January 20, 2014 (1)

Smoking diabetes bad foods destroy the lining

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Unformatted text preview: too much is not good ). LDAC bad cholesctorol .Smoking, diabetes, bad foods destroy the lining. Macrophages consume LDAC , accumulation of fatty streaks ,plaque expands in lining of artery/if plaque keeps to grow / reduces ability of blood to get trough artery /making hard and flexible.blood clot formed and limit the blood flow • specific form of arteriosclerosis (hardening of the arteries) in which an artery wall thickens as a result of the accumulation of calcium and fatty materials such as cholesterol Cerebral embolism • Most common source is from an abnormality with the heart – atrial fibrilation • Atrial fibrillation is the leading source of cardioembolic stroke • Emboli lodge in the MCA 80% of cases; PCA10%; VA 10%. Emboli rarely reach the ACA. foreign body ( blood cloth) enter in brain and clog in the artery.Atrial fibrillation is abnormal heartbeat. ( higher chance of having a stroke).Plaques form ( buildup) and then gets lodge within the brain. Emboli lodge in the middle cerebral artery ( most cases) Caplan's Stroke (Fourth Edition)A Clinical Approach Systemic hypoperfusion • Reduction of blood flow to all parts of the body. • It is most commonly due to: • heart failure from cardiac arrest or arrhythmias • reduced cardiac output due to myocardial infarction, pulmonary embolism, or bleeding •Often causes a “watershed stroke” reduction of blood flow/common cause -heart failure /cardiac arrest / cardiac output ( stroke in the heart)/watershred areas end up losing are hit hardest ( blood pressure is not high enough to get to these areas ) Caplan's Stroke (Fourth Edition)A Clinical Approach Ischemic Areas Not lot of overlap btw arteries ( core) reduced to 10-25% , cells are going to die immediately/ they die by necrosis which causes inflammatory reactions. Penumbra reduction of blood flow ( 25-50%) still are dying off ( apoptosis) program cell death /cascade of events less in reduction of blood flow. These cells can still last for hours. Stroke recovery -Area within core is practically gone/ we are trying to save neurons in the penumbra /recruit synapse • Core •Blood flow below 10-25% •Loss of oxygen and glucose results in cells dying by NECROSIS • Penumbra •Blood flow is reduced to 25-50% •Cells here may be viable for hours – can eventually die by APOPTOSIS Caplan's Stroke (Fourth Edition)A Clinical Approach Collateral blood flow less neurons dying. Eventually it will grow and grow /lacking glucose and oxygen The size of the core and the penumbra depends on the blood flow provided by the collaterals Core region where blood flow doesnt hit/ we dont get much blood supply (ischemic ) neurons die first and fast with neucrosis Acute Ischemic Stroke Imaging and Intervention Second Edition, Springer Major pathways implicated in ischemic cell dea...
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This document was uploaded on 02/03/2014.

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