Cardiogenic embolic strokes- associated with cardiac dysrythmias, usually atrial fibriliation. Also associated with valvular heart disease and thomboli in the left ventricle. Emboli originates from the heart and circulate to the cerebral vasculature, most commonly the left middle cerebral artery, resulting a stroke.
Cryptogenic strokes- no know cause and strokes from other cause, such as illicit drug use,coagulopathies,migraine, and spontaneous dissection of the carotid or vertebral arteries.
Hemorrhagic strokes are caused by arteriovenous malformations (AVM’s), aneurysm ruptures, certain drugs, uncontrolled hypertension, hemangioblastomas, and trauma. These strokes can occur in epidural, subarachnoid, or intracerebral hemorrhage.
Ischemic strokes can be caused by cardiovascular disease (cerebral embolism may originate in the heart) and dysrhytmia (atrial fibrillation); risk factors for coronary artery disease apply to stroke as well. Ischemic stroke can also be caused by vasospasm, migraines, and coagulopathies (eg, high hematocrit).
General cerebral ischemia may be caused by excessive or prolonged drop in blood pressure.
Drug abuse (cocaine) can cause stroke , particularly in adolescents and young adults.
Alcohol consumption may also be a risk factor
Pathopysiology Energy failure ION IMBALANCE ACIDOSIS GLUTAMATE DEPOLARIZATION INTRACELLULAR CALCIUM INCREASED CELL MEMBRANES AND PROTEINS BREAKDOWN FORMATION OF FREE RADICALS PROTEIN PRODUCTION DECREASED CELL INJURY AND DEATH ISCHEMIA
Warfarin Sodium ( Coumadin ) for those with atrial fibrillation ( or cardioembolic stroke ).
Platelet inhibiting medications , including aspirin, extended-release dipyridamole (Persantine) plus aspirin, clopidogrel (Plavix), and ticlopidine (Ticlid), decrease the incidence of cerebral infarction.
3-hydroxy-2-methyl-glutaryl-coenzyme A reductase inhibitors (statins) to reduce coronary events and strokes.
An increase in cerebral edema – the consequences may be deadly if not treated early – is indicated by any change or decrease in the level of consciousness, a rapid increase in the systolic blood pressure with no change in the diastolic – called a widened pulse pressure, bradycardia, & a change from a slow to rapid irregular breathing pattern.
Artery in the brain can be the site of cerebral aneurysm.
The cerebral arteries most affected by an aneurysm are the internal carotid artery (ICA), anterior cerebral artery (ACA), ante communicating artery (ACoA), posterior communicating artery (PCoa), posterior cerebral artery (PCA), and middle cerebral artery (MCA)