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This document summarizes the pathophysiology of stroke. It discusses the two main types of stroke - ischemia (lack of blood flow) and hemorrhage (bleeding). Ischemic injury depends on factors like the rate and duration of reduced blood flow as well as collateral circulation. There are different zones of brain tissue impacted by ischemia. Neuronal death occurs through mechanisms like excitotoxicity, coagulation necrosis, and apoptosis over varying timeframes. Strokes can be caused by thrombosis, embolism, or hypotension. Restoring blood flow after ischemia can cause hemorrhage or edema in the brain.
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Pathophysioloy of stroke
This document summarizes the pathophysiology of ischemic stroke and reperfusion injury. It describes how a reduction in blood flow during stroke can lead to tissue damage through various mechanisms like depletion of ATP, ionic imbalances, and free radical accumulation. It also discusses cerebral autoregulation and how its impairment during stroke contributes to low oxygen delivery. The consequences of reduced blood flow like focal ischemia, cell injury pathways like excitotoxicity and inflammation are summarized. Risk factors for reperfusion syndrome following revascularization like hypertension, dysautoregulation and ischemia-reperfusion are highlighted. Methods to assess risk and prevent reperfusion injury through blood pressure control are also summarized.
Stroke.
The document discusses stroke, including its definition, classification, epidemiology, etiology, pathophysiology, clinical presentation, investigations, diagnosis, treatment and rehabilitation. Stroke is defined as a neurological deficit caused by focal cerebral ischemia or hemorrhage. It is classified clinically or by mechanism. Risk factors include hypertension, smoking, hypercholesterolemia and atrial fibrillation. Treatment involves thrombolysis with tPA within 3 hours, aspirin, rehabilitation therapies, and secondary prevention including anticoagulation and antihypertensives.
Stroke patho physiology
This document discusses the mechanisms and pathophysiology of ischemic stroke. There are three main mechanisms of ischemic stroke: thrombosis, embolism, and decreased systemic perfusion. Thrombosis occurs due to localized blood vessel narrowing, embolism occurs when a clot forms elsewhere and blocks a vessel, and decreased perfusion is caused by low blood pressure. The brain requires constant blood flow and oxygen to function, and ischemic stroke causes damage when blood and oxygen are cut off from brain tissue. The location and duration of ischemia determines the severity of injury.
Pathophysiology stroke
Stroke occurs when the blood supply to the brain is interrupted or reduced, leading to brain damage and neurological deficits. It is a medical emergency. According to the WHO, 15 million people suffer strokes worldwide each year, resulting in 5 million deaths and 5 million cases of permanent disability. The main types of stroke are ischemic, which accounts for 85% of cases and is caused by a blockage of blood vessels in the brain, and hemorrhagic, which results from a ruptured blood vessel in the brain. Risk factors include high blood pressure, high cholesterol, diabetes, smoking, obesity, physical inactivity, previous TIAs, and older age. Symptoms depend on the affected area of the brain and may include weakness, numb
Ischemic heart diseases..
Ischemic heart disease is usually caused by atherosclerosis in the coronary arteries which limits blood supply to the heart. It has a spectrum of clinical manifestations from mild angina to myocardial infarction depending on the severity of ischemia. Angina pectoris is recurrent chest pain due to transient ischemia while a myocardial infarction occurs when ischemia is prolonged leading to cell death and scarring of heart muscle. Atherosclerosis develops from childhood and lifestyle factors influence its progression, with plaques vulnerable to rupture typically containing inflammatory cells, lipids, and a thin fibrous cap.
Infective Endocarditis
Infective endocarditis refers to a microbial infection of the heart's endothelium, usually affecting the valves. It has an incidence rate of 5 to 15 cases per 100,000 people per year, with over 50% of cases occurring in individuals over age 60. The infection can be either acute or subacute, with acute cases caused by more virulent organisms on normal valves, resulting in large destructive vegetations and embolic events. Subacute cases are caused by less virulent organisms on previously damaged valves, resulting in less valve destruction and the presence of granulation tissue on vegetations. Blood cultures and echocardiography, particularly transesophageal echocardiography, are important for diagnosis. Treatment involves antibiotics,
Acute myocardial infarction
This document defines myocardial infarction and provides classifications. It discusses the epidemiology, risk factors, pathophysiology, diagnostic approach, and treatment strategies for myocardial infarction. Key points are that MI is sudden myocardial necrosis caused by ischemia. Classification includes STEMI and NSTEMI. Risk factors include age, smoking, diabetes, hypertension, and hyperlipidemia. Diagnosis involves ECG and biomarkers. Treatment focuses on dissolving thrombus with aspirin and anticoagulants, reducing atheroma with statins, and selecting an invasive or non-invasive strategy based on risk.
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Pathophysioloy of stroke
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Stroke.
The document discusses stroke, including its definition, classification, epidemiology, etiology, pathophysiology, clinical presentation, investigations, diagnosis, treatment and rehabilitation. Stroke is defined as a neurological deficit caused by focal cerebral ischemia or hemorrhage. It is classified clinically or by mechanism. Risk factors include hypertension, smoking, hypercholesterolemia and atrial fibrillation. Treatment involves thrombolysis with tPA within 3 hours, aspirin, rehabilitation therapies, and secondary prevention including anticoagulation and antihypertensives.
