stroke 8.17.35 AM

Stroke 8.17.35 AM - Stephen B Lewis MD FRACS Department of Neurosurgery University of Florida Stroke General overview Ischemic stroke a Thrombotic

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Stephen B. Lewis MD FRACS Department of Neurosurgery University of Florida
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General overview Ischemic stroke a) Thrombotic vs embolic b) Factors affecting extent c) Effect of location c) Lacunar c) Territorial Hemorrhagic stroke a) Aneurysms b) Hypertension Cerebral herniation Stroke
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A sudden and often severe cerebral vascular catastrophe that may temporarily or permanently impair brain function Types 1. Ischemic: blockage within blood vessel a. Thrombotic: locally generated obstruction b. Embolic: occlusion secondary to traveling particle originating proximally in bloodstream 2. Hemorrhagic: bleeding from blood vessel resulting in clot formation within brain substance or over its surface Stroke
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Heart Sites of atheromatous disease - aorta - common carotid bifurcation - distal intracranial vertebral artery - proximal half basilar artery - perforating microvessels Favored locations Stroke
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Stroke: emboli Emboli lodge at bifurcations - ICA bifurcation - basilar artery tip Final lodgement a function of: - hemodynamic forces - size Perforator (lacunar) strokes - thrombotic (local disease) Territorial strokes - embolic or thrombotic PCA Basilar apex Basilar A. Vertebral A. ACA MCA
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Stroke: factors affecting extent of stroke Anastomotic channels - ACoA - PCoA - Between territories ACA MCA Anastomotic vessels
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Clinical example – when things fail
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This note was uploaded on 01/12/2012 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Stroke 8.17.35 AM - Stephen B Lewis MD FRACS Department of Neurosurgery University of Florida Stroke General overview Ischemic stroke a Thrombotic

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