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Related Concept Videos

Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Brainstem01:19

Brainstem

The brainstem, located inferior to the brain and superior to the spinal cord, serves as a bridge between the cerebrum and the spinal cord. It plays a vital role in relaying information and controlling critical life functions. It comprises three primary regions: the midbrain, pons, and medulla oblongata.
The Midbrain
The midbrain is located beneath the diencephalon and connects the cerebrum with the lower parts of the brain. The cerebral peduncles are prominent midbrain structures that house the...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Transient Ischemic Attack l: Introduction01:26

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...

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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
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[Involuntary movements in brainstem ischemic lesions].

M Herrera1, M E Erro, N Aymerich

  • 1Sección de Neurología, Hospital de Navarra, Pamplona. isasima@hotmail.com

Neurologia (Barcelona, Spain)
|September 15, 2007
PubMed
Summary

Movement disorders in brainstem vascular disease are underrecognized. These involuntary movements may stem from disrupted cortical inhibitory projections, not epilepsy, aiding early diagnosis.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroscience

Background:

  • Movement disorders in brainstem vascular disease are rarely documented and often misdiagnosed as seizures.
  • The exact pathophysiological mechanisms remain uncertain, with theories including seizure-generating brainstem centers or corticospinal tract ischemia.

Observation:

  • Three patients with basilar artery disease and brainstem infarction presented with sudden, brief, and varied involuntary limb movements.
  • Electroencephalographic studies were performed during these episodes in one patient.

Findings:

  • The involuntary movements, characterized by preserved consciousness and unresponsiveness to antiepileptic drugs, suggest a failure of cortical inhibitory projections.
  • Normal electroencephalogram findings in one case further support a non-epileptic origin.

Implications:

  • Recognizing these initial movement disorder symptoms is crucial for early diagnosis of brainstem vascular disease.
  • Transcranial Doppler can aid diagnosis, enabling prompt and aggressive treatment for this serious condition with a poor prognosis.