Stroke patho physiology
This document discusses the mechanisms and pathophysiology of ischemic stroke. There are three main mechanisms of ischemic stroke: thrombosis, embolism, and decreased systemic perfusion. Thrombosis occurs due to localized blood vessel narrowing, embolism occurs when a clot forms elsewhere and blocks a vessel, and decreased perfusion is caused by low blood pressure. The brain requires constant blood flow and oxygen to function, and ischemic stroke causes damage when blood and oxygen are cut off from brain tissue. The location and duration of ischemia determines the severity of injury.
Pathophysiology stroke
Stroke occurs when the blood supply to the brain is interrupted or reduced, leading to brain damage and neurological deficits. It is a medical emergency. According to the WHO, 15 million people suffer strokes worldwide each year, resulting in 5 million deaths and 5 million cases of permanent disability. The main types of stroke are ischemic, which accounts for 85% of cases and is caused by a blockage of blood vessels in the brain, and hemorrhagic, which results from a ruptured blood vessel in the brain. Risk factors include high blood pressure, high cholesterol, diabetes, smoking, obesity, physical inactivity, previous TIAs, and older age. Symptoms depend on the affected area of the brain and may include weakness, numb
Ischemic heart diseases..
Ischemic heart disease is usually caused by atherosclerosis in the coronary arteries which limits blood supply to the heart. It has a spectrum of clinical manifestations from mild angina to myocardial infarction depending on the severity of ischemia. Angina pectoris is recurrent chest pain due to transient ischemia while a myocardial infarction occurs when ischemia is prolonged leading to cell death and scarring of heart muscle. Atherosclerosis develops from childhood and lifestyle factors influence its progression, with plaques vulnerable to rupture typically containing inflammatory cells, lipids, and a thin fibrous cap.
Infective Endocarditis
Infective endocarditis refers to a microbial infection of the heart's endothelium, usually affecting the valves. It has an incidence rate of 5 to 15 cases per 100,000 people per year, with over 50% of cases occurring in individuals over age 60. The infection can be either acute or subacute, with acute cases caused by more virulent organisms on normal valves, resulting in large destructive vegetations and embolic events. Subacute cases are caused by less virulent organisms on previously damaged valves, resulting in less valve destruction and the presence of granulation tissue on vegetations. Blood cultures and echocardiography, particularly transesophageal echocardiography, are important for diagnosis. Treatment involves antibiotics,
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- Hypertrophic cardiomyopathy involves abnormal thickening of the heart muscle and can lead to outflow obstruction. It is a common cause of sudden death in young athletes.
- Restrictive cardiomyopathy causes stiff ventricles and impaired ventricular filling due to disorders like amyloidosis. It presents with symptoms of right and left heart failure.
- Other rare types discussed include arrhythmogenic right ventricular dysplasia and obliterative cardiomyopathy. Diagnosis involves imaging and endomyocardial biopsy
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1. Stroke is defined as a clinical syndrome of rapid onset of focal deficits of brain function lasting more than 24 hours or leading to death. There are two main types - ischemic and hemorrhagic.
2. Ischemic strokes account for 80% of cases and result from arterial occlusion blocking blood flow. Hemorrhagic strokes can be either intracerebral hemorrhage from ruptured small arteries damaged by hypertension, or subarachnoid hemorrhage from ruptured aneurysms.
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Essential Hypertension
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Infective Endocarditis
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Pathology of Hypertension
The document discusses hypertension (high blood pressure) including its classification, pathogenesis, complications, and pathological features. It notes that essential (primary) hypertension accounts for 95% of cases and has unknown etiology, while secondary hypertension makes up 5-10% of cases and has a known cause such as renal or endocrine disorders. Complications of long-term high blood pressure include damage to organs like the heart, brain, kidneys and eyes due to reduced blood flow and vessel damage over time.
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Rheumatic heart disease is caused by rheumatic fever, which occurs after a streptococcal throat infection and causes inflammation of the heart valves. Genetic factors influence the risk of developing rheumatic heart disease. Acute rheumatic fever causes inflammatory lesions called Aschoff bodies in heart tissue that contain characteristic giant cells. Long-term rheumatic heart disease results in thickened and scarred heart valves that may become narrowed or insufficient.
CHF
Congestive heart failure (CHF) results from any structural or functional cardiac disorder that impairs the ventricle's ability to fill with or eject blood. It is diagnosed based on history, physical exam, chest x-ray, EKG, and echocardiogram. Treatment focuses on restoring normal cardiopulmonary physiology by using ACE inhibitors, beta-blockers, diuretics, and addressing pulmonary complications. Management involves evaluating the patient's stage of CHF and functional classification to determine appropriate pharmacotherapy and monitoring according to guidelines from the American Heart Association.
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3. Primary percutaneous coronary intervention is recommended over thrombolysis when certain criteria are met for STEMI patients.
Myocardial infraction presentation
Myocardial infarction, commonly known as a heart attack, is caused by the blockage of a coronary artery which interrupts blood flow to the heart. This occurs when an atherosclerotic plaque ruptures within the artery. The resulting ischemia and oxygen shortage can damage or destroy heart muscle tissue if not treated promptly. Diagnosis involves factors like chest pain symptoms, ECG changes, and elevated cardiac enzyme levels. Treatment focuses on restoring blood flow, managing pain and anxiety, preventing clots and arrhythmias, and reducing risk of future attacks.
