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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...

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...

Cerebral Edema ll: Pathophysiology

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...

Increased Intracranial Pressure ll: Pathophysiology

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...

Increased Intracranial Pressure l: Introduction

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...

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Updated: Jun 16, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

[Malignant cerebral infarction and hemicraniectomy].

Sakari Simula¹, Timo Koivisto, Jaakko Rinne

¹KYS ja Kuopion yliopisto, neurologian klinikka PL 1777, 70211 Kuopio.

Duodecim; Laaketieteellinen Aikakauskirja

|February 24, 2010

Summary

This summary is machine-generated.

Hemicraniectomy can decrease the high mortality rate of malignant cerebral infarction. This study found that 50% of patients survived after the procedure, with lower acute systolic blood pressure in survivors.

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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Published on: October 15, 2021

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Last Updated: Jun 16, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Published on: October 15, 2021

Area of Science:

Neurosurgery
Neurology
Critical Care Medicine

Context:

Malignant cerebral infarction (MCI) carries an 80% mortality rate.
Surgical intervention, specifically hemicraniectomy, is explored as a method to reduce this mortality.
This study reviews cases from Kuopio University Hospital between 2003 and 2009.

Purpose:

To evaluate the effectiveness of hemicraniectomy in patients with malignant cerebral infarction.
To identify factors associated with patient outcomes following hemicraniectomy for MCI.

Summary:

A retrospective analysis of 12 consecutive patients who underwent hemicraniectomy for MCI was performed.
The study found a 50% survival rate.
Lower acute systolic blood pressure was significantly associated with survival, while operation delay was not.

Impact:

Hemicraniectomy can be a life-saving procedure for selected patients with malignant cerebral infarction.
Findings suggest that early recognition and intervention may be crucial, with blood pressure management being a key consideration.