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Patho-physiology
A. Theoretical Based
Cerebrovascular disease is a group of brain dysfunctions related to disease of the blood vessels
supplying the brain. Hypertension is the most important
cause; it damages the blood vessel lining, endothelium, exposing the
underlying collagen where platelets aggregate to initiate a repairing process
which is not always complete and perfect. Sustained hypertension
permanently changes the architecture of the blood vessels making them
narrow, stiff, deformed, uneven and more vulnerable to fluctuations in blood
pressure.
A stroke is caused by the interruption of the blood supply to the brain, usuallybecause a blood vessel
bursts or is blocked by a clot. This cuts off the supplyof oxygen and nutrients, causing damage to the brain
tissue.
The effects of a stroke depend on which part of the brain is injured and how severely it is affected. A
very severe stroke can cause sudden death. The 1990 Global Burden of Disease (GBD) study provided the
first global
estimate on the burden of 135 diseases, and cerebrovascular diseases
ranked as the second leading cause of death after ischemic heart disease.
During the past decade the quantity of especially routine mortality data has
increased, and is now covering approximately one-third of the
world’s population. The increase in data availability provides the possibility
for updating the estimated global burden of stroke.
Modifiable: Non-modifiable:
Carotid stenosis
Compensatory rennin-
Adequate or Catecholamine
aldosterone, ADH
increased blood Increased SVR compensatory
volume release
Decreased Cardiac
Increased Blood
output, Decreased
pressure
ejection fraction
Decreased tissue
perfusion
Impaired cellular
metabolism