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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...

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 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...

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...

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Updated: Jul 10, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Published on: January 15, 2017

Ballast and NeuronMax in stroke thrombectomy.

Bradley A Gross¹, Jaydevsinh Dolia², Daniel A Tonetti³

¹Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA grossb2@upmc.edu.

Journal of Neurointerventional Surgery

|June 25, 2020

Summary

The new Ballast 6F long sheath demonstrated faster procedural times in stroke thrombectomy compared to the NeuronMax sheath, with similar successful revascularization and patient outcomes. This suggests Ballast offers an efficient alternative for endovascular stroke treatment.

Keywords:

catheter stroke thrombectomy

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Last Updated: Jul 10, 2026

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Published on: May 6, 2021

Area of Science:

Endovascular surgery
Neurointerventional radiology
Stroke treatment

Background:

Comparative performance data for long sheaths in stroke thrombectomy is limited.
The NeuronMax sheath has been the historical institutional standard.

Purpose of the Study:

To compare the initial experience with the new Ballast 6F long sheath against the NeuronMax sheath.
To evaluate trackability, navigability, and procedural outcomes between the two long sheaths.

Main Methods:

A 6-month prospective analysis of a thrombectomy database.
Comparison of transfemoral approaches using NeuronMax versus the Ballast long sheath.
Evaluation of procedural and angiographic outcomes.

Main Results:

No significant differences in patient demographics or stroke characteristics were observed.
Similar single-pass success (41% vs. 44%) and final revascularization rates (91% vs. 98%) were achieved.
The Ballast sheath was associated with faster puncture-to-access times (6.5 min vs. 9.2 min) and a trend towards shorter procedural times (25 min vs. 31 min).

Conclusions:

The Ballast 6F long sheath achieved faster procedural times compared to the NeuronMax sheath.
Similar angiographic success and 90-day outcomes were observed between the two sheaths.
Ballast offers an efficient alternative for stroke thrombectomy procedures.