Pathological Causes of Stroke and Ischimia BY D' ZALLI

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Pathological Causes of Stroke and Ischimia
BY D. ZALLI
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What is Stroke?

• Stroke is the third leading cause of death and
  the number one cause of disability in the United
  States.  A stroke or cerebrovascular accident
  (CVA) occurs when the blood supply to part of the
  brain is suddenly interrupted or when a blood
  vessel in the brain bursts, spilling blood into
  the spaces surrounding brain cells. Brain cells
  die when they no longer receive oxygen and
  nutrients from the blood or there is sudden
  bleeding into or around the brain

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Types of Stroke

• Ischemic stroke
• An ischemic stroke occurs when an artery
  supplying the brain with blood becomes blocked,
  suddenly decreasing or stopping blood flow to the
  brain. Eighty percent of all strokes fall into
  this category
• It usually results from either a thrombus or an
  embolus.   A thrombotic stroke or cerebral
  thrombosis occurs when a brain artery becomes
  blocked by a blood clot developing directly in
  the brain artery.  flow. 

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• Such clots usually develop at sites of
  arteriosclerosis.  In embolic stroke or cerebral
  embolism, a blood clot develops in another
  artery, or even the heart, and travels to the
  brain where it becomes lodged in a brain artery
  and prevents continued blood flow.  In either
  case, oxygen rich blood is prevented from
  reaching areas of the brain beyond the blockage. 
  When deprived of oxygen, brain tissue quickly
  begins to die resulting in a stroke or cerebral
  infarction. 

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• Hemorrhagic Stroke or bleeding stroke is caused
  by the ruptured blood vessels
• Two types of weakened blood vessels usually cause
  hemorrhagic stroke aneurysms and arteriovenous
  malformations (AVMs).
• An aneurysm is a ballooning of a weakened region
  of a blood vessel.  If left untreated, the
  aneurysm continues to weaken until it ruptures
  and bleeds into the brain

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• An arteriovenous malformation (AVM) is a cluster
  of abnormally formed blood vessels. Any one of
  these vessels can rupture, also causing bleeding
  into the brain

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• Transient ischemic attacks, also called TIAs, are
  minor or warning strokes.
• the obstruction (blood clot) occurs for a short
  time and tends to resolve itself through normal
  mechanisms.
• Even though the symptoms disappear after a short
  time, TIAs are strong indicators of a possible
  major stroke. Steps should be taken immediately
  to prevent a stroke.

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Location of Stroke

• Each side of your brain controls the opposite
  side of your body, so a stroke affecting one side
  will result in complications in the opposite side
  of the body.
• If the stroke occurs in the left side of the
  brain, the right side of the body and the left
  side of the face may be affected. There may be
  paralysis on the right side, speech and language
  problems, memory loss, and a slow, deliberate
  manner of acting.

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• There may be paralysis on the right side, speech
  and language problems, memory loss, and a slow,
  deliberate manner of acting
• Right side - If the stroke occurs in the right
  side of the brain, the left side of the body and
  the right side of the face may be affected. There
  may be paralysis on the left side, vision
  problems, memory loss and a quick, curious manner
  of acting

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Atherosclerosis major cause of stroke

• Atherosclerosis occurs when fatty substances,
  cholesterol, cellular waste products, calcium,
  and other materials build up on the inside lining
  of the arteries. The buildup is more likely to be
  in parts of the artery that have been injured. It
  usually occurs where the artery bends or
  branches. Once plaque builds up, it may cause the
  cells in the artery lining to make chemicals that
  cause more plaque buildup.
• A stroke from atherosclerosis is classified as an
  ischemic stroke, which means it is caused when
  the blood supply to the brain is interrupted.
  Atherosclerosis is a thickening or hardening of
  the arteries. It can partially or totally block
  the flow of blood through an artery to the brain.
  The brain cells then die from lack of oxygen. The
  products released when cells die cause swelling
  in the brain. Since the skull doesn't allow much
  room for expansion, this swelling can damage the
  brain tissue even further.

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Problems resulting from plaques

• Two problems can result from the plaque.
• First, the blood vessel can become narrow,
  preventing blood flow to the area served by the
  artery. For example, if an artery to the heart
  becomes 80 to 90 blocked, a person can develop
  chest pain.
• Second, the plaque can rupture and send a blood
  clot streaming through the artery. A blood clot
  that goes to other parts of the body is called an
  embolus.

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• The embolus can be deposited in a smaller area of
  the artery or in another artery, completely
  cutting off the blood supply. This blockage can
  cause a heart attack, stroke, pulmonary embolus,
  or other serious medical problem

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• 1 lumen (opening)2 plaque3 artery wall

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What is Ischimia Heart Disease ?

• It's the term given to heart problems caused by
  narrowed heart arteries. When arteries are
  narrowed, less blood and oxygen reaches the heart
  muscle. This is also called coronary artery
  disease and coronary heart disease. This can
  ultimately lead to heart attack.

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• Ischimi can lead to Angina.
• Angina is chest pain or discomfort that occurs
  when your heart is not getting enough blood.
• Heart attack. A heart attack happens when a blood
  clot suddenly cuts off most or all blood supply
  to part of the heart. Cells in the heart muscle
  that do not receive enough oxygen-carrying blood
  begin to die. This can cause permanent damage to
  the heart muscle.

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• Over time, CAD can weaken your heart muscle and
  contribute to
• Heart failure. In heart failure, the heart is not
  able to pump blood to the rest of the body
  effectively. Heart failure does not mean that
  your heart has stopped or is about to stop
  working. But it does mean that your heart is
  failing to pump blood the way that it should.
• Arrhythmias. Arrhythmias

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