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Ischemic Stroke ll: Pathophysiology

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...

Ischemic Stroke l: Introduction

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: Pathophysiology

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...

Hemorrhagic Stroke l: Introduction

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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...

Stroke: Introduction and Types

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Ischemic Heart Disease: Overview

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Transient Middle Cerebral Artery Occlusion Model of Neonatal Stroke in P10 Rats

Transient Middle Cerebral Artery Occlusion Model of Neonatal Stroke in P10 Rats

Published on: April 21, 2017

Presumed perinatal ischemic stroke: vascular classification predicts outcomes.

Adam Kirton¹, Gabrielle Deveber, Ann-Marie Pontigon

¹Division of Neurology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada. adam.kirton@calgaryhealthregion.ca

Annals of Neurology

|February 29, 2008

Summary

Presumed perinatal ischemic stroke (PPIS) can result from arterial strokes or venous periventricular infarction (PVI). Identifying PPIS patterns aids in predicting long-term neurological outcomes and guiding treatment.

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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Area of Science:

Neurology
Pediatric Medicine
Neuroimaging

Background:

Perinatal stroke is a significant cause of childhood neurological disability.
Presumed perinatal ischemic stroke (PPIS) describes chronic focal brain infarction identified postnatally.
Recent evidence suggests periventricular venous infarction (PVI) in preterm infants may also manifest as PPIS.

Purpose of the Study:

To define arterial and PVI PPIS syndromes.
To determine the neurological outcomes associated with each PPIS type.
To analyze the largest published cohort of PPIS cases.

Main Methods:

Systematic neuroradiological scoring of a consecutive PPIS cohort (1992-2006).
Defined criteria for PVI, including unilateral injury patterns and specific imaging findings.
Validated arterial and PVI classifications and correlated them with neurological outcomes using the Pediatric Stroke Outcome Measure.

Main Results:

Of 59 PPIS cases, 94% involved potential middle cerebral artery territories.
Arterial infarction was most common (35%), followed by venous PVI (22%), which accounted for 75% of subcortical injuries.
Basal ganglia involvement predicted motor outcomes (hemiparesis, spasticity), while cortical involvement predicted nonmotor outcomes (cognitive, visual, epilepsy).

Conclusions:

Recognizable PPIS patterns effectively predict long-term neurological morbidity.
PVI is an underrecognized cause of PPIS and congenital hemiplegia.
Classification of PPIS subtypes can guide surveillance, therapy, and counseling for affected children.