Myocarditis
Myocarditis is an inflammatory disease of the heart muscle that can be caused by infectious or non-infectious triggers. It has a variable clinical presentation ranging from mild symptoms to life-threatening conditions. The diagnosis is challenging due to the heterogeneity of symptoms but can involve electrocardiogram, cardiac biomarkers, echocardiogram, cardiac MRI and endomyocardial biopsy. About half of acute cases resolve in 2-4 weeks but some develop heart failure or arrhythmias. Treatment focuses on supporting heart function and managing symptoms while the disease runs its course.
Stroke Presentation Ms
A stroke occurs when the blood supply to the brain is interrupted or reduced, causing brain cells to die. It is a medical emergency. There are two main types of strokes: ischemic, caused by a blockage in a blood vessel, and hemorrhagic, caused by a ruptured blood vessel. Symptoms vary depending on the affected area of the brain but can include paralysis, confusion, and headaches. Diagnostic tests including CT scans and MRI images are used to determine the type and location of the stroke. Treatment options depend on the type of stroke but may include clot-busting drugs or surgery to repair damaged blood vessels. Prevention is key through controlling risk factors like high blood pressure, diabetes, and smoking.
Stroke (1)
This document provides an overview of strokes, including:
- Strokes are caused by a blockage or rupture of an artery to the brain, cutting off oxygen flow.
- Symptoms include weakness, paralysis, difficulty speaking or swallowing.
- Diagnosis involves medical imaging, blood tests, and physical exams to determine the type and location of blockage or rupture.
- Treatment depends on the type of stroke but may include clot-busting drugs, surgery, medication, and lifestyle changes to prevent future strokes.
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Angina pectoris
This document provides an overview of angina pectoris (chest pain). It defines angina as a clinical syndrome caused by transient myocardial ischemia due to an imbalance between oxygen supply and demand in the heart. Angina is common in middle-aged and older adults and can be classified as stable, Prinzmetal's variant, or unstable. It is caused by conditions that limit blood supply to the heart like atherosclerosis or coronary artery spasm. Symptoms include chest pain and shortness of breath. Risk factors include physical exertion, smoking, and hypertension. Treatment involves medications to relieve symptoms and improve blood flow as well as procedures like stents or bypass surgery.
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This document provides information on the care of patients with congestive heart failure (CHF), including definitions, types, pathophysiology, clinical manifestations, diagnosis, medical and surgical management, and nursing management. Key points discussed include the definition of CHF, common causes and risk factors, symptoms of left and right sided heart failure, diagnostic criteria and tests, pharmacological treatments to improve pumping and reduce workload on the heart, lifestyle modifications, potential complications, and approaches to managing common issues experienced by CHF patients such as fluid overload, decreased activity, and anxiety.
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Treatment Algorithms
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- Dilated cardiomyopathy is caused by an unknown etiology and results in left ventricular dilatation and systolic dysfunction. It is a common cause of heart failure.
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Cardiomyopathies are diseases of the heart muscle that are classified based on etiology and functional characteristics. The main types are dilated, hypertrophic, restrictive, and arrhythmogenic right ventricular dysplasia. Symptoms vary depending on the type but often include heart failure symptoms like shortness of breath. Treatment focuses on managing underlying causes, controlling symptoms, preventing worsening of the disease, and reducing complications through medications, lifestyle changes, and procedures.
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Stroke is the third leading cause of death in Malaysia. The document defines stroke, classifies its types, and outlines its diagnosis and management. Key points include that stroke is caused by blocked blood flow to the brain, and risk factors include age, gender, family history, hypertension, diabetes, atrial fibrillation, smoking, and high cholesterol. Diagnostic tests include CT/MRI scans and angiograms to determine the cause. Treatment focuses on rehabilitation, managing risk factors, and preventing future strokes.
Approach to a patient with stroke - Pathophysiology of stroke
1. Stroke is defined as a clinical syndrome of rapid onset of focal deficits of brain function lasting more than 24 hours or leading to death. There are two main types - ischemic and hemorrhagic.
2. Ischemic strokes account for 80% of cases and result from arterial occlusion blocking blood flow. Hemorrhagic strokes can be either intracerebral hemorrhage from ruptured small arteries damaged by hypertension, or subarachnoid hemorrhage from ruptured aneurysms.
3. The pathophysiology of ischemic stroke involves development of an ischemic core with immediate cell death surrounded by an ischemic penumbra of reversibly dysfunctional tissue that can potentially be salvaged by reperfusion
Heart failure, sunita kharel
The document is a presentation on congestive cardiac failure submitted by Ms. Sunita Kharel. It includes an introduction to heart failure, classifications of heart failure, pathophysiology, clinical features, diagnostic tests, management, complications, and nursing management. It provides an overview of congestive cardiac failure covering definition, causes, types, signs and symptoms, diagnosis, treatment, and nursing care.
