Ischemic vs Hemorrhagic Stroke

What occurs during an ischemic stroke?

• Loss of perfusion to part of brain

• Produces central area of irreversible infarction

• Surrounded by potentially ischemic tissue

What is an embolic stroke?

• ~20% of ischemic CVAs

• Embolus travels through bloodstream → cerebral artery occlusion

• Often associated with cardiovascular disease

• Commonly affects middle cerebral artery

• Typically:

  • Rapid onset

  • Little/no warning

  • May present with headache

What is a thrombotic stroke?

• Atherosclerotic plaque develops in an artery

• Eventually occludes artery/branch → infarction

• Variable onset

  • Minutes → several days

• Often occurs:

  • During sleep

  • Upon awakening

  • After MI

  • After surgery

What characterizes a hemorrhagic stroke?

• 10–15% of CVAs

• Abnormal bleeding within brain

• Infarction results from:

  • Disrupted blood supply

  • Compression from accumulated blood

• Hypertension = major precipitating factor

• Can involve:

  • Aneurysm

  • AV malformation

  • Trauma

What are common signs of a hemorrhagic stroke?

• Severe headache

• Vomiting

• High blood pressure

• Abrupt symptom onset

• Symptoms may evolve rapidly

• High early mortality risk