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Pathophysiology and Etiology

Defnitions

Stroke

A stroke (apoplexy ) is the sudden onset o weakness, numbness, paralysis,slurred speech, aphasia, problems with vision and other maniestations o a

sudden interruption o blood ow to a particular area o the brain. The

ischemic area involved determines the type o ocal defcit that is seen in the

patient.

Transient Ischemic Attack (TIA)

A TA is similar to a stroke, but the interruption o blood ow is temporary.

 The clot resolves sporadically. The symptoms are relatively the same as a

stroke but last less than !" hours, whereas stroke symptoms persist or

#reater than !" hours.

$auses o %troke

 The primary pathophysiolo#y o stoke is an underlyin# heart or blood vessel

disease. The secondary maniestations in the brain are the result o one or

more o these underlyin# diseases or risk actors. The primary patholo#ies

include hypertension, atherosclerosis leadin# to coronary artery disease,

dyslipidemia, heart disease, and hyperlipidemia. The two types o stroke that

result rom these disease states are ischemic and hemorrha#ic strokes.

&on'reducable isk actors

*. The possibilities o a stroke occurrin# increases with a#e. or every

decade (*+ years) over the a#e o , the possibility o a stroke

occurrin# doubles. A patient that is - years o a#e has our times the

risk o havin# a stroke compared to someone who is years old. all

strokes that occur in people, appro/imately 01 occur in those who are

over the a#e o 0.

!. Those who have had a stroke or TA are more likely to have anotherstroke or transient ischemic attack. Appro/imately 0+1 o strokes occur

in patients who have had a previous TA.

2. %trokes #enerally occur more oten in males than emales, until the

a#e o 3 ater a#e the risk is the same or both men and women.

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". The occurrence o stroke is hi#her in the Arican'American, 4ispanic,

and Asian'5acifc slander population than in other ethnical

back#rounds.

. 5atients who have immediate amily members (mother, ather, or

siblin#) that have had a stroke or TA are at #reater risk or havin# a

stroke or TA than those who do not have a amily history with these

events.

0. 5eople who have diabetes are also at #reater risk o stroke that those

without diabetes.educable isk actors

*. 6ower your hi#h blood pressure. 4ypertension (hi#h blood pressure) is

the number one most treatable risk actor or stroke. 7ou can help

prevent a TA or stroke considerably by workin# to lower your blood

pressure.

!. 6owerin# cholesterol levels may decrease the risk o stroke. 8y workin#to lower your cholesterol, you can help prevent a TA or stroke.

2. %top smokin#. you stop smokin#, you can decrease your risk or

stroke to that o a non'smoker within two to fve years.

". 9ana#ement o heart disease and diabetes may also help to decrease

your risk o stroke.