Stroke
Definition: Sudden death of brain cells in a localised brain region due to inadequate blood flow |
Risk factors/causes:
- Age (above 55), race/ethnicity (African Americans, Hispanics), sex (male over females), hormones (birth control use/hormone therapies)
- Lifestyle: overweight, physical inactivity, alcohol/drug abuse
- Medical: hypertension, smoking, high cholesterol, diabetes, obstructive sleep apnea, cardiovascular disease (heart failure, defects, infection or arrhythmia [atrial fibrillation]), family Hx (stroke, heart attack, transient ischemic attack), covid-19 |
Pathophysiology & mechanism: Acute ischemia / intracerebral haemorrhage / subarachnoid haemorrhage / venous sinus thrombosis → impaired blood supply to affected area → loss of function, with symptoms related to the function of the affected brain tissue → stroke |
Signs & symptoms:
- Trouble speaking & understanding what others are saying
- Paralysis or numbness of the face, arm or leg
- Problems seeing in one or both eyes
- Headache
- Trouble walking |
Complications:
- Paralysis or loss of muscle movement
- Difficulty talking or swallowing
- Memory loss or thinking difficulties
- Emotional problems
- Pain
- Changes in behaviour & self-care ability |
Treatment: Medication & surgery |
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Acute ischemia
Definition: Local/distant cause - blood clot (embolus) blocks/narrows an artery leading to the brain causing cell death |
Risk factors/causes:
- Hypertension, diabetes, heart conditions, smoking, males over 55, Hx of stroke or TIA
- Fatty deposits that build up in blood vessels or by blood clots or other debris that travel through the bloodstream, most often from the heart, & lodge in the blood vessels in the brain |
Pathophysiology & mechanism: Small artery occlusion / large artery atherosclerosis / cardiac embolism / other → cerebral blood flow is impaired →damage is the lack of blood flow (ischemia) → ↑cell death / inflammation of brain tissue → signs/symptoms |
Signs & symptoms:
- Severe headache without known cause
- Numbness or weakness of face, arms, legs (especially one side)
- Confusion
- Trouble seeing in or both eyes
- Trouble walking, dizziness, loss of balance or coordination |
Complications:
- Blood clots
- UTIs
- Bowel & bladder problems
- Pneumonia risk
- Muscle weakness
- Bed sores
- Mobility problems & falls |
Treatment: Clot-busting medications & using a guided wire to retrieve blood clots in the blood vessels (aka. focus on restoring blood flow to the brain) |
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