Essential Hypertension
Hypertension, or high blood pressure, affects over 1 billion people worldwide and is a major risk factor for heart attacks and strokes. It is defined as a systolic blood pressure over 140 mmHg or a diastolic blood pressure over 90 mmHg. Essential or primary hypertension accounts for 90-95% of hypertension cases and results from an interaction of environmental and genetic factors, though the specific causes are unknown. If left untreated, hypertension can damage organs like the heart, brain, and kidneys, potentially leading to heart attacks, strokes, kidney failure or other complications. Treatment involves lifestyle modifications and medication to control blood pressure and reduce health risks.
Pathophysiology of ISchemic Stroke
This document discusses the pathophysiology of ischemic stroke. It describes the main mechanisms of ischemic stroke including large artery disease, small artery disease, and cardiac embolism. Large artery disease is mainly caused by thrombosis superimposed on atherosclerosis in major arteries. Atherosclerosis preferentially occurs in bifurcation areas of arteries. Stroke mechanisms in large artery disease include artery-to-artery embolism, in situ atherothrombotic occlusion, hypoperfusion, and branch occlusion. Small artery disease causes lacunar infarctions through lipohyalinosis in small penetrating arteries. Cardiac embolism accounts for 20-25% of ischemic strokes and is mainly caused by atrial fibrillation,
Infective Endocarditis
Infective endocarditis is an infection of the inner lining of the heart chambers and heart valves. It has an incidence of about 1 in 1,000 hospital admissions and risks include structural heart disease, immunosuppression, pacemakers, prolonged cardiac surgery, intravenous drug use, and nosocomial infections. Clinical presentations can be acute with toxicity and metastatic infection developing over days to weeks, or subacute progressing over weeks to months with less toxicity. Complications include heart failure, abscesses, and embolism, with an overall mortality rate of 10-20%. Treatment involves antibiotics tailored to the infecting organism and surgery may be required in some cases.
Pathology of Hypertension
The document discusses hypertension (high blood pressure) including its classification, pathogenesis, complications, and pathological features. It notes that essential (primary) hypertension accounts for 95% of cases and has unknown etiology, while secondary hypertension makes up 5-10% of cases and has a known cause such as renal or endocrine disorders. Complications of long-term high blood pressure include damage to organs like the heart, brain, kidneys and eyes due to reduced blood flow and vessel damage over time.
Approach to vasculitis
Vasculitis refers to inflammation of blood vessels. The document discusses the classification, pathogenesis, clinical manifestations, investigations, and histopathology of various types of vasculitis. It classifies vasculitis based on vessel size (large, medium, small vessel) and cause (primary, secondary to infection, drugs, etc). Pathogenesis may involve infectious or non-infectious mechanisms like immune complex deposition, ANCA, or anti-endothelial cell antibodies. Investigations assess organ damage, immune mechanisms, and provide tissue diagnosis. Clinical features and histopathology vary depending on the type and organs involved in the vasculitis.
Rheumatic heart disease
Rheumatic heart disease is caused by rheumatic fever, which occurs after a streptococcal throat infection and causes inflammation of the heart valves. Genetic factors influence the risk of developing rheumatic heart disease. Acute rheumatic fever causes inflammatory lesions called Aschoff bodies in heart tissue that contain characteristic giant cells. Long-term rheumatic heart disease results in thickened and scarred heart valves that may become narrowed or insufficient.
CHF
Congestive heart failure (CHF) results from any structural or functional cardiac disorder that impairs the ventricle's ability to fill with or eject blood. It is diagnosed based on history, physical exam, chest x-ray, EKG, and echocardiogram. Treatment focuses on restoring normal cardiopulmonary physiology by using ACE inhibitors, beta-blockers, diuretics, and addressing pulmonary complications. Management involves evaluating the patient's stage of CHF and functional classification to determine appropriate pharmacotherapy and monitoring according to guidelines from the American Heart Association.
293. ischemic heart disease
1. The document discusses the classification, diagnosis, and treatment of acute coronary syndromes including unstable angina and myocardial infarction.
2. Key points include definitions of unstable angina, NSTEMI, and STEMI; causes of acute coronary syndromes including plaque rupture and vasospasm; the importance of history, ECG, biomarkers in diagnosis; and the use of antiplatelet agents, beta blockers, nitroglycerin, and anticoagulants in treatment.
3. Primary percutaneous coronary intervention is recommended over thrombolysis when certain criteria are met for STEMI patients.
Myocardial infraction presentation
Myocardial infarction, commonly known as a heart attack, is caused by the blockage of a coronary artery which interrupts blood flow to the heart. This occurs when an atherosclerotic plaque ruptures within the artery. The resulting ischemia and oxygen shortage can damage or destroy heart muscle tissue if not treated promptly. Diagnosis involves factors like chest pain symptoms, ECG changes, and elevated cardiac enzyme levels. Treatment focuses on restoring blood flow, managing pain and anxiety, preventing clots and arrhythmias, and reducing risk of future attacks.
Myocarditis
Myocarditis is an inflammatory disease of the heart muscle that can be caused by infectious or non-infectious triggers. It has a variable clinical presentation ranging from mild symptoms to life-threatening conditions. The diagnosis is challenging due to the heterogeneity of symptoms but can involve electrocardiogram, cardiac biomarkers, echocardiogram, cardiac MRI and endomyocardial biopsy. About half of acute cases resolve in 2-4 weeks but some develop heart failure or arrhythmias. Treatment focuses on supporting heart function and managing symptoms while the disease runs its course.
