NAME:AYENI MOTUNRAYO
MATRIC No:220712022
Topic:STROKE
Definition: A stroke, also known as a cerebrovascular accident (CVA), occurs when there is a
sudden interruption in the blood supply to the brain, leading to damage to brain tissue. This
interruption can occur either due to a blockage in a blood vessel (ischemic stroke) or the rupture of
a blood vessel (hemorrhagic stroke).
Epidemiology: Strokes are a significant global health concern, with millions of cases occurring
each year worldwide. They are a leading cause of death and disability, particularly among older
adults. The incidence and prevalence of strokes vary across different populations and are
influenced by factors such as age, sex, ethnicity, and socioeconomic.
Classification: Strokes can be classified into different types based on their underlying cause and
clinical presentation. The main types include:
Ischemic strokes
Hemorrhagic stroke
Transient ischemic attacks (TIAs)
cryptogenic stroke
• Ischemic strokes: These occur when a blood vessel supplying blood to the brain is
obstructed, leading to reduced blood flow. This can be caused by a blood clot or a narrowing of
the blood vessels.
• Hemorrhagic stroke: This type of stroke occurs when a blood vessel in the brain
ruptures or leaks, leading to bleeding into or around the brain.
• Transient ischemic attacks (TIAs): TIAs are often referred to as “mini-strokes” and
occur when there is a temporary disruption of blood flow to a part of the brain. They typically last
only a few minutes and do not cause permanent damage, but they are warning signs of a possible
future stroke.
• Cryptogenic stroke: This term is used when the cause of a stroke is unknown even after
thorough investigation. It’s a type of stroke where the origin or cause cannot be determined despite
extensive evaluation.
Pathophysiology of Stroke
1. Ischemic Stroke: This type of stroke occurs when there’s a blockage or narrowing of
arteries supplying blood to the brain. The blockage can be due to a blood clot (thrombus) that
forms locally in the brain’s blood vessels or travels from elsewhere in the body (embolus). When
blood flow is interrupted, brain cells in the affected area become deprived of oxygen and
nutrients, leading to ischemia (lack of blood supply).
2. Hemorrhagic Stroke: This type of stroke occurs when a weakened blood vessel in the
brain ruptures and leaks blood into surrounding brain tissue (intracerebral hemorrhage) or into
the space between the brain and the skull (subarachnoid hemorrhage). The presence of blood in
the brain disrupts normal brain function and can cause pressure on nearby brain tissue.
In both types of stroke, the lack of oxygen and nutrients to brain cells initiates a cascade of events
leading to cell injury and death:
• Energy Failure: Brain cells require a constant supply of glucose and oxygen to produce
energy (ATP) for their functions. When blood flow is interrupted, ATP production decreases,
leading to energy failure within cells.
• Excitotoxicity: Ischemia triggers the release of excitatory neurotransmitters, such as
glutamate, which overactivate receptors on neighboring neurons. This excessive stimulation leads
to calcium influx into cells, causing further damage and cell death.
• Inflammatory Response: The brain’s immune cells become activated in response to
injury, releasing inflammatory molecules that contribute to tissue damage and swelling (edema).
• Blood-Brain Barrier Disruption: The blood-brain barrier, which normally protects the
brain from harmful substances in the bloodstream, becomes compromised during stroke,
allowing toxins and immune cells to enter the brain tissue and exacerbate damage.
• Cell Death: Ultimately, prolonged ischemia and the resulting cellular dysfunction lead to
irreversible damage and death of brain cells in the affected area, resulting in neurological deficits
such as weakness, paralysis, speech difficulties, or cognitive impairment, depending on the
location of the stroke.
Symptoms:
sudden numbness or weakness in the face, arm, or leg (especially on one side of the body)
Confusion
Trouble speaking or understanding speech
Trouble seeing in one or both eyes
Dizziness
Loss of balance or coordination
Severe headache with no known cause.
Risk Factors: Several factors increase the risk of experiencing a stroke, including modifiable
factors such as ;
Hypertension
Diabetes
High cholesterol
Smoking
Obesity
Physical inactivity
Unhealthy diet.
Non-modifiable risk factors include age, gender, family history, and certain medical
conditions.
Complications: Strokes can lead to various complications, depending on the severity and location
of the brain injury. These may include physical disabilities such as:
Paralysis or Weakness
Cognitive impairments such as memory loss or difficulty speaking
Emotional changes such as depression or anxiety, and communication difficulties
Management as a Nurse:
Nurses play a crucial role in the management of stroke patients across the continuum of care.
This includes assessing patients for signs and symptoms of stroke, implementing evidence-based
interventions such as administering clot-busting medications (if applicable), monitoring vital signs
and neurological status, providing supportive care, coordinating rehabilitation services, educating
patients and families about stroke prevention and management, and collaborating with other
members of the healthcare team to ensure comprehensive care delivery.
A MAN SUFFERING FROM STROKE…..
In Conclusion
Stroke occurs when blood flow to part of the brain is disrupted, either by a blockage (ischemic
stroke) or bleeding (hemorrhagic stroke). This leads to brain cell damage or death due to lack of
oxygen and nutrients. The resulting neurological deficits depend on the affected brain region.
Early intervention is critical to minimize damage and improve outcomes.
REFERENCES
1. “Stroke: Pathophysiology, Diagnosis, and Management” by J. P. Mohr, Philip A. Wolf,
Michael A. Moskowitz, Marc R. Mayberg, and Rudiger von Kummer.
2. “Handbook of Stroke” by David O. Wiebers and James F. Toole.
3. “Stroke Rehabilitation: A Function-Based Approach” by Glen Gillen.
4. “Stroke: Essentials for Primary Care” by Patrick D. Lyden and Margaret Kelly-Hayes.
5. “Stroke: A Practical Guide to Management” by A. David Mendelow and Martin M.
Brown.
