Stroke

Stroke

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  PRESENTED BY , SpurthiBS Doctor of Pharmacy (PharmD) Mallige college of pharmacy STROKE : The silent killer
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  INTRODUCTION STROKE is definedas an abrupt onset of focal neurologic deficit that lasts at least 24hrs and is presumed to be vascular origin. It affects the left side of the face, right arm and even small area.  BASED ON ETIOLOGICAL CLASSIFICATION: 1. ISCHEMIC STROKE (87%) 2. HEMORRHOGIC STROKE (13%)
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  ISCHEMIC STROKE It occurseither by local thrombus formation or by emboli phenomenon which results in occlusion of cerebral artery.  CAUSES: 1) ATHEROSCLEROSIS (70%) 2) CRYPTOGENIC (30%)
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  HEMORRHAGIC STROKE SUB-ARACHNOID HEMORRHAGE Occurs whena blood vessels on the surface of the brain ruptures and bleeds into the space between the brain and the skull. INTRA-CRANIAL HEMORRHAGE Occurs when a blood vessels bleeds into the tissue deep within the brain SUB-DURAL HEMATONA Abnormal collection of blood between duramater and arachnoid
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  PATHOGENESIS OF ISCHEMICSTROKE ARTERIAL OCCLUSION Severe reduction in cerebral blood flow Maintain membrane ISCHEMIC PENUMBRA integrity (INFARCT CORE) Decrease nutrients to ischemic cell Decreased ATP,accumulation of extracelluar Na+, intracellular Na+ , H20 ISCHEMIA
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  Cell swelling andlysis of cell Increased intracellur Ca2+ activates Lipases, protease and endonucleases Breakdown of membrane phospholipids liberate Free fatty acids and Amino acids( GLUTAMATE AND ASPARATE) Further continue neuronal cell damage and accumulation of free fatty acids Arachidonic acid (activates COX and LOX PROSTAGLANDINS, LEUKOTRIENE , FREE RADICALS AND CYTOTOXIC SUBSTANCES.
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  Attack cell membrane Increasedintracellular acidosis Imbalance b/w C02 and bicarbonates All the events occurs within 2-3hrs of the onset of ischemia leading to cell death. CELL DEATH
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  PATHOGENESIS OF HEMORRHAGICSTROKE Presence of blood in the brain parenchyma Damage to surrounding tissue by mechanical effect and neuro toxicity of blood components and degradation products.