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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...

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.

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...

Stroke: Introduction and Types

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...

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Sub-acute Cerebral Microhemorrhages Induced by Lipopolysaccharide Injection in Rats

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Published on: October 17, 2018

Nascent lobar microbleeds and stroke recurrences.

Toshio Imaizumi¹, Shigeru Inamura¹, Ikuhide Kohama¹

¹Department of Neurosurgery, Kushiro City General Hospital, 1-12 Shunkodai, Kushiro, Hokkaido 085-0822, Japan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association

|June 27, 2013

Summary

Nascent lobar microbleeds (MBs) detected on MRI may indicate a higher risk for deep intracerebral hemorrhages (ICHs). This association suggests MBs could be a predictor for future ICH events in at-risk patients.

Keywords:

Cerebral microbleeds intracerebral hemorrhage recurrence risk factor stroke

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Area of Science:

Neurology
Radiology
Stroke Research

Background:

Lobar microbleeds (MBs) are sometimes observed on T2*-weighted MRI in patients with deep intracerebral hemorrhages (ICHs).
The relationship between nascent lobar MBs and the development of deep ICHs requires further investigation.

Purpose of the Study:

To investigate the potential contribution of nascent lobar microbleeds to the occurrence of deep intracerebral hemorrhages.
To determine if the presence of lobar MBs on MRI predicts future deep ICH events.

Main Methods:

Prospective analysis of patients with index strokes between April 2004 and November 2009.
Counting nascent lobar MBs on T2*-weighted MRI scans approximately one year post-stroke and comparing with admission MRIs.
Utilizing Kaplan-Meier curves and multivariate logistic regression to assess deep ICH occurrence and associated risk factors.

Main Results:

Repeated MRIs of 508 patients revealed 157 nascent lobar MBs in 62 individuals.
The annual deep ICH occurrence rate was significantly higher in patients with MBs (1.9%) compared to those without (0.5%, P = .012).
Nascent lobar MBs were significantly associated with deep ICH recurrences (OR: 3.85, P = .020) after adjusting for hypertension, diabetes, antithrombotic drug use, white matter lesions, age, and gender.

Conclusions:

Lobar microbleeds may be associated with an increased risk of deep intracerebral hemorrhages.
Nascent lobar MBs could serve as a potential imaging biomarker for predicting deep ICHs.