Stroke Types: 80% Ischemic

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Stroke Types

80% ischemic

Thrombosis Embolism Hypoperfusion


Intracerebral Subarachnoid

20% hemorrhagic

Ischemic Strokes

Thrombosis-most common cause Etiology


Atherosclerotic disease-most common Vasculitis Dissection Polycythemia Hypercoagulable states Infectious Diseases-HIV, TB, syphilis

Hemorrhagic Strokes

Intracerebral hemorrhage (ICH)


- approx. 10% of all strokes Risk Factors

HTN Increasing Age Race: Asians and Blacks Amyloidosis- esp. in the elderly AVMs or tumors Anticoagulants/Thrombolitic use History of previous stroke Tobacco, ETOH, and cocaine use

Ischemic Pathophysiology

Neurons are very sensitive to cerebral blood flow and die within minutes of complete cessation Extent of injury depends on vessel involved and presence or absence of collateral blood flow Penumbra

Reversibly injured neurons surrounding the primary injury with collateral circulation, which can be preserved with proper timely intervention

Hemorrhagic Pathophysiology

In ICH and SAH, intracranial pressure rises following vascular rupture with resulting global hypoperfusion Marked reduction in perfusion occurs near the hematoma as a result of local compression

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