L3.3.3: Cerebrovascular Disease

• Cerebrovascular Disease/Accident (Stroke)

  ● Loss or alteration of bodily function that results from an insufficient supply of blood to some parts of the brain

  ○ Brain tissues may die due to lack of blood.

  ■ Causing disability, like speech disability, etc.

  ● One of the leading causes of disability.
• ETIOLOGY – Progression

  TYPES OF STROKE (TEH!)

  • Thrombotic Stroke BLOCKED
  • Embolic Stroke TRAVELLING
  • Hemorrhagic Stroke RUPTURED
• Thrombotic Stroke BLOCKED

  • Development of blood clot in the blood vessel, obstructing flow of circulation.
  • Thrombus–Formation
• Embolic Stroke TRAVELLING

  • Clot is dislodged and becomes part of the flow of circulation. The clot/fats is driven to different parts of the body.
  • Embolus–Transportation
• Hemorrhagic Stroke RUPTURED

  • When the traveling clot ends up stuck in tinier vessels in which an area can no longer receive blood because it’s obstructed.
  • Increased BP & Stasis may also occur.
  • Ischemia–Loss of Supply
• Hemorrhagic Stroke RUPTURED

  • Infarction: Part of the body worsening because of the lack of oxygenation.
  • Necrosis: Death of tissue
• Hemorrhagic Stroke RUPTURED

  Causes

  ○ Uncontrolled Hypertension

  ○ Aneurysm

  ■ Weak muscles of blood vessels
• THROMBUS VS EMBOLUS

  ● Thrombus

  ○ A blood clot that forms within a blood vessel

  ● Embolus

  ○ A piece of a blood clot, fat, air bubble, or other substance that breaks free and travels through the bloodstream
• THROMBUS VS EMBOLUS

  ● Both can block the blood flow and increase the risk of heart attack

  ● Cure: Thrombolytics - tinutunaw ang blood clod (ex. aspirin)
• HEMORRHAGIC STROKE

  ● It occurs when there is a bleeding into or around the brain, leading to damaged tissue and neurological dysfunction

  ● Aneurysm

  ○ a part of cerebral hemorrhage
• RISK FACTORS OF CVD

  ● Increasing Age

  ● Sex

  ● Heredity and Race

  ● HPN

  ● Smoking

  ● DM

  ● Excessive Alcohol Intake

  ● Drug Abuse
• RISK FACTORS OF CVD

  ● High RBC (blood clots)

  ○ High circulating blood volume

  ○ High BP

  ● Season & Climate

  ● Socioeconomic Factors
• Not so fun fact: Lack of sleep increases risk for CVD because the body is not given the time to replenish energy and repair cells, tissues, & muscles.
• SIGNS OF STROKE IN MEN AND WOMEN

  ● Numbness or weakness (house paresis) in the face, arm, or leg, especially on one side of the body.

  ● Confusion or trouble with speaking or understanding speech

  ● Trouble seeing in one or both eyes

  ● Trouble walking (gait), dizziness, or problems with balance

  ● Severe headache with no known cause
• PREVENTION OF CVD

  ● Treatment & Control of Hypertension

  ● Smoking Cessation – nicotine narrows blood vessels

  ● Prevent thrombus formation in Rheumatic Heart Disease (RHD) and arrhythmias with appropriate medications

  ○ Associated with bacterial infection

  ○ Symptom: sore throat
• PREVENTION OF CVD

  ● Limit alcohol consumption (more on tx not prevention)

  ● Avoid IV drug abuse and cocaine

  ● Watch out for Hemiparesis

  ○ weakness or the inability to move on one side of the body

  ○ Usually in the arms, hands, face, chest, legs, or feet
• CLASSIFICATION OF BP (Joint National Convention 7 Report)

  Category | SBP mmHg | DBP mmHg

  Normal | < 120 | < 80

  Prehypertension | 120 - 139 | 80 - 89

  HPN, Stage 1 | 140 - 159 | 90 - 99

  HPN, Stage 2 | ≥ 160 | ≥ 100