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Updated: Jun 8, 2026
06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Reducing Inequalities in Stroke Events-Hemorrhagic Disparities (RISE-HD): a 10-Year Longitudinal Study in Florida.
Natália Vasconcellos de Oliveira Souza1,2, Alejandra Díaz-Rohena1,3, Amra Sakusic4
1Department of Neurocritical Care, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
Journal of Racial and Ethnic Health Disparities
|June 6, 2026
Summary
In-hospital mortality for hemorrhagic stroke has decreased, but significant disparities persist for Black patients, rural residents, and those in specific Florida regions. Targeted strategies are needed to address these health inequities.
Area of Science:
- Neurology
- Public Health
- Health Disparities
Background:
- Intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) are severe stroke types with high mortality and disability rates.
- Despite overall declining mortality, persistent disparities exist across racial, socioeconomic, and geographic groups.
Purpose of the Study:
- To analyze in-hospital mortality trends for ICH and SAH in Florida.
- To identify demographic, socioeconomic, and geographic factors associated with mortality disparities.
Main Methods:
- Analysis of inpatient data from the Florida Agency for Health Care Administration (2013-2024).
- Multivariable logistic regression and Kaplan-Meier analysis to assess associations with in-hospital mortality.
- Adjustment for the Elixhauser Comorbidity Index to control for patient health status.
Main Results:
- In-hospital mortality for hemorrhagic stroke significantly declined (P < .001).
- Higher mortality was associated with Black race, Medicaid/other insurance, rural residence, and specific Florida regions (Northwest and South).
- Most patients resided in rural areas, but few received care in rural hospitals.
Conclusions:
- Hemorrhagic stroke mortality has decreased, but significant racial, geographic, and socioeconomic disparities remain.
- Black patients, rural residents, those with non-Medicare insurance, and individuals in Northwest and South Florida experience higher mortality.
- System-level interventions are crucial to mitigate these persistent health inequities.
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01:17Hemorrhagic 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...
01:29Hemorrhagic 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...
01:15Ischemic 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.
01:29Stroke: 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...
01:15Ischemic 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...
01:27Regulation of Stroke Volume
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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