Ischemic Brain damage
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26 Terms
What is the global ranking of stroke as a cause of death?
Stroke is the 2nd most common cause of death globally
What percentage of strokes are non-fatal?
About 70% of strokes are non-fatal
What percentage of strokes are ischaemic?
About 85% of strokes are ischaemic
What causes an ischaemic stroke?
Thrombosis or blockage of a