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Approach to a patient with stroke - Pathophysiology of stroke
Approach to a patient with stroke - Pathophysiology of stroke
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Stroke Presentation Ms
A stroke occurs when the blood supply to the brain is interrupted or reduced, causing brain cells to die. It is a medical emergency. There are two main types of strokes: ischemic, caused by a blockage in a blood vessel, and hemorrhagic, caused by a ruptured blood vessel. Symptoms vary depending on the affected area of the brain but can include paralysis, confusion, and headaches. Diagnostic tests including CT scans and MRI images are used to determine the type and location of the stroke. Treatment options depend on the type of stroke but may include clot-busting drugs or surgery to repair damaged blood vessels. Prevention is key through controlling risk factors like high blood pressure, diabetes, and smoking.
Stroke (1)
This document provides an overview of strokes, including:
- Strokes are caused by a blockage or rupture of an artery to the brain, cutting off oxygen flow.
- Symptoms include weakness, paralysis, difficulty speaking or swallowing.
- Diagnosis involves medical imaging, blood tests, and physical exams to determine the type and location of blockage or rupture.
- Treatment depends on the type of stroke but may include clot-busting drugs, surgery, medication, and lifestyle changes to prevent future strokes.
Ischemic stroke
The document discusses ischemic stroke, including its epidemiology, classification, risk factors, and etiopathogenesis. Some key points:
- Stroke occurs every 5 seconds worldwide and is a leading cause of death and disability globally. Incidence and prevalence varies significantly between countries and regions.
- Strokes are classified based on their underlying cause (ischemic vs hemorrhagic) and further subtyped based on etiology (large vessel atherosclerosis, cardioembolism, small vessel disease, etc).
- Major risk factors for ischemic stroke include hypertension, atrial fibrillation, diabetes, smoking, obesity, high cholesterol, lack of physical activity, and a family history of stroke.
Stroke
Stroke disebabkan oleh gangguan aliran darah ke otak yang menyebabkan kerusakan jaringan otak. Stroke dapat terjadi akibat penyumbatan atau perdarahan pembuluh darah di otak. Gejalanya bervariasi mulai dari kelumpuhan separuh tubuh hingga gangguan kognitif dan bahasa. Diagnosis didasarkan pada pemeriksaan CT scan atau MRI, sedangkan pengobatannya meliputi terapi fisik dan rehabilitasi.
Ischemic Stroke-DBediako1
This document presents an outline for a presentation on ischemic stroke. It discusses the background, pathophysiology, risk factors, epidemiology, and treatment options for ischemic stroke. It summarizes evidence from studies that show combination therapy with clopidogrel and aspirin is more effective at reducing stroke risk than aspirin alone, though it increases bleeding risk with long term use. The combination was found to reduce recurrent stroke risk in the CHANCE trial without increasing hemorrhage.
Introduction to Stroke Pathophysiology And Atherosclerosis Prepared By Arlyn ...
Introduction to Stroke Pathophysiology And Atherosclerosis Prepared By Arlyn ...Arlyn Valencia, M.D.
The document outlines a PowerPoint presentation on stroke. It covers:
1. An introduction to stroke epidemiology, types, and risk factors.
2. The pathogenesis and pathophysiology of stroke, including atherosclerosis, cerebral embolism formation, effects on brain function, and cellular injury during ischemia.
3. The evaluation and management of stroke, including emergent evaluation, clinical presentations, localization techniques, treatment, and prevention.
4. It then discusses atherosclerosis, thrombosis, and the ischemic penumbra in more detail.stroke ( ischemic stroke )
Is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery and is more common than hemorrhagic stroke.
It can occur
in the carotid
artery of the
neck as well as
other arteries.
When an artery is acutely occluded by thrombus or embolus, the area of the CNS supplied by it will undergo infarction if there is no adequate collateral blood supply.
Surrounding a central necrotic zone, an ‘ischemic penumbra’ remains viable for a time, i.e. it may recover function if blood flow is restored.
CNS ischemia may be accompanied by swelling for two reasons:
● cytotoxic oedema – accumulation of water in damaged glial cells and neurones,
● vasogenic oedema – extracellular fluid accumulation as a result of breakdown of the blood–brain barrier.
In the brain, this swelling may be sufficient to produce clinical deterioration in the days following a major stroke, as a result of a rise in intracranial pressure and compression of adjacent structures.
Stridor
Stridor is an abnormal high-pitched respiratory sound caused by partial airway obstruction. It can be inspiratory, expiratory, or biphasic depending on the location and nature of the obstruction. A thorough history and physical exam seeking signs of airway distress are important to determine the underlying cause and severity. Potential causes include infections, tumors, vascular anomalies, and traumatic or congenital structural abnormalities. Treatment involves addressing the specific cause through medications, surgery, or assisting ventilation depending on the severity and location of airway compromise.
