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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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Related Experiment Video

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A Coupled Experiment-finite Element Modeling Methodology for Assessing High Strain Rate Mechanical Response of Soft Biomaterials
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Changing patterns in civilian arterial injuries.

P V Sharma, S C Babu, P M Shah

    The Journal of Cardiovascular Surgery
    |January 1, 1985
    PubMed
    Summary

    Review of arterial injuries shows increased complexity and associated injuries, despite improved resuscitation reducing hypotension. Advances in surgical techniques and management did not improve limb salvage or survival rates.

    Area of Science:

    • Vascular Surgery
    • Trauma Management

    Background:

    • Arterial injuries present complex challenges in trauma care.
    • Patterns of injury and management strategies evolve over time.

    Purpose of the Study:

    • To review changing patterns in clinical findings, management, and outcomes of arterial injuries.
    • To evaluate the impact of evolving treatment strategies on limb salvage and survival.

    Main Methods:

    • A critical review of 185 patients with 211 arterial injuries over an eleven-year period.
    • Analysis of clinical findings, management techniques, and patient outcomes.

    Main Results:

    • A ten-fold increase in multiple arterial injuries and associated venous/visceral injuries observed in the latter five years.

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  • Hypotension on arrival halved due to rapid transport and resuscitation.
  • Increased use of end-to-end anastomoses, grafts, heparin, fasciotomy, shunts, venous repair, and bypass.
  • No improvement in limb salvage or survival despite advances.

    • Conclusions:

    • Increased injury complexity and aggressive repair strategies contribute to unchanged limb salvage and survival rates.
    • Early resuscitation improves initial patient stability but may increase the number of unsalvageable patients.
    • Mortality remains unchanged, likely due to the severity of injuries and management approaches.