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Related Concept Videos

Regulation of Stroke Volume01:27

Regulation of Stroke Volume

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The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
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Stroke: Introduction and Types01:29

Stroke: Introduction and Types

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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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Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

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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.
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Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

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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...
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Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

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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...
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Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

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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

Updated: May 4, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

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Long-Term Risk of Stroke Recurrence: A  Competing Risk Analysis Based on the South London Stroke Register.

Li Zhang1,2, Marc Delord1, Iain Marshall1

  • 1School of Life Course and Population Sciences King's College London London United Kingdom.

Journal of the American Heart Association
|March 10, 2026
PubMed
Summary

Stroke recurrence risk is significant after a first stroke. Factors like race, hypertension, and prior TIA increase risk, necessitating targeted prevention strategies. Accurate risk assessment requires accounting for competing mortality risks.

Keywords:
competing risksecondary preventionstroke recurrence

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Area of Science:

  • Neurology
  • Epidemiology
  • Public Health

Background:

  • Previous stroke recurrence studies often overlooked competing mortality risks, potentially skewing results.
  • This research addresses this gap by estimating stroke recurrence and associated factors in first-ever stroke patients.

Purpose of the Study:

  • To accurately estimate the risk of stroke recurrence after a first-ever stroke.
  • To identify demographic and clinical factors associated with stroke recurrence.
  • To account for the competing risk of death in risk estimation.

Main Methods:

  • Utilized data from the South London Stroke Register (SLSR) spanning 1995-2019.
  • Employed cumulative incidence functions and Fine-Gray competing risk models.
  • Treated death as a competing event to analyze stroke recurrence.

Main Results:

  • Included 5509 patients; 12.3% experienced stroke recurrence over 34,874 person-years.
  • Cumulative recurrence risk reached 15.2% at 25 years, higher after ischemic stroke (10-year risk 12.7%) than hemorrhagic stroke (10-year risk 11.1%).
  • Identified risk factors for ischemic stroke recurrence: Black race, hypertension, prior TIA, and non-hospital admission. Diabetes was a risk factor for hemorrhagic stroke recurrence.

Conclusions:

  • Stroke recurrence risk is substantial for both ischemic and hemorrhagic stroke types.
  • Competing risk analysis provides more accurate recurrence estimates.
  • Demographic and clinical factors are crucial for developing effective stroke recurrence prevention strategies.