F:\Ppppppppp
This document outlines the pathophysiology, clinical presentation, diagnosis, and treatment of ischemic stroke with intravenous tissue plasminogen activator (tPA). It discusses that ischemic stroke is caused by decreased blood flow to the brain and can lead to neuronal cell death. Clinical features and differential diagnosis are provided. It recommends administering intravenous tPA within 3 hours of symptom onset based on evidence from randomized controlled trials showing improved outcomes. Extended time windows up to 4.5 hours may also be considered based on additional trials. Contraindications, management, and local stroke treatment protocols are reviewed.
Alcoholic liver cirrhosis
This case study describes a 70-year-old male patient admitted to the hospital with abdominal distention, weakness, decreased appetite, and weight loss. His medical history revealed he was an alcoholic and smoker. Diagnostic tests showed signs of liver damage. Alcoholic liver cirrhosis occurs in stages from fatty liver to inflammation and scarring of the liver. Risk factors include quantity of alcohol consumed, genetics, and malnutrition. Treatment requires stopping alcohol consumption and may include vitamins, diet, and transplantation for severe cases.
Transient ischaemic attack (TIA) investigation and management in the emergenc...
1) The document discusses the challenges in diagnosing transient ischemic attacks (TIAs) and differentiating them from stroke and other conditions with similar symptoms like syncope, seizures, migraines, and functional disorders.
2) It also discusses the importance of rapid risk assessment and investigation of TIA patients to identify underlying causes and initiate secondary prevention treatments urgently since the risk of subsequent stroke is high.
3) The optimal approach to managing and investigating TIA patients between inpatient admission versus outpatient treatment is debated, with factors like risk level, access to rapid diagnostics, and medical comorbidities influencing the decision.
Management of stroke
This slide deals with the basic description of the types of stroke and further discuss about the management in short and precise manner
Stridor by Dr. Anna
Stridor is a harsh sound produced by turbulent airflow through a narrowed or obstructed airway. It can occur in the nose, larynx, trachea, or lower respiratory tract. Stridor in infants and children is concerning as their airways are naturally narrow. Minor reductions in airway diameter can cause significant obstruction and difficulty breathing. Acute stridor may be caused by infections like croup or epiglottitis, while chronic stridor can be due to conditions like laryngomalacia. Croup is usually caused by a viral infection causing airway inflammation and narrowing. Epiglottitis is a medical emergency due to risk of complete airway obstruction. Foreign body aspiration is also a risk in
Stridor
This document discusses stridor, which is a noisy respiration caused by turbulent airflow through a narrowed airway. It defines three types of stridor based on where in the respiratory cycle the noise occurs: inspiratory, expiratory, and biphasic. Common causes of stridor in children include infections like croup as well as foreign objects. Diagnosis involves examining the timing, quality and other characteristics of the noise along with imaging tests to find the specific obstruction. Treatment depends on the underlying cause but may include medications to reduce swelling like steroids or racemic adrenaline to ease breathing.
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Transient Ischemic Attack
Transient ischemic attacks, or TIAs, are brief episodes of neurological dysfunction that last less than 24 hours and are caused by temporary blockages of blood flow to the brain. Approximately one-third of TIA patients will later experience a stroke, so having a TIA increases the risk of stroke. Symptoms of a TIA mirror those of a stroke and include weakness, vision changes, speech problems, and headaches, but are temporary. Proper medical care and management of conditions like ineffective tissue perfusion and deficient knowledge are needed to prevent progression to a stroke.
Stroke and neuroprotection
Stroke is a leading cause of death and disability worldwide. In India, stroke incidence and mortality rates are higher than in developed countries. The major risk factors for stroke include hypertension, smoking, diabetes, heart disease, and atrial fibrillation. Stroke occurs when blood flow to the brain is interrupted, causing cell death. Treatments aim to rapidly restore blood flow and protect brain cells. Thrombolysis can help dissolve clots but must be given within 3 hours, limiting its use. Neuroprotection seeks to protect brain cells and expand the time window for treatment.
Pathology+of+cerebrovascular+disease+dr+anim
This document summarizes pathology related to cerebrovascular disease. It discusses different types of strokes including ischemic, hemorrhagic, and transient ischemic attacks. Specific factors that can contribute to tissue damage in ischemic strokes are explained. Locations and appearances of infarcts over time are described. Causes and presentations of hemorrhagic strokes including those from aneurysms and arteriovenous malformations are covered.
Stridor Presentation
This document discusses the etiology and presentation of laryngeal stridor in infants and children. It defines laryngeal stridor as a high-pitched noisy breathing caused by airway obstruction from the nasal cavity to the bronchi. Stridor can be inspiratory, expiratory, or biphasic depending on the location of the obstruction. Common causes include congenital anomalies, infections like croup, trauma, extraesophageal reflux, and foreign bodies. Croup (laryngotracheobronchitis) is described as an acute viral inflammation causing subglottic edema and barking cough. Supraglottitis is a medical emergency caused by epiglottis inflammation mostly due to H.
