BIOLOGY I Report

WHAT IS STROKE?Brief Description:…, previously known medically as a cerebrovascular accident (CVA), is the

rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain.

…, many now prefer alternative concepts, such as brain attack and acute ischemic cerebrovascular syndrome (modeled after heart attack and acute coronary syndrome respectively.

…, can be due to ischemia caused by blockage (thrombosis, arterial embolism), or a hemorrhage.

…, as result, the affected area of the brain is unable to function, which might result to lifetime paralysis.

…, there are many risk factors and symptoms that must be considered, subtypes as well.

Stroke Epidemiology…

…, Stroke is currently the second leading cause of death in the entire world population, ranking after heart disease and before cancer, causing 10% deaths worldwide.

…, the incidence of strokes occur 95% on people aging 45+, and ⅔ of this 95% occur on over 65+ of age.

…, men are 25% more likely to suffer stroke than women, yet 60% of deaths from stroke occur in women (factors: prenancy, childbirth menopause and the treatment thereof).

History…

…, Hippocrates first described the phenomenon of sudden paralysis that is often associated with ischemia.

…, Apoplexy, from the Greek word meaning “struck down with violence”, first appeared in Hippocratic writings to describe this phenomenon.

…, In 1658, in his Apoplexia, Johann Jacob Wepfer (1620-1695) identified the cause of hemorrhagic stroke when he suggested that people who died of apoplexy had bleeding in their brains.

…, Rudolf Virchow first described the mechanism of thromboembolism as a major factor

TYPES… Ischemic Stroke;

Hemorrhagic Stroke;

What is Ischemic Stroke?...…, simply the lack of blood flow

…, caused by an obstruction in an artery, generally one of the carotid arteries, the major arteries in the neck that carry oxygen-rich blood from the heart to the brain

…, the path to this stroke begins when arteriosclerosis develops in one of the carotid arteries

…thrombosis... the formation of a clot…embolus… traveling clot

< CT scan slice of the brain showing a

right-hemispheric ischemi

c stroke.

< CT scan slice of the brain showing an

intracranial hemorrhagic stroke.

What is Hemorrhagic Stroke?

…, is the accumulation of blood anywhere within the skull vault.

…, result in tissue injury by causing compression of tissue from an expanding hematoma or hematomas, which can distort and injure tissue, for which the pressure may lead to a loss of blood supply to affected tissue.

4 reasons this might happen…

Thrombosis (obstruction of a blood vessel by a blood clot forming locally)

Embolism (obstruction due to an embolus from elsewhere in the body)

Systemic hypoperfusion (general decrease in blood supply, e.g., in shock)

Venous thrombosis

How does it feel?...

Symptoms of a stroke…

Altered smell, taste, hearing or vision(total or partial) Ptosis (drooping of eyelid) and weakness of ocular muscles Decreased reflexes Decreased sensation and muscle weakness of the face Balance problems and nystagmus Altered breathing and heart rate Inability to turn head on one side Weakness of tongue aphasia (difficulty with verbal expression, auditory

comprehension) Memory deficits Disorganized thinking, confusion, hypersexual gestures Trouble walking Altered movement coordination Disequilibrium Loss of consciousness, headache, and vomiting

Diagnosis… A neurological examination

CT scans (most often without contrast enhancements)

MRI scans

Doppler ultrasound

Arteriography

Imaging…For diagnosing ischemic stroke in the

emergency setting:

CT scans (without contrast enhancements)

sensitivity= 16%specificity= 96%

MRI scansensitivity= 83%specificity= 98%

For diagnosing hemorrhagic stroke in the emergency setting:

CT scans (without contrast enhancements)

sensitivity= 89%specificity= 100%

MRI scansensitivity= 81%specificity= 100%

For detecting chronic hemorrhages, MRI scan is more sensitive.

Do you know that…

Fernando Poe Jr. died in stroke?...The official cause of death was

thrombosis with multiple organ failure. Hence, his death is a sort of ischemic stroke.

Reynaldo Alfredo R. Hipolito (most well-known screenname Palito) also died in stroke?...

Also, Luther Vandross?...

Modifiable risk factors… High blood pressure (hypertension) Atrial fibrillation High blood cholesterol levels High blood sugar levels (diabetes) Cigarette smoking (active and passive) Heavy alcohol consumption and drug

use Lack of physical activities Obesity Red meat consumption

References… http://en.wikipedia.org/wiki/Stroke

Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved.

http://www.strokecenter.uci.edu/whatisastroke.shtml

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