1) Ischemic stroke, which accounts for about 87% of stroke cases, occurs when blood flow to the brain is interrupted, depriving brain cells of oxygen. 2) The main types of ischemic stroke are thrombotic, caused by blood clots; embolic, caused by clots traveling from other parts of the body to the brain; and artery to artery embolism. 3) Common risk factors for ischemic stroke include atherosclerosis, atrial fibrillation, heart attack, and hypercoagulable disorders.

1. CLINICAL PICTURES &TYPES of stroke
Presented By
Mr. Pradeepsingh N B
Asst. Professor & HODOf Medical Surgical Nursing
KLE’SInstituteOf Nursing Sciences Ankola

2. World Stoke Day
• The theme for World Stroke Day 2023 is
"Together we are Greater Than Stroke."
The theme for World Stroke Day 2023 is "Together we are Greater Than Stroke."

3. Introduction
• A stroke, sometimes called a brain attack, It
occurs when something blocks blood supply to
part of the brain or when a blood vessel in the
brain bursts. In either case, parts of the brain
become damaged or die.

4. Statistic related to stoke
• World wide stroke is the 2nd leading cause of
mortality rate & 3rd leading cause of disability.
• Globally, 70% CVA and 87% of both CVA
related mortality rates & Disability adjusted
life year(DALY) it occur in low & middle
income territories.

5. Cont..
• In the United States, about 795,000 people
suffer a stroke each year. Someone has a stroke
every 40 seconds, and every 4 minutes
someone dies from stroke. There are more than
140,000 deaths each year from stroke.
Statistics show that about 40% of stroke deaths
occur in males and 60% in females.

6. Cont..
• Stroke is a significant global health problem
and a major cause of mortality and morbidity
in developed countries and increasingly in
low-middle income countries (LMICs).
• Life expectancy in India has recently 50 to 60
years of age, leading to an increase in age-
related, non-communicable diseases including
stroke cases also may increased.
• India’s fourth leading cause of death and fifth
leading cause of disability.

7. DEFINITION
Stroke:
•Also known as cerebrovascular Accident (CVA)
•Results in the sudden death of the brain cells
due to the:
•O2 deficiency when the blood flow to the brain
is lost by obstruction/ rupture of cerebral
arteries, when supplies to the brain.
•Loss of neurological functions, lasting more
than 24hours or leading to death.

8. TIA
• CVA is distinguished from Transient Ischemic
Attack
• TIA: It is defined as a temporary interruption
of blood supply to the brain may last for few
minutes to 24hours with no evidence of
infarction.

12. TYPES OF STROKE
TYPES OF STROKE
ISHEMIC STROKE
HEMORRHAGIC
STROKE

16. Etiology of Ischemic stroke
Thrombotic:
• Lacunar stroke
• Large vessels thrombosis
• Hypercoagulable disorders
Artery to artery:
• Carotid bifurcation
• Aortic arch

17. Cont…
Cardioembolic:
• Atrial fibrillation
• MI
• Mural thrombus
• Bacterial endocardiatitis
• Mitral stenosis
• Paradoxical embolus

18. Thrombotic stroke
• Atherosclerosis: is the most common
pathology leading to thrombotic occlusion of
blood vessels.
• Lacunar stroke:
• Accounts for 20% of all stroke
• Results from occlusion of small deep
penetrating arteries of the brain.
• Thrombosis leads to small infarcts known as
lacunes.
• Clinically manifested as lacunar syndrome

19. Embolic stroke
• Cardioembolic stroke:
• Embolus from the heart gets lodged in
intracranial vessels.
• Arterial fibrillation is the most common cause.
• Others: MI, Prosthetic valves, RHD
• Artery to artery embolism:
• Thrombus formed on atherosclerotic plaque
gets embolised to intracranial vessels.

20. Hemorrhagic stroke
• Explosive entry of blood into the brain
parenchyma structurally disrupts neurons.
• White matter fibre tracts are split.
• Immediate cessation of neural function.
• Expanding hemorrhage can acts as a mass
lesion and cause further progression of
neurological deficit.
• Large hemorrhage can cause transtentorial
coning of rapid death.

21. Hemorrhagic stroke
• When abnormal bleeding occurs into the
extravascular areas of the brain. Results from
the rupture of cerebral blood vessels or
trauma.
• Affecting about 13% of all stroke cases.
• The most common causes are:
Hypertension(30-40%), cerebral amyloid
angiopathy (10-30%), anticoagulations(1-2%)
& vascular structural lesions (3-8%)

22. Intracerebral hemorrhage:
• Results of chronic Hypertension.
• Small arteries are damaged due to Hypertension
• In advanced stages vessels wall is disrupted &
leads to leakage.
Subarachnoid hemorrhage:
• Most common cause is rupture of saccular or
berry aneurysms.
• Other causes include arteriovenous
malformation, angiomas, mycotic aneurysmal
rupture, etc
• It associated with extremely severe headache.

28. ISCHEMIC STROKE