Cerebrovascular Infarct: Stroke

摘要: The brain consumes an enormous amount of energy (20%) that is disproportionate to its small size (2%). It relies on the constant delivery oxygen and glucose produce adenosine triphosphate, cellular unit required maintain cells’ functioning. Even brief loss blood flow as a result blockage or rupture cerebral vessel, called ischemia, leads sudden appearance neurological symptoms. Stroke usually affects only one side brain, perfusion field affected vessel defines specific pattern sensory motor symptoms produced. In minority patients (10%) disrupted because rupture, causing hemorrhagic stroke. vast majority have consequence atherosclerotic plaque, narrowing vessels, distant giving rise floating fragments emboli can lodge in vessels. most effective treatment for stroke involves rapid opening occluded either mechanically using tissue plasminogen activator (tPA), clot-busting chemical. Time essence neurons die quickly absence tPA becomes almost ineffective 3 h after molecular processes underlying ischemic cascade culminates neuronal cell death are well understood, particularly importance excitatory neurotransmitter glutamate (Glu), which elevated toxic concentrations Its binding Glu receptors triggers process excitotoxicity, causes necrotic slow apoptotic death. Approximately 800,000 new cases diagnosed annually United States 200,000 from it. spite excellent poststroke physical occupational therapy, many 4 million survivors live with permanent disability at huge cost individual, their families, society.