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Pathophysio
Ischemic stroke accounts for 80% of all strokes and occurs when a blood clot blocks or plugs an artery supplying blood to the brain. This deprives neurons of oxygen and glucose, causing rapid damage. The core of damaged tissue is surrounded by an area called the ischemic penumbra where blood flow is reduced but neurons can survive for hours if reperfused. Neuronal injury is caused by excitotoxicity as glutamate accumulates, allowing calcium and other ions to enter cells and activate destructive enzymes. Two main types of cell death occur - coagulation necrosis within hours and apoptosis starting within an hour via DNA cleavage. The pathophysiology is complex with multiple factors like collateral circulation and glucose levels influencing injury progression
cerebral ischemia and infarction.pptx
Cerebral ischemia occurs when blood flow to the brain is reduced, limiting oxygen and glucose delivery. This can lead to reversible brain dysfunction or irreversible infarction. The core of an infarct sees blood flow drop below 10ml/100g/min, causing necrosis. The ischemic penumbra has blood flow of 10-20ml/100g/min, where cells face apoptosis if flow is not restored. Autoregulation and collateral circulation help maintain blood flow, but below 20ml/100g/min for over 3 minutes causes energy failure and cell damage from free radicals and acidosis. Early reperfusion can salvage penumbral tissue at risk of progression to infarction.
Paj 5103 clinical neuropahtophys ii hn10
The document discusses several topics related to brain injury and disorders. It begins by explaining the mechanisms of primary and secondary brain injury, including ischemia, cellular energy failure, excitatory amino acids, and reperfusion injury. It then discusses types of traumatic brain injury like concussions and hematomas. It also covers cerebrovascular disease and strokes, central nervous system infections like meningitis and abscesses, and chronic neurological disorders such as seizures, dementia, Parkinson's disease, and hydrocephalus.
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This document provides an overview of cerebrovascular accidents (CVAs), also known as strokes. It defines CVAs, describes the blood supply to the brain, and classifies the major types of strokes as ischemic (caused by reduced blood flow) or hemorrhagic (caused by bleeding). It discusses the causes, risk factors, clinical presentation, progression, and management of different stroke subtypes, including transient ischemic attacks, infarction, and intracerebral hemorrhage.
stroke
This document defines stroke as an acute CNS injury resulting from reduced blood flow to the brain. Strokes can be ischemic, caused by blockage of a blood vessel, or hemorrhagic, caused by rupture of a blood vessel. The main types of ischemic stroke are thrombotic, caused by clots within blood vessels, and embolic, caused by clots or debris traveling from elsewhere. Cardioembolic strokes are a type of embolic stroke where clots originate from the heart. Risk factors, signs and symptoms, treatment, and the effects of left versus right brain strokes are described. Transient ischemic attacks are also summarized.
Etiopathogenesis of stroke
1) Stroke is defined as acute neurological dysfunction caused by abnormal blood supply to the brain. The two main types are ischemia and hemorrhage.
2) Ischemia is caused by thrombosis, embolism, or decreased blood flow. Hemorrhage includes intracerebral, subarachnoid, subdural, and epidural bleeding.
3) At the cellular level, ischemia triggers an excitotoxic cascade involving glutamate, sodium/calcium influx, oxidative stress, and apoptosis, ultimately leading to cell death. Maintaining cerebral blood flow is crucial for preventing neurological injury.
Stroke
The document discusses stroke, including its types, risk factors, pathophysiology, and clinical manifestations based on the artery affected. Ischemic stroke is more common than hemorrhagic and results from blockage of an artery depriving the brain of blood flow. Clinical features vary depending on the specific artery involved, such as contralateral weakness with middle cerebral artery stroke or visual field defects with posterior cerebral artery stroke. Complications can include altered consciousness, speech/language issues, and emotional or cognitive changes.
CT in CVA
The document discusses cerebral vascular accidents (CVA or stroke). It describes the main types of ischemic stroke including those caused by cerebral atherothrombosis, cardiogenic embolism, penetrating artery disease, and other rare causes. It discusses risk factors and the clinical presentation of ischemic stroke. It then covers the pathophysiology of ischemia including the penumbra model and thresholds for irreversible tissue damage. Diagnostic imaging findings on non-contrast CT are summarized for acute, subacute and chronic stages. CT perfusion is also discussed for assessing infarct core and penumbra size to guide treatment decisions.
The central nervous system ii
The document discusses cerebrovascular diseases, which are abnormalities of the brain caused by pathologies of blood vessels. It describes the main categories of cerebrovascular diseases including thrombosis, embolism, hemorrhage and strokes. It then focuses on hypoxia, ischemia and infarction resulting from impaired blood supply as well as hemorrhages from ruptured vessels. Specific conditions discussed include global and focal cerebral ischemia, infarction, intracranial hemorrhages, vascular malformations and hypertensive cerebrovascular disease.
Vasospasm in subarachnoid haemorrhage pre finale
This document discusses cerebral vasospasm (CVS), which is an abnormal constriction of cerebral arteries following subarachnoid hemorrhage. It can lead to delayed cerebral ischemia and infarction. The document covers risk factors, pathophysiology involving oxyhemoglobin and inflammation, diagnosis using tools like transcranial Doppler and angiography, and management including prevention with calcium channel blockers, treatment of symptomatic vasospasm with balloon angioplasty, and protecting the brain from ischemia.
Cerebrovascular diseases.pptx
This document discusses cerebrovascular diseases and strokes. It defines key terms like cerebrovascular disease, thrombosis, embolism, hemorrhage, hypoxia, ischemia, and infarction. It describes the different types of cerebrovascular diseases including cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, and vascular malformations. It discusses the causes, clinical features, pathophysiology, and pathology of each condition. Hypertension is a major risk factor and can cause hypertensive hemorrhage, lacunar infarcts, and hypertensive encephalopathy.
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The document provides information on ischemic heart disease (IHD), including:
1) IHD is caused by inadequate blood supply to the heart muscle and can be due to blockages in the coronary arteries from atherosclerosis or other causes like vasospasm.
2) IHD can present as stable angina, unstable angina, myocardial infarction, or heart failure. A myocardial infarction occurs when prolonged ischemia causes death of heart muscle tissue.
3) The pathology of a myocardial infarction involves plaque rupture, thrombus formation, and complete blockage of blood flow leading to irreversible damage to heart muscle within minutes to hours.
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Stroke is a medical emergency caused by interrupted or reduced blood flow to the brain. The main types are ischemic (caused by blockage) and hemorrhagic (caused by bleeding). Risk factors include high blood pressure, atrial fibrillation, diabetes, and smoking. Symptoms depend on the affected brain region and may include paralysis, confusion, and speech problems. Diagnosis involves brain imaging and blood tests. Treatment focuses on restoring blood flow and preventing complications and recurrence through medication and lifestyle changes. Outcomes vary depending on the severity and location of brain damage.
Cns Stroke 5th Class Medstudents.
This document summarizes cerebrovascular disease and stroke. Stroke is the third leading cause of death and a common cause of disability. Imaging such as CT and MRI are used to distinguish between ischemic and hemorrhagic stroke and identify underlying vascular abnormalities. Risk factors include age, hypertension, cardiac sources of embolism, and other conditions. Treatment aims to reverse pathology, prevent complications, and reduce risk of further strokes.
Cns Stroke 5th Class.
This document summarizes cerebrovascular disease and stroke. Stroke is the third leading cause of death and a common cause of disability. Imaging such as CT and MRI are used to distinguish between ischemic and hemorrhagic stroke and identify underlying vascular abnormalities. Risk factors include age, hypertension, cardiac sources of embolism, and vascular diseases. Acute stroke is characterized by rapid onset neurological deficits localized to the brain region supplied by an occluded artery. Differential diagnosis includes tumors, infections, and seizures.
approach to a patient with stroke.pdf
The document defines various terms related to strokes, including stroke, TIA, progressive stroke, completed stroke, and hemorrhagic vs ischemic stroke. It discusses the epidemiology, risk factors, types, clinical features, investigations, and differential diagnosis of strokes. Specifically, it provides details on the clinical presentations and neurological deficits associated with occlusion of different arteries in the anterior and posterior circulations. It also outlines the objectives and modalities used to investigate a potential stroke, including non-invasive tests like CT, MRI, and Doppler ultrasound and invasive tests like angiography.
Cns Stroke 5th Class.
This document discusses cerebrovascular disease and stroke. It provides classifications and descriptions of different types of strokes including transient ischemic attacks, hemorrhagic strokes, and thrombotic vs. embolic ischemic strokes. It also summarizes the clinical assessment and presentation of strokes, differential diagnoses, pathophysiology of cerebral infarction, and general risk factors.
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This document provides an overview of the pathophysiology of ischemic stroke. It defines stroke and classifies it, discusses the concept of the ischemic penumbra where tissue is at risk of infarction, and outlines the molecular mechanisms and cascade of injury that occurs during ischemia, including edema, microvascular thrombosis, programmed cell death, and necrosis. It notes that the penumbra exists as a dynamic region where tissue has the potential for recovery if blood flow is restored in a sufficient timeframe.
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pathophysiology
- 1. Pathophysiology of Stroke Sid M. Shah, MD Assistant Residency Director Assistant Clinical Professor Department of Emergency Medicine Michigan State University East Lansing, MI
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Editor's Notes
- 1 54 54
- In an ischemic stroke lack of circulating blood …. And in a hemorrhagic stroke extravasculaar release of blood
- Some neurons are more susceptible to ischemia than others. The more common ones are listed here. The pyramidal cell layer of hippocampus and the purkinje cell layer or the cerebral cortex are most vulnerable to lack of oxygen. This is believed to be due to the fact that these neurons are rich in neurotransmitter glutamate Now I will review what happens when CBF is restored as it occurs either spontaneously or thru interventional therapy.
- Arterial occlusion causes ischemia to capillaries, arterioles and vascular walls in addition to the deleterious effects on neurons Hemorrhage called (red infarcts) result when the fragile “ischemic” or “injured” vessels rupture after sudden restoration of blood flow Vasogenic edema can also occur following a massive stroke or sudden restoration of blood flow to an ischemic area The pathophysiological basis of evolution of reperfusion hemorrhage is important to understand. The initial obstruction occurs usually at a bifurcation. The occlusion may obstruct one or both of the branches, producing ischemia of the distal tissue. When the occluding embolus is either lyses spontaneously or breaks up and migrates distally, CBF is now restored to the “injured or ischemic” arterioles. This can result in a hemorrhagic (red infarct) in what had previously been a blood less field.The area of brain which continues to be poorly perfused ends up as “Anemic infarction.”