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Related Concept Videos

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.
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...
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...
Stroke: Introduction and Types01:29

Stroke: Introduction and Types

A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
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...
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...

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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Published on: January 18, 2018

Early ischemic stroke presentation in Pakistan.

Ayeesha Kamran Kamal1, Bhojo Asumal Khealani, Sajjad Ahmed Ansari

  • 1Neurology Section, Department of Medicine, Aga Khan University, Karachi, Pakistan.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|April 22, 2009
PubMed
Summary
This summary is machine-generated.

Only 21% of acute ischemic stroke patients in Pakistan presented within the crucial three-hour window for thrombolytic therapy. Public awareness and faster primary care referrals are key to improving early stroke presentation.

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Area of Science:

  • Neurology
  • Public Health
  • Emergency Medicine

Background:

  • Limited data exists on stroke presentation rates in Pakistan.
  • Understanding presentation times is critical for administering timely thrombolytic therapy (recombinant tissue plasminogen activator - rtPA) for acute ischemic stroke.
  • Current protocols restrict rtPA use to within three hours of symptom onset.

Purpose of the Study:

  • To investigate stroke presentation rates in Pakistan.
  • To identify factors associated with early or delayed presentation of acute ischemic stroke.
  • To inform strategies for improving patient access to time-sensitive stroke treatments.

Main Methods:

  • Prospective identification of 269 adult patients with acute ischemic stroke (symptom duration ≤ 48 hours).
  • Data collected from the Aga Khan University Stroke Data Bank over 22 months (ending May 2001).
  • Analysis of presentation times and associated demographic and clinical factors.

Main Results:

  • 21% of patients presented within three hours, and 41% within six hours of stroke onset.
  • Delayed presentation was linked to unawareness of treatment options and inappropriate field triage.
  • Small vessel occlusion strokes were associated with delayed presentation, while cardioembolic strokes presented earlier.

Conclusions:

  • Early stroke presentation rates in this Pakistani facility are comparable to some developed countries.
  • Public awareness campaigns about stroke treatment options are needed.
  • Expedited referral by primary care providers is essential to increase the number of patients eligible for thrombolytic therapy.