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cerebrovascular disease (Signs and symptoms (a severe and sudden headache,…
cerebrovascular disease
Defination
Cerebro" which refers to the large part of the brain, and "vascular" which means arteries and veins.
Together, the word cerebrovascular refers to blood flow in the brain.
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Signs and symptoms
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difficulty communicating, including slurred speech
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Causes
Large artery thrombosis. Large artery thromboses are caused by atherosclerotic plaques in the large blood vessels of the brain.
Small penetrating artery thrombosis. Small penetrating artery thrombosis affects one or more vessels and is the most common type of ischemic stroke.
Cardiogenic emboli. Cardiogenic emboli are associated with cardiac dysrhythmias, usually atrial fibrillation.
Risk factors
hypertension, or blood pressure of 130/80 mm Hg or above
Smoking: Decrease risk by quitting smoking. Risk may be increased further with the use some forms of oral contraceptives and are a smoker
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poor diet, and lack of exercise
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Pathophysiology
Decreased cerebral blood flow. The ischemic cascade begins when cerebral blood flow decreases to less than 25 mL per 100g of blood per minute
Aerobic respiration. At this point, neurons are unable to maintain aerobic respiration.
Anaerobic respiration. The mitochondria would need to switch to anaerobic respiration,
which generates large amounts of lactic acid, causing a change in pH and rendering the neurons incapable of producing sufficient quantities of ATP.
Loss of function. The membrane pumps that maintain electrolyte balances fail and the cells cease to function.
Surgical management
Carotid endarterectomy. This is the removal of atherosclerotic plaque or thrombus from the carotid artery to prevent stroke in patients with occlusive disease of the extracranial cerebral arteries.
Hemicraniectomy. Hemicraniectomy may be performed for increased ICP from brain edema in severe cases of stroke.