The term "Heart attack" is very common used term and well understood by common people for a condition in which heart is affected and patient requires urgent medical treatmnt. Similarly in stroke, blood supply to the brain is affected and patient requires urgent medical attention.
Abrupt onset of Neurologic deficit is caused by inadequate perfusion of a region of brain.
Stroke is a common cause of neurological disability and death in elderly persons. Arterial thrombosis with occlusion of the cerebral arteries is the most common cause of stroke.
Most common modifiable risk factors are hypertension, cigarette smoking, obesity, increased blood lipids, heavy alcohol consumption, poor control of diabetes mellitus, stress, etc.
TIA ( Transient ischemic attack)
Episode of focal neurological dysfunction as a result of ischemia which resolves completely within 24 hours.
TIA are important determinant of stroke. around 30-50% of cases had previous transient ischemic attacks.
STROKE or CVA
About 85% of strokes are Ischemic and 15% Hemorrhagic.
HEMORRHAGIC STROKE
About 20% of strokes are hemorrhagic which is due to the spontaneous intracerebral hematoma (ICH). Hemorrhage most commonly results from rupture of the small penetrating arteries damaged by the degenerative effects of chronic hypertension.. In 1868, Charcot and Bouchard described the rupture of " microaneurysms" as the cause of ICH.
Common cause of spontaneous intracerbral hematoma in elderly is hypertensive bleed. As commonly seen in elderly that there is unnoticed hypertension in many elderly persons who are not aware about this condition or on irregular treatment of hypertension. Common site of hypertensive bleed is basal ganglia.
So, the commonest cause of spontaneous intracerebral hematoma in adults is a hypertensive arteriosclerotic basal ganglionic bleed. The median age of spontaneous intracerebral hemorrhage is about 56 years.The common clinical features are sudden onset severe headache, vomiting, slurring of speech, depressed level of consciousness and weakness of face and limbs.
Commonest cause is long standing hypertension, irregular antihypertensive medication, history of smoking and alcohol intake, diabetes and lack of physical exercise.
CT scan of brain is the initial investigation.
The brain is
critically dependent on an uninterrupted supply of oxygenated blood. About 18%
of the total blood volume in body circulates in the brain, which accounts for
about 2% of body weight. Loss of consciousness occurs in less than 15 seconds
after blood flow to the brain has stopped, and irreparable damage to the brain
tissue occurs within 5 minutes.
Cerebrovascular
accident or cerebrovascular disease or stroke occurs as a result of vascular
compromise or hemorrhage and is one of the most frequent sources of neurologic
disability.Abrupt onset of Neurologic deficit is caused by inadequate perfusion of a region of brain.
Stroke is a common cause of neurological disability and death in elderly persons. Arterial thrombosis with occlusion of the cerebral arteries is the most common cause of stroke.
Most common modifiable risk factors are hypertension, cigarette smoking, obesity, increased blood lipids, heavy alcohol consumption, poor control of diabetes mellitus, stress, etc.
TIA ( Transient ischemic attack)
Episode of focal neurological dysfunction as a result of ischemia which resolves completely within 24 hours.
TIA are important determinant of stroke. around 30-50% of cases had previous transient ischemic attacks.
STROKE or CVA
About 85% of strokes are Ischemic and 15% Hemorrhagic.
HEMORRHAGIC STROKE
About 20% of strokes are hemorrhagic which is due to the spontaneous intracerebral hematoma (ICH). Hemorrhage most commonly results from rupture of the small penetrating arteries damaged by the degenerative effects of chronic hypertension.. In 1868, Charcot and Bouchard described the rupture of " microaneurysms" as the cause of ICH.
Common cause of spontaneous intracerbral hematoma in elderly is hypertensive bleed. As commonly seen in elderly that there is unnoticed hypertension in many elderly persons who are not aware about this condition or on irregular treatment of hypertension. Common site of hypertensive bleed is basal ganglia.
So, the commonest cause of spontaneous intracerebral hematoma in adults is a hypertensive arteriosclerotic basal ganglionic bleed. The median age of spontaneous intracerebral hemorrhage is about 56 years.The common clinical features are sudden onset severe headache, vomiting, slurring of speech, depressed level of consciousness and weakness of face and limbs.
Commonest cause is long standing hypertension, irregular antihypertensive medication, history of smoking and alcohol intake, diabetes and lack of physical exercise.
CT scan of brain is the initial investigation.
Basal ganglia ( Putamen, globus pallidus, caudate nucleus) is the commonest site of the hypertensive intracranial bleed.
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