PATHOPHYSIOLOGY

A. Anatomy and Physiology

The brain is one of the largest and
most complex organs in the human
body.

It is made up of more than 100 billion

nerves that communicate in trillions of
connections called synapses.

The brain is made up of many specialized areas that work together:

• The cortex is the outermost layer of brain cells. Thinking and voluntary
movements begin in the cortex.
• The brain stem is between the spinal cord and the rest of the brain. Basic
functions like breathing and sleep are controlled here.
• The basal ganglia are a cluster of structures in the center of the brain. The
basal ganglia coordinate messages between multiple other brain areas.
• The cerebellum is at the base and the back of the brain. The cerebellum is
responsible for coordination and balance.

The brain is also divided into several lobes:

• The frontal lobes are responsible for problem solving and judgment and motor
function.
• The parietal lobes manage sensation, handwriting, and body position.
• The temporal lobes are involved with memory and hearing.
• The occipital lobes contain the brain's visual processing system.

B. Overview of the Disease

Encephalopathy is a term that means brain disease, damage, or malfunction.
Encephalopathy can present a very broad spectrum of symptoms that range from mild,
such as some memory loss or subtle personality changes, to severe, such
as dementia, seizures, coma, or death. In general, encephalopathy is manifested by an
 altered mental state that is sometimes accompanied by physical manifestations (for
example, poor coordination of limb movements).

The term encephalopathy, in most cases, is preceded by various terms that describe the
reason, cause, or special conditions of the patient that leads to brain malfunction. For
example, anoxic encephalopathy means brain damage due to lack of oxygen, and hepatic
encephalopathy means brain malfunction due to liver disease.

C. Schematic diagram

Encepalopathy
Malignant cellular survival
Predisposing Factors: ETIOLOGY:
Precipitating Factors:
 Age (61 years old) May be caused by one or several
 Diet (High fat diet)
factors stated
 Sedentary Lifestyle

Rapid or sudden increase in blood

pressure

The autoregulatory systems of the

brain is overwhelmed and
malfunctions

loss of blood-brain barrier integrity

Increased cerebral perfusion

Clinical manifestations Client Manifestations

 Severe headache Fluid exudes into the brain 

 Alterations in
consciousness
 Personality changes
 Alteration in mental status
 Irritability
 Vomiting
 Seizures
 Visual Alterations
(blindness, blurring, color
blindness)
 Poor coordination of limbs
 Diagnostic exams:
CT scan
ECG

Nursing management Medical management:

 Administer medications as 
prescribed
 Administer Intravenous therapy
as prescribed

PROGNOSIS

The neurologic dysfunction and MRI findings are often reversible with BP control;
as noted above, providers must use caution to avoid rapid reduction of BP to
reduce permanent neurologic problem In general, the diagnosis of hypertension
predicts increased long-term morbidity and mortality for patients; however for any
individual patient, the prognosis will depend on the treatment options and
prognosis of the underlying disease process

Ref: B. Bar, in Primer on Cerebrovascular Diseases (Second Edition), 2017

In general, the diagnosis of hypertension predicts increased long-term

morbidity and mortality for patients; however for any individual patient,
the prognosis will depend on the treatment options and prognosis of the
Final
underlying disease diagnosis: Encephalopathy secondary to
proces
Cerebrovascular disease