Pathophysiology of Ischemic Stroke

Predisposing Factors: Precipitating Factors:

1) Age ۞ 1) Hypertension ۞

2) Heredity ۞ 2) Cigarette Smoking

3) Race 3) Diabetes Mellitus ۞

4) Sex ۞ 4) Carotid or other Artery Disease ۞

5) Prior Stroke, TIA or heart attack ۞ 5) Atrial Fibrillation

6) Socioeconomic Factors ۞ 6) Other heart disease

7) Sickle cell disease
8) Undesirable levels of cholesterol
9) Poor diet ۞
10) Physical inactivity
11) Obesity
12) Alcohol Abuse
13) Drug Abuse

Atherosclerosis

Formation of Plaque deposits

Thrombosis

Occlusion by major vessel

CEREBRAL
HYPOPERFUSION

Impaired distribution of
oxygen and glucose

Tissue hypoxia and cellular

starvation

Cerebral Ischemia

Initiation of ischemic
cascade
 TRANSIENT ISCHEMIC
ATTACK

Cerebral edema

Vascular Congestion

Compression of tissue

Increased intracranial

Impaired perfusion and

function

CEREBRUM has 2 Hemispheres CEREBELLUM BRAINSTEM

Parietal Lobe Temporal Lobe Occipital Lobe  Muscle  Heart Rate

Frontal Lobe
Coordination  Blood Pressure
 Balance  Breathing
Problem in Problem in  Hearing  Vision  GI function
 Movement  Sensory  Smell  Consciousness
 Executive Information  Memory
Function  Languages
 Facial
Recognition
 If MANAGED: If NOT managed:

Palliative care-
Frequent vital sign and
neurovital signs, intubation, Continued insufficiency of
mechanical ventilation, blood flow
vasodilators, osmotic
diuretics, ventriculostomy,
ICP monitoring Further compression of
tissues

Poor cerebral perfusion

Coma

Poor improvement
Cerebral Death

POOR PROGNOSIS
Cessation of physiologic
functions
(Main Body System)

Systemic Failure

DEATH