Pathophysiology of Stroke 11_19_12

Dyslipidemia cardiac disease fagan sc hess dc stroke

Info icon This preview shows pages 9–17. Sign up to view the full content.

View Full Document Right Arrow Icon
Dyslipidemia Cardiac disease Fagan SC, Hess DC. Stroke. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:353-356.
Image of page 9

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Drugs Associated with Stroke Risk Oral contraceptives Postmenopausal hormone therapy Amphetamines Alcohol Heroin Sympathomimetics Pseudoephedrine Ephedrine 1. Cantu C et al. Stroke Associated With Sympathomimetics Contained in Over-the Counter Cough and Cold Drugs. Stroke 2003;34:1667-72. Goldstein LB et al. Guidelines for the Primary Prevention of Stroke. Stroke 2011;42:517-84.
Image of page 10
Atrial Fibrillation and Stroke Risk Average annual risk of stroke in patients with atrial fibrillation is ~5% CHADS2 Score C ongestive heart failure (+1) H ypertension (+1) A ge >75 years (+1) D iabetes (+1) S troke or TIA (+ 2 ) CHADS2 Score Annual Stroke Risk (%) 0 1.9 1 2.8 2 4.0 3 5.9 4 8.5 5 12.5 6 18.2 Camm AJ et al. Guidelines for the management of atrial fibrillation. Eur Heart J 2010;31:2369-2429.
Image of page 11

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Carotid Atherosclerosis Accumulation of lipids and inflammatory cells in artery intima + Hypertrophy of arterial smooth muscle cells Plaque formation 1. Fagan SC, Hess DC. Stroke. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:353-356. 2. Image: [Accessed 30 Oct 2012].
Image of page 12
Pathophysiology of Ischemic Stroke Shear stress may result in plaque rupture, collagen exposure, platelet aggregation, and clot formation Arterial occlusion decreases cerebral blood flow and causes ischemia distal to occlusion Local occlusion: clot remains in vessel Embolism: clot lodges downstream in a cerebral vessel Cardiogenic embolism: local clots formed Fagan SC, Hess DC. Stroke. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:353-356.
Image of page 13

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image: Lomen-Hoerth C, Messing RO. Nervous System Disorders. In: McPhee SJ, Hammer GD, editors. Pathophysiology of Disease. 6th ed. New York: McGraw-Hill; 2010. . [Accessed 02 Nov 2012.]
Image of page 14
Cerebral Autoregulation Cerebral blood vessels dilate and constrict in response to changes in blood pressure Impaired by atherosclerosis, hypertension, and stroke 0 20 Mean Arterial Pressure (mmHg) rebral Blood Flow (mL/min/100 g) Ischemia Infarction 50 mL/min/100 g Gardner CJ, Lee K. CNS Spectr. 2007;12(1):35-42.
Image of page 15

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Pathophysiology of Ischemic Stroke Apoptosis: occurs many hours after acute insult Begins within 2 hours after onset of ischemia May last several days 1. Fagan SC, Hess DC. Stroke. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:353-356.
Image of page 16
Image of page 17
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern