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50 ml/100g/min

normal rate of CBF


CBF decreases to this rate and neurons stop firing but are still viable: ischemic penumbra


CBF decreases to this rate and brain cells are irreversibly dead r/t lactic acidosis and cytotoxic edema

causes of ischemic stroke

large artery artherosclerosis, cardioembolic events, small artery occlusive disease

large artery artherosclerosis

caused by cholesterol plaque, thrombus on plaque or embolis

risk factors for large artery artherosclerosis (and also for stroke)

HTN, Diabetes, smoking and possibly high cholesterol

cardioembolic stroke

caused by A fib, rheumatic heart disease, AMI, endocarditis, mitral valve stenosis and prosthetic heart valves

mechanism of action of cardioembolic stroke

clot formation due to low flow of blood from the heart

cardiac abnormality is the source of the emboli causing stroke in the first place

why important to treat underlying cardiac problem as well as neuro problem when someone has cardioembolic stroke?

lacunar stroke

HTN, Diabetes, small vessel occlusive disease cause this type of stroke where fat coats cerebral arteries in brain and thickens walls causing stroke

places in brain lacunar stroke most often occurs

basil ganglia, sub cortical white matter, thalamus, cerebellum and brainstem

10 -12 x's more often

Lucunar strokes occur how much more often than other types of stroke?

vascular dementia

one of the cognitive deficits caused by lucunar stroke

pure motor, pure sensory or both

patients can present with which features when they have a lucunar stroke?

primary causes of hemorrhagic stroke

primary intraparenchymal hemorrhage, ruptured cerebral aneurysm, AV malformation

secondary causes of hemorrhagic stroke

over anticoagulation (heparin, warfarin or rtPa), vasopressors, cocaine abuse, liver or renal failure, thrombcytopenia

bleeding into brain substance from uncontrolled HTN

cause of intraparenchymal hemorrage


percentage of hemorrhagic strokes caused by intraparenchymal hemorrhage

location of bleeding, compression and herniation

what does the severity of stroke from intraparenchymal hemorrhage depend on?

risk of rupture and hemorrhage into sub arachnoid space

what does AV malformation increase the risk of?

impaired perfusion

AV malformation impairs what?

complications of AV malformation

ischemia, scarring of brain tissue, abnormal tissue development, compression, hemorrhage and hydrocephalus

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