If not managed AccumulationPredisposing Factors: Good the the ventricles Increased passageway ICP Obstruction of CSF in ventricles Formation

of small and large clots metabolism by mitochondria Anaerobic Cerebral Ischemia Blood seeps intoprognosis > 60 Initiation of ischemic cascade If managed: Tissue Impaired distribution of oxygen Vasospasm of tissue Precipitating Factors: cellular starvation and CEREBRAL HYPOPERFUSION and glucose arteries hypoxia and Ventricles dilate behind the point of obstructionLodgesml hemorrhage < 30 ml hemorrhage ml hemorrhage unto other cerebral arteries 30-60 1) Age tomy, VP shunt, ICP Monitoring 1) Hypertension 2) Heredity SCHEMATIC PATHOPHYSIOLOGY OF CVA Smoking 2) Cigarette 3) Race Production Meliitus Poor prognosis 3) Diabetes of oxygen free radicals and other reactive oxygen spe Intermediate prognosis 0100090000037800000002001c00000000000400000003010800050000000b0200000000050000000c023808f609040000002e0118001c000000fb021000070000000000bc02000 4) Sex 000000102022253797374656d0008f6090000a2afc7c42051110004ee8339e8b342040c020000040000002d01000004000000020101001c000000fb02ceff00000000000090010000 4) Carotid or other Artery Disease 5) Prior Stroke, TIA or heart attack 00000740001254696d6573204e657720526f6d616e0000000000000000000000000000000000040000002d010100050000000902000000020d000000320a2d00b00001000400b0 5) Atrial Fibrillation 000000a60a340820001600040000002d010000030000000000 6) Socioeconomic Factors 0100090000037800000002001c00000000000400000003010800050000000b0200000000050000000c023808f609040000002e0118001c000000fb021000070000000000bc02000 6) Other heart disease 000000102022253797374656d0008f6090000a2afc7c42051110004ee8339e8b342040c020000040000002d01000004000000020101001c000000fb02ceff00000000000090010000 7) Sickle cell disease 00000740001254696d6573204e657720526f6d616e0000000000000000000000000000000000040000002d010100050000000902000000020d000000320a2d00b00001000400b0 000000a60a340820001600040000002d010000030000000000 8) Undesirable levels of cholesterol 9) Poor diet 10) Physical inactivity 11) Obesity 12) Alcohol Abuse 13) Drug Abuse

1 2

dependent If of metalloprotrease process Transient Ischemic Attacknot managed Release acid and 3 Acidosis Failure of energyofsustains triphosphatase cerebral damage Break productionBrain calcium energy depletion Failuredown of Influxadenosine an irreversibleblood vessel endothelium of pumping) Damage to the Unrelieved obstruction Generates Metabolic ReleaseIf managed:collagen, hyaluronicglutamateother elements of connective tissue n of brain tissues will the circulation not occur Further of Prognosis and nuclear calcium-dependent enzymes) Guardedexcitatory(ion (zinc andmaterial large amounts ofproteins, lipidsneurotransmitter lactic acid e for return of CSF in Guarded Prognosis Activates enzymes that digest cell -t-PA (urokinase, streptokinase) Failure of mitochondria -calcium channel blockers

Cerebral edema Compression of tissue Increased intracranial pressure Vascular Congestion Structural integrity loss perfusion and function 4vessels Impaired of brain tissue and blood Breakdown of the protective Blood Brain Barrier

Anterior cerebral artery Posterior CerebraI Artery Internal Carotid Artery Vertebrobasilar System Anteroinferior Cerebellar Posteroinferior cerebellar iddle Cerebral Artery

Cerebellum and brain stem Cerebellum Frontal Lobe Occipital lobe; anterior and medialophthalmic, PCA, anterior choroidal, ACA, MCA portion of temporal lobe Branches into al, parietal and temporal lobes, basal ganglia

Cerebellum

Poor improvement Poor cerebral perfusion

Poor Prognosis

If not managed: Further Cerebral Death tissues compression of Coma Loss of neural feedback mechanisms Continued insufficiency of blood flow

If managed: Palliative carens, intubation, mechanical ventilation, vasodilators, osmotic diuretics, ventriculostomy, ICP monitoring

Cardiovascular GIT Loss of bowel control GUT Other systems Pulmonary Failure of accessory muscles for breathing movement Loss of lung Cessation of physiologic functions System sDecreased cardiacRelaxation of venous valves of cardiac muscle output function System Relaxation of intestines and sphincters

Neurogenic bladder

Loss of sphincter control

Cardiopulmonary arrest

Systemic Failure

PATHOPHYSIOLOGY OF ESSENTIAL HYPERTENSION 8

Managed by Lifestyle changes, Dietary modifications, Exercise, Medications

If not managed, complications occur: cardiac, cerebrovascular, renal and peripheral vascular diseas