The document discusses cerebrovascular accidents (strokes) including definitions, blood supply to the brain, conditions caused by occlusion of different arteries, classification of strokes, diagnostic studies, and management of strokes. It covers topics such as transient ischemic attacks, the circle of Willis, effects of reduced cerebral blood flow, intravenous thrombolysis with tPA, complications of strokes, and risk factors. Rehabilitation goals and emerging therapies are also mentioned.

1. By….. Dr Guruprasad shetty. Padubidri.. Cerebro vascular accident

3. Blood Supply to the Brain

10. SMA Primary Motor cortex Primary Visual cortex (Broca’s area) Primary auditory ortex (Wernicke’s area) Angular gyrus (Arcuate Fasciculus) Brain areas involved

12. Classification of Stroke Stroke Primary Hemorrhagic (20% of Strokes) Primary Ischemic (80% of Strokes) Thrombotic 53% Embolic 31% Intracerebral Hemorrhage 10% Subarachnoid Hemorrhage 6%

13. Primary Ischemic Stroke

16. C E R E B R A l A N E U R Y S M s

17. Pathogenesis Ischemic Cascade

19. Effects of Reduced CBF Normal ml/100g/min 50 – 55 25 20 15 8 Ischemia Edema Loss of Na/K+ pump ↑ lactate electrical failure; ↓ ATP activity Penumbra Infarction Cell Death

20. Cerebral Infarction

21. Facial Weakness? Where is my lesion: summary? Spinal cord No Yes FW same side as limb W? Pons No Internal Capsule Yes Yes Leg and arm equal? No Cortical signs? Ipsilateral damage Contralateral damage Cortex Corona Radiata Yes No

30. Surgical Treatment Craniotomy Aneurysm Clipping Aneurysm Coiling Endovascular Procedures

32. Major Risk Factors Risk Factor Prevalence HTN Heart Disease 35% 10 – 120 % Previous CVA Carotid Bruit 2% 4% Diabetes Smoking 4-6% 25%

33. Unmodifiable Risk Factors for Stroke Age Incidence of stroke more than doubles each decade after age 55 Sex Incidence is about 30% higher for men than women

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