2. INDEX
• INTRODUCTION OF STROKE
• DEFINITION
• ETIOLOGY
• EPIDEMIOLOGY
• SYMPTOMS
• NON-MODIFIABLE RISK FACTOR
• MODIFIABLE RISK FACTOR
• PATHOPHYSIOLOGY
• DIAGNOSIS

3. INTRODUCTION
stroke is a sudden interruption in the blood supply of the brain. Most strokes are caused by an abrupt
blockage of arteries leading to the brain (ischemic stroke). Other strokes are caused by bleeding into brain
tissue when a blood vessel bursts (hemorrhagic stroke). Because stroke occurs rapidly and requires
immediate treatment, stroke is also called a brain attack. When the symptoms of a stroke last only a short
time (less than an hour), this is called a transient ischemic attack (TIA) or mini-stroke.
The effects of a stroke depend on which part of the brain is injured, and how severely it is injured. Strokes
may cause sudden weakness, loss of sensation, or difficulty with speaking, seeing, or walking. Since
different parts of the brain control different areas and functions, it is usually the area immediately
surrounding the stroke that is affected. Sometimes people with stroke have a headache, but stroke can also
be completely painless. It is very important to recognize the warning signs of stroke and to get immediate
medical attention if they occur.

4. TYPES OF STROKE
Ischemic Stroke
The most common type of stroke, accounting for almost 80 percent of all strokes, is caused by a clot or other
blockage within an artery leading to the brain.
Intracerebral Hemorrhage
An intracerebral hemorrhage is a type of stroke caused by the sudden rupture of an artery within the brain. Blood
is then released into the brain compressing brain structures.
Subarachnoid Hemorrhage
A subarachnoid hemorrhage is also a type of stroke caused by the sudden rupture of an artery. A subarachnoid
hemorrhage differs from an intracerebral hemorrhage in that the location of the rupture leads to blood filling the
space surrounding the brain rather than inside of it.

5. DEFINITION
Ischemic (“is-skeem-ic”) stroke occurs when an artery to the
brain is blocked. The brain depends on its arteries to bring
fresh blood from the heart and lungs. The blood carries
oxygen and nutrients to the brain, and takes away carbon
dioxide and cellular waste. If an artery is blocked, the brain
cells (neurons) cannot make enough energy and will
eventually stop working. If the artery remains blocked for
more than a few minutes, the brain cells may die. This is why
immediate medical treatment is critical.

6. ETIOLOGY
Ischemic stroke can be caused by several different kinds of diseases. The most common
problem is narrowing of the arteries in the neck or head. This is most often caused by
atherosclerosis, or gradual cholesterol deposition. If the arteries become too narrow, blood
cells may collect and form blood clots. These blood clots can block the artery where they
are formed (thrombosis), or can dislodge and become trapped in arteries closer to the
brain (embolism). Another cause of stroke is blood clots in the heart, which can occur as
a result of irregular heartbeat (for example, atrial fibrillation), heart attack, or
abnormalities of the heart valves. While these are the most common causes of ischemic
stroke, there are many other possible causes. Examples include use of street drugs,
traumatic injury to the blood vessels of the neck, or disorders of blood clotting.

7. TYPES OF ISCHEMIC STROKE
Ischemic stroke can be divided into two main types: thrombotic and embolic
• Thrombotic strokes are caused by a blood clot (thrombus) in an artery going to the brain. The clot blocks blood flow
to part of the brain. Blood clots usually form in arteries damaged by plaque.
• Embolic strokes are caused by a wandering clot (embolus) that’s formed elsewhere (usually in the heart or neck
arteries). Clots are carried in the bloodstream and block a blood vessel in or leading to the brain

8. EPIDEMIOLOGY

9. SYMPTOMS
Trouble with speaking and understanding. You may experience confusion. You may slur your words or have
difficulty understanding speech.
Paralysis or numbness of the face, arm or leg. You may develop sudden numbness, weakness or paralysis in
your face, arm or leg, especially on one side of your body. Try to raise both your arms over your head at the
same time. If one arm begins to fall, you may be having a stroke. Similarly, one side of your mouth may droop
when you try to smile.
Trouble with seeing in one or both eyes. You may suddenly have blurred or blackened vision in one or both
eyes, or you may see double.
Headache. A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered
consciousness, may indicate you're having a stroke.
Trouble with walking. You may stumble or experience sudden dizziness, loss of balance or loss of
coordination.

10. NON-MODIFIABLE RISK FACTORS
First : Age
Age is the strongest determinant of stroke, which is less common before 40 years old. becoming double in each
successive decade from 55 years old. Hence, prevalence of stroke for individuals older than 80 years is approximately
27% compared with 13% for individuals 60-79 years of age
In the case of CHD, age is also, by far, one of the most powerful risk factors. The highest incidence of ACS is found in
younger patients than stroke, around the 5th and 6th decades of life. Even though, a quarter of ACS patients are younger
than 55 years, and a similar proportion are older than 75. An observational study conducted in Spain showed that 36%
of patients were younger than 45 years old
Second: Sex
A recent meta-analysis [47] showed that stroke is 33% more incident in men than in women. However, due to longer life
expectancy and much higher incidence of stroke in older ages, women suffer more strokes than men. Etiology and risk
factors of stroke are not the same in men than in women: cardio embolism is the main cause of stroke in women,
whereas large and small vessel disease is the main cause among men .
Ethnicity Genetics-HeredityOther Non-modifiable Risk Factor :

11. MODIFIABLE RISK FACTOR
High Blood Pressure
High blood pressure (HBP) or hypertension affects nearly 30% of the world’s population. It is a risk factor for stroke,
CHD, chronic heart failure, kidney failure, vascular dementia and, in general, for all cardiovascular diseases. According
to WHO data, 62% of all strokes and 49% of CHD are attributable to HBP. The risk of CHD and stroke increases
linearly when blood pressure is higher than 115/75.
Diabetes Mellitus
Diabetes mellitus (DM) is a disease with increasing prevalence. It is associated with a high risk of both ischemic
cardiopathy and cerebrovascular disease, for being a clearly predisposing factor for the development of both Large-
vessel and small-vessel atheroma. It is estimated that 44-52% of deaths in diabetic patients are due to cardiovascular
diseases and ischemic cardiopathy and cerebrovascular disease caused 26.9% of deaths.
Dyslipidemia SmokingAlcoholObesity DietOther Modifiable Risk Factor:

12. PATHOPHYSIOLOGY

13. DIAGNOSIS
When someone has shown symptoms of a stroke or a TIA (transient ischemic attack), a
doctor will gather information and make a diagnosis. He or she will review the events that
have occurred and will:
• get a medical history from you or a family member
• do a physical and neurological examination
• have certain laboratory (blood) tests done
• get a CT or MRI scan of the brain
• study the results of other diagnostic tests that might be needed

14. REFERENCE
http://www.mayoclinic.org
www.strokeassociation.org
http://www.strokecenter.org
www.medlineplus.gov
www.ncbi.nlm.nih.gov