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Mechanisms that Produce a Stroke - PowerPoint PPT Presentation


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Mechanisms that Produce a Stroke. Blockage of an artery (80% of strokes) -- causes ischemia (inadequate blood flow) This deprives the brain of oxygen and glucose, and slows waste removal -- affected brain tissue functions abnormally or stops

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Presentation Transcript
slide1

Mechanisms that

Produce a Stroke

  • Blockage of an artery (80% of strokes)
    • --causes ischemia (inadequate blood flow) This
    • deprives the brain of oxygen and glucose, and
    • slows waste removal
    • --affected brain tissue functions abnormally or stops
    • functioning, and will die if ischemia persists
  • Rupture of an artery (20% of strokes)
  • --causes hemorrhage within or around the brain. This
  • distorts, compresses, and tears surrounding tissue

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Lumen

slide2

Stroke Risk Factors

Relationship to pathology

Directly or indirectly promote conditions that ‘encourage’ blockage or rupture of arteries supplying the brain:

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  • Development of atherosclerotic plaque
  • Thrombus formation in heart or cerebral arteries
  • Physical stress and direct damage to walls of
  • large and small arteries

Lumen

slide3

Stroke Risk Factors

Behaviors / Lifestyles

‘Who We Are’

Medical Conditions

(treatable/controllable)

Age

Gender

Race/Ethnicity

Family History

Prior Stroke/TIA

Cigarette Smoking

Physical Inactivity

Excess Alcohol Use

Obesity

Hypertension

Heart Disease

Myocardial Infarction

Atrial Fibrillation

Diabetes Mellitus

Hyperlipidemia

Carotid Stenosis

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Lumen

slide4

Stroke Risk Factors

Behaviors or Lifestyles

  • Cigarette Smoking
    • Increases risk about 1.5X
    • The heavier the smoking, the greater the risk
    • 5 years after quitting, risk matches that for nonsmokers
  • Physical Inactivity
    • Sedentary lifestyle is independent risk factor
    • (30 min. moderate-to-vigorous daily exercise recommended)
  • Excessive Alcohol Consumption
    • ≥ 5 drinks/day and binge drinking
  • Obesity
    • Body mass index ≥ 30 doubles risk

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Lumen

slide5

Stroke Risk Factors

Medical conditions: treatable or controllable

  • Hypertension
    • Blood pressure ≥ 140/90 mm Hg for extended periods
  • Heart Disease
    • Myocardial Infarction
    • Atrial Fibrillation
  • Diabetes Mellitus
    • Fasting plasma glucose ≥ 126 mg/dL
  • Hyperlipidemia
    • Total cholesterol ≥ 240 mg/dL accelerates atherosclerosis
  • Carotid Artery Stenosis
    • ≥ 70% narrowing of the carotid artery in the neck
  • Hypertension is the most significant treatable risk factor!

increase risk of thrombus formation

in heart, and thus embolic strokes

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slide6

Stroke Risk Factors

Unmodifiable conditions: ‘Who we are’

  • Age
    • Risk of stroke doubles every 10 years after age 55
  • Gender
    • Women’s first strokes occur when they are older
  • Race/Ethnicity
    • African-Americans 60% more likely to have a stroke,
    • and twice as likely to die compared to other groups
  • Family History
    • First-degree relative with stroke
    • Inherited defects influencing blood clotting
  • Previous Stroke or TIA
    • 1:6 ischemic stroke survivors has another stroke in 2 yrs
    • Having a TIA increases the chances of stroke 10 times

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Lumen

slide7

plaque

Basilar Artery

atherosclerotic plaque narrows lumen ( )

slide8

Aorta - Atherosclerosis

Numerous ulcerated plaques

slide9

Carotid Bifurcation

atherosclerotic plaque and thrombus

Thrombus on

plaque surface

plaque

Thrombus on

plaque surface

slide10

Embolus Plugging Artery

Piece of thrombus that traveled from heart

Arterial wall

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Lumen

Plugged lumen

slide11

Intracerebral Hemorrhage

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Lumen

Clotted

blood

slide12

Intracerebral Hemorrhage

CT Scan - 3 Hours after onset of symptoms

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