Stroke

Stroke

1. www.medrockets.com
Fb:Medrockets

3. Current concepts
www.medrockets.com
Fb:Medrockets

4. www.medrockets.com
Fb:Medrockets

5. Emerging Risk Factors
•Helicobacter pylori
•HIV/AIDs
•CMV/EBV/HSV
•Increased CRP
•Hyperhomocysteinaemia
•RAS
CVD and major risk actorsCVD and major risk actors
•Tobacco
•Diet
•Alcohol
•Physical Activity
Behavioural
Risk Factors
Non-modifiable
Risk Factors
•Age
•Sex
•Race
•Genes
•SCD
•CADASIL
•MELAS
•Migraine with aura
Genetic factors:
MODIFIABLE RISK FACTORS
•Hypertension
•DM
•dyslipidaemia
•Obesity / Overweight
•OCP
•Migraine
•polycythemia

6. www.medrockets.com
Fb:Medrockets

7. www.medrockets.com
Fb:Medrockets

8. www.medrockets.com
Fb:Medrockets

9. Blood supply to the brain

12. CLASSIFICATION OF STROKE
Stroke
Primary Hemorrhagic
(20% of Strokes)
Primary Ischemic
(80% of Strokes)
Thrombotic
50%
Embolic
30%
Intracerebral
Hemorrhage 15%
Subarachnoid
Hemorrhage 5%
www.medrockets.com
Fb:Medrockets

15. www.medrockets.com
Fb:Medrockets

16. Normal
ml/100g/mi
n
50 – 55 25 20 15
8
Ischemia
Edema Loss of Na/K+
electrical pump
↑lactate activity failure; ↓
ATP

Penumbra
Infarction
Cell
Death

17. www.medrockets.com
Fb:Medrockets

18. Penumbra
Infarction

19. Stroke Warning Signs
CLINICAL FEATURES OF
STROKE
www.medrockets.com
Fb:Medrockets

22. www.medrockets.com
Fb:Medrockets

24. www.medrockets.com
Fb:Medrockets

27. www.medrockets.com
Fb:Medrockets

28. www.medrockets.com
Fb:Medrockets

29. Brain swelling
Ventricular compression
Focal cortical effacement
www.medrockets.com
Fb:Medrockets

30. Ischemic stroke Hemorrhage stroke
Craniocerebral / cervical trauma
Meningitis/encephalitis
Intracranial mass
•Tumor
•Subdural hematoma
Seizure with persistent neurological signs
Migraine with persistent neurological signs
Metabolic
•Hyperglycemia (nonketotic hyperosmolar coma)
•Hypoglycemia
•Post-cardiac arrest ischemia
•Drug/narcotic overdose
www.medrockets.com
Fb:Medrockets

31. www.medrockets.com
Fb:Medrockets

32. www.medrockets.com
Fb:Medrockets

33. www.medrockets.com
Fb:Medrockets

35. www.medrockets.com
Fb:Medrockets

36. Brain tissue
ischemia
Cerebral arterial
stenosis/occlusion
LAA/CE/SVD/others
Decreased CBF
Cerebral autoregulation
(endothelial function etc)

37. First stroke
blood
pressure
glucose
smoking
lipids
mass popl.
strategy
hypertension
TIA
Atrial fibrillation
other vascular disease
high risk strategy
stroke
mortality
acute treatment
Secondary
prevention
recurrent
stroke
Stroke related
disability
Rehabilitation

38. www.medrockets.com
Fb:Medrockets

39. www.medrockets.com
Fb:Medrockets

40. www.medrockets.com
Fb:Medrockets

41. THANK YOU
www.medrockets.com
Fb:Medrockets