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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.

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...

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

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...

Transient Ischemic Attack l: Introduction

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...

Regulation of Stroke Volume

Regulation of Stroke Volume

The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...

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Updated: Jul 2, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Cardio-protection in acute stroke.

Jagdish C Sharma¹, Ian Ross, Michael Vassallo

¹Kings Mill Hospital, Sutton in Ashfield, Notts NG17 4JL, UK. jagdish.sharma@sfh-tr.nhs.uk

International Journal of Stroke : Official Journal of the International Stroke Society

|August 19, 2008

Summary

Protecting the heart in acute stroke patients may reduce mortality. Elevated cardiac biomarkers like NT-proBNP indicate heart risk and higher mortality, suggesting therapeutic interventions are warranted.

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Last Updated: Jul 2, 2026

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:

Cardiology
Neurology
Biomarkers

Context:

Acute stroke mortality remains a significant concern despite existing damage limitation strategies.
Cardiovascular factors, including cardiac impairment and injury, play a critical role in acute stroke outcomes.
The neurohumoral response in stroke can lead to cardiac stress and damage.

Purpose:

To review the influence of cardiovascular factors, specifically NT-proBNP, on stroke mortality.
To evaluate the prognostic value of cardiac biomarkers in acute stroke patients.
To explore potential therapeutic strategies targeting cardiac protection in stroke.

Summary:

Cardiovascular abnormalities, evidenced by ECG changes, tachycardia, and elevated cardiac biomarkers (Troponin, NT-proBNP), are associated with increased mortality in acute stroke.
NT-proBNP levels are particularly significant, showing a strong correlation with short- and long-term mortality, sometimes exceeding the predictive power of clinical stroke severity.
Neurohumoral activation and Renin-Angiotensin-Aldosterone-System (RAAS) changes in stroke contribute to cardiac stress, but also present potential targets for cardioprotective therapies.

Impact:

Identifying occult cardiac damage in stroke patients is crucial for understanding mortality.
Investigating cardioprotective interventions, using existing or novel drugs (e.g., beta-blockers, RAAS inhibitors), could significantly reduce stroke-related deaths.
This research highlights the critical brain-heart axis and the potential for a broad therapeutic window for cardiac interventions in acute stroke management.