This document provides information about cerebrovascular accidents or strokes. It begins by defining a stroke as an interruption in blood flow to the brain, which can cause brain cell death. It then discusses that strokes are a leading cause of death and disability worldwide. The document is a case study of an individual, Julio Aldriano Medina Salaverry, who suffered 4 heart attacks and 15 strokes between ages 34-46. It details his symptoms, likely causes including a B12 deficiency, and treatment approach involving nutrition, supplementation, physical activity and training, and mental health support. It concludes by noting his motor functions were compromised but not severely due to his strength training, and that he has now gone 8 years without further heart

1. CEREBROVASCULAR
ACCIDENTS
J U L I O A L D R I A N O M E D I N A S A L AV E R RY.
N U T R I T I O N I S T A N D S P O RT T R A I N E R .
M A S T E R S H E A LT H A N D S P O RT.
R E S I S T E N C E T R A I N I N G S P E C I A L I S T.
C E RT I F I C AT I O N .
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2. WHAT IS A CEREBROVASCULAR
ACCIDENTS OR STROKE?
• A stroke, also referred to as a cerebral
vascular accident (CVA) or a brain attack,
is an interruption in the flow of blood to cells
in the brain. When the cells in the brain are
deprived of oxygen and nutrients, they die.
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3. • It is considered the third cause of death and
the leadind cause of disability world. It is
more frequent and devastating than we think.
• It is said that, one in six people have a stroke
and that every six seconds a person diez for
this reason.
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4. THIS HAPPENED TO ME…
• I am Julio Aldriano Medina Salaverry and 1 am 54
years old.
• I am of peruvian nationality
• I am nutricionist, sport trainer and dancer by
profesion.
• Between the age of 34 to 46 years, seffered from 4
myocardial infarction and 15 cerebrovascular
accidents, being 7 of these transient ischemic attack
and 8 iptus, of which two were lacunar.
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5. AND THIS IS MY CASE:
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6. SIGNS AND SYMPTOM
• Disorientation.
• Paralysis right and sometimes left side.
• Neuropathy.
• Heartburn.
• Indigestion
• Decreased livid.
• Dispareunia.
• Muscle stiffness and pain.
• Energy slumps.
• Lack of balance.
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7. PERSONNEL BACKGROUND
• Most of my paternal family died young of some kind of brain
attack
• Arterial hypertension.
• Asthma from the age of one and a half.
• Gluttony eating disorder up to 21 years of age.
• Removal of the spleen at age 21 years.
• Stress for a type of addiction to work.
• I was going through a separation, that ended in divorce.
• He was also atudying for a masters degree at that time, which
was time-consuming and very stressful for me.
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8. ON THE OTHER HAND…I ´M
• Sporstman
• Fitness dance teacher.
• Yoga practitioner and teacher.
• Walking and running practitioner.
• I do not booze.
• I do not smoke.
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9. PROBABLE DIAGNOSIS
Deficiency in the absorption of traslated B12.
• Megaloblastic and pernicious anemia.
• Thrombophilia.
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10. WE KNOW THAT…
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11. ANATOMY AND
PATHOPHYSIOLOGY
• Artery supply of the brain.
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12. 12

13. THIS HAPPENED TO ME
BECAUSE OF THE MANY
DIFFERENT TYPES OF CEREBRAL
ATTACKS.
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14. ANTERIOR
CEREBRAL
ARTERY
ACCLUSION
Contralateral
hemiparesis and
hemisensory los
involving mainly the
leg and foot (
paracentral lobule of
cortex).
Inability to identify
objects correctly,
apathy and
personality changes (
frontal and parietal
lobes).
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15. MIDDLE
CEREBRAL
ARTERY
OCCLUSION
Contralateral
hemiparesis and
hemisensory loss
involving mainly the
face and arm
(precentral and
postcentral gyri)
Aphasia if the left
hemisphere is affected
(rarely if the right
hemisphere is affected)
Contralateral
homonymous
hemianopia (damage
to the optic radiation)
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16. POSTERIOR
CEREBRAL
ARTERY
OCCLUSION
Contralateral
homonymous
hemianopia with
some degree of
macular sparing
(damage to the
calcarine cortex).
Visual agnosia
(ischemia of the left
occipital lobe).
Impairment of
memory (damage of
medial aspect of the
temporal lobe).
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17. MOST AFFECTED
AREAS
Aphasia damage to
the areas of the
brain, that control
your ability to speak
or understand other
people speaking.
These were the most
affected areas in my
case.
.
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18. APRAXIA
Diferent types of
Apraxia,the primary
structures of the brain
associated with motor
control and coordination
include
the cerebellum, basal
ganglia, frontal
lobe, prefrontal cortex,
and parietal lobe. These
structures all work together
to send signals to the
muscles, telling them when
to contract and relax.
These were the most
affected areas in my case.
.
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19. KEY FEATURES OF BLOOD
FLOW IN BRAIN
• Fundamental factors to maintain balance. There are 3:
• Colts, Electrons, O2, CO2.
• Circulatory blood flow represents 20% of the blood volume.
• Normal circulating flow requires 3.6 – 3.8 ml/O2/100gr de tissue/min.
• Between 5-10gr. Of glucose/ hour
• In an adult, CBF is typically
• 750 ml/min or 50-55ml/100g/min or 15 % of the cardiac output (CO)
• In normal individuals, CBF remains constant when
• the mean arterial pressure varies between
• “60 and 140 mmHg”
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20. MATTER OF CONCERN
• Cerebral Blood Flow (CBF) :
• Less than 35ml/100g/min
• Insufficiency of protein synthesis.
• Less than 20ml/100g/min, physiological
• electrical function of the cell begins to fail.
• Decreses the formation of neurotransmitters
• “ischemic penumbra”.
• Insufficiency of neurotransmitters.
• •Below 10 ml/100g/min, ionic membrane
• transport failure, Irreversible cell death- which
• leads to- “infarction”.
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21. ISCHEMIC PENUMBRA
•Is the term used for the reversibly
injured brain tissue around
ischemic core.
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22. 22

23. •This is what was done in
my case…
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24. ESTRATEGIES AND
TREATMENT
• The first hypotensive weeks.
• Rest
• Parasymoathetic activation through recreational activities, walks, trips and
adequate rest.
• Diet based on vegetables and fruits accompanied by a source of lean meat
protein, especially fish and eggs.
• B1,B6,B12 supplements.
• Progressive walks between 1 and 18 km.
• Training practice shorts and progressive the force.
• Yoga practice.
• Dance practice.
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25. NUTRITION AND
SUPPLEMENTATION
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26. 26

27. 27

28. 28

29. PHYSICAL ACTIVITY AND
TRAINING
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30. MENTAL HEALTH
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31. IT IS ALSO KNOWN THAT…
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32. WE KNOW THAT…
• The motor system hierarchy consists of 3 or 4
levels, affinis whith:
• the spinal cord, the brain stem, the motor
cortex and the association cortex.
• It also contains two side loops: the basal
ganglia or basal nucleo and the cerebellum,
which interact with the hierarchy through
connections with the thalamus.
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33. 33

34. THESE ARE…
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• Reflexes.
• Stereotyped autonomous type
movements.
• Body expression movements.
• These were not much affected

35. 35

36. IN CONCLUSION:
• In my particular case, my motor hierarchy was compromised, but
happily, not many and according to specialists and my own theory it
was thanks to my strength training, yoga, pilates and especially the
dance and the quick reaction that was had.
• Lets remember that paying attention to the signs and symptom and go
immediately to the nearest health center translated into can sabe our
lives.
• I want to conclude by mentioning that to date i have beem without
heart attacks for 8 years, i did not have COVID ( of course i took care of
myself and i have all my vaccines traslated) i must have caught a cold
three times in the 8 years, i feel more energetic and whith new projects
in the médium and long term.
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37. THE END
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