity