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Stroke
Jonathan Bland
Pathophysiology
Professor Lori McGowan

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What is a stroke? A stroke is cerebrovascular accident is may be caused by

partial occlusion of an artery, caused by atherosclerosis, or from a small embolus, a
vascular spasm, or local loss of auto-regulation. TIAs are advantageous if they serve as
a warning and lead to early diagnosis and treatment of a problem before the occurrence
of a cerebrovascular accident (CVA, or stroke). The brain must have a constant source
of glucose and oxygen or suffer permanent damage. Not all strokes are preceded by
TIAs (Gould, 2006). Depending on the locations of the vessel depends on how it
affects the body. In most instances, a CVA on the right side of the body affects the left.
Meaning that the patient may have weakness associated to the left side. This works for
both sides of the body. Left side CVA will most often times affect the right side of the
body. The manifestations of TIA are directly related to the location of the ischemia. The
patient remains conscious. Intermittent short episodes of impaired function, such as
muscle weakness in an arm or leg, visual disturbances, or numbness and paresthesia in
the face, may occur. Transient aphasia or confusion may develop. The attack may last a
few minutes or longer but rarely lasts more than 1 to 2 hours, and then the signs
disappear. Repeated attacks are frequently a warning of the development of obstruction
related to atherosclerosis (Gould, 2006).
There are three main categories of stroke. An occlusion of an artery by an
atheroma is the most common cause of CVA (Gould, 2006). This where the patient
slowly develops a build- up of plague in the arterial lumen, it could also be a thrombus.
A second obstruction is caused by embolus lodging in a cerebral artery. Emboli can
also result from other materials, such as tumors, air, or infection (e.g., endocarditis)

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(Gould, 2006). The third main cause is intracerebral hemorrhage, cause by a rupture of
a blood vessel. This is the most severe and destructive of the three main causes of
strokes. This may affect both sides of the brain due to the blood flow into the brain
tissue causing an increase in the intracranial pressure (ICP).
There are risk factors that may cause patients to be at chance of developing
strokes. Those include: diabetes, hypertension, systemic lupus erythematosus,
elevated cholesterol levels, hyperlipidemia, and atherosclerosis, a history of TIAs,
increasing age, and heart disease. The risk factors for atherosclerosis apply similarly to
CVA (Gould, 2006).
Most often times the warning signs the patient may have is what is called a TIA,
Transient ischemic attack. This is a temporary localized reduction of blood flow in the
brain. The TIA may happen just once or multiple times. Again just like the stroke, the
TIA affects the body depending on the location of the reduction of blood flow in the
brain. Not all strokes are preceded by TIAs.
Treatment often depends on how fast the stroke is diagnosed. If the patient is in
the hospital shortly after the stroke happens and it can be determined that the patient is
having a stroke of that is not a rupture the patient can be placed on thrombolytic drugs
that are known as clot-busting agents tPA, tissue plasminogen activator. If the patient
is having a ruptured arterial vessel surgical intervention may be need to stop and
correct the rupture. In some states EMS, is directly involved in identifying strokes and
starting tPA. Glucocorticoids may reduce cerebral edema (Gould, 2006). Once the

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stroke has occurred the medical field can only do so much to reverse what has
happened. In some instances the stroke patient cannot be helped by medications. The
patient may have to go through rehab to learn how to do basic things in life because of
the damage done by stroke.

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Works Cited
Gould, B. E. (2006). Pathophysiology for the Health Professionals, 3rd Edition. Philadelphia: W.B.
Sauders.