Pathophysiology, Etiology, Clinical manifestations, Treatment of Stroke, Ischemic stroke, Hemorrhagic stroke, Transient Ischemic stroke, Stenting, Clamping,Coiling, Thrombectomy, D.Pharm,B.pharm

1. CENTRAL NERVOUS SYSTEM
DISORDERS
STROKE
A PRESENTATION BY:
AMAN GUPTA
LECTURER
GCRG COLLEGE OF PHARMACY, LUCKNOW
NCJ @ AMAN

2. DEFINITION
A stroke happens when blood flow to a part of the brain stops.
It is sometimes called a "brain attack”.
Blood supply to a part of the brain is interrupted or severely reduced.
Brain tissue does not get enough oxygen and nutrients.
Brain cells begins to die.
STROKE
A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of
oxygen and nutrients. Within minutes, brain cells begin to die.
OR NCJ @ AMAN
A stroke is a rapid loss of brain function due to the disturbance in the blood supply to brain.

4. TYPES OF STROKES
Stroke is classified as follows:
STROKE
ISCHEMIC STROKE HEMORRHAGIC STROKE TRANSIENT ISCHEMIC ATTACK
1. Ischemic Stroke: Ischemic stroke is the most common form of stroke. About 80 percent of strokes are ischemic strokes.
This type of stroke is caused by = blockages or narrowing of the arteries that provide blood to the brain = resulting in
ischemia: severely reduced blood flow. NCJ @ AMAN
2. Haemorrhagic Stroke: Haemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain haemorrhages
can result from many conditions that affect your blood vessels. These include: (a)Uncontrolled high blood pressure
(hypertension) .(b)Overtreatment with anticoagulants (blood thinning medications). (c)trauma.(d) aneurysms (weaknesses in
blood vessel walls).
3. Transient Ischemic Attack (TIA): TIAs are different from the both kinds of stroke because the flow of blood to the brain is
only briefly interrupted. A transient ischemic attack (TIA) is sometimes also known as a ministroke.

5. ETIOLOGY OF STROKE
Stroke can be caused due to:
• A stroke may be caused by a blocked artery (ischemic stroke).
• The leaking or bursting of a blood vessel (haemorrhagic stroke).
• Some people may experience only a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA) that
doesn't cause permanent damage.
The different types of strokes have different causes. However, stroke is more likely to affect people if they have the following
risk factors: NCJ @ AMAN
 Being overweight.
 Hypertension and high cholesterol.
 Being aged 55 years or older.
 A personal or family history of stroke.
 An inactive lifestyle a tendency to drink heavily, smoke, or use illicit drugs.
 Any major brain injury or trauma.

6. PATHOPHYSIOLOGY OF STROKE
Brain uses about one quarter of the body's energy supply. Brain uses glucose as for energy metabolism. Glucose metabolism
leads to conversion of adenosine diphosphate (ADP) into adenosine triphosphate (ATP).
A constant supply of ATP is needed to maintain neuron (nerve cell) activity.
Ischemic stroke occurs due to decrease in blood supply to part of the brain, initiating the ischemic mechanism.
Brain tissues get injured after 60 to 90 seconds of ischemia or less oxygen supply.
Within 3 hours of ischemia, brain tissues injured irreversibly leads to death of tissue.
Atherosclerosis reduces the diameter of blood vessels by farming plaque which reduces blood supply to the brain.
Reduced cerebral blood flow.
STROKE
NCJ @ AMAN

7. CLINICAL MANIFESTATIONS OF STROKE
• Trouble with speaking and understanding: Patient may experience confusion. There may be a slurring of speech or he
may feel difficulty in understanding speech.
• Paralysis or numbness of the face, arm or leg: Patient may develop sudden numbness, weakness or paralysis in facial
muscles, arm or leg. This often happens just on one side of patient body.
• Visual effects: Patient may suddenly have blurred or blackened vision in one or both eyes.
• Headache: A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness may
indicate that person is having a stroke.
• Trouble with walking: Patient may stumble or experience sudden dizziness, loss of balance or loss of coordination.
NCJ @ AMAN

8. DIAGNOSIS OF STROKE
• MRI scan.
• CT scan.
• Cerebral angiogram: To get a detailed look at the arteries in the neck and brain.
• Carotid ultrasound: A carotid ultrasound, also called a carotid duplex scan, can show fatty deposits (plaque) in your
carotid arteries, which supply the blood to your face, neck, and brain.
• Echocardiogram: It can find the source of clots in the heart. these clots may travel to brain and can cause a stroke.
NCJ @ AMAN

9. TREATMENT OF STROKE
Treatment for stroke depends on the type of stroke:
Ischemic stroke and TIA: Since a blood clot or blockage in the brain causes these stroke types,
they're largely treated with similar techniques. They can include:
• Clot-breaking drugs: Examples: Tissue plasminogen activator (TPA) or Alteplase IV
• Mechanical thrombectomy: During this procedure, a doctor inserts a catheter into a large
blood vessel inside your head. They then use a device to pull the clot out of the vessel. This
surgery is most successful if it's performed 6 to 24 hours after the stroke begins.
• Stents: If a doctor finds where artery walls have weakened, they may perform a procedure to
inflate the narrowed artery and support the walls of the artery with a stent.
• Surgery: In the rare instances that other treatments don't work, surgery can remove a blood clot
and plaques from the arteries.

11. TREATMENT CONTINUED……….
Haemorrhagic stroke: Strokes caused by bleeds or leaks in the brain require different treatment strategies.
Treatments for haemorrhagic stroke include:
• Medications: Medicines are given to make a blood clot. NCJ @ AMAN
• Coiling: During this procedure, doctor guides a long tube to the area of haemorrhage or weakened blood
vessel. They then install a coil-like device in the area where the artery wall is weak. This blocks blood flow
to the area, reducing bleeding.
• Clamping: During imaging tests, doctor may discover an aneurysm(weakness in blood vessel walls) that
hasn't started bleeding yet or has stopped. To prevent additional bleeding, a surgeon may place a tiny
clamp at the base of the aneurysm. This cuts off blood supply and prevents a possible broken blood vessel
or new bleeding.

13. THANK YOU
NCJ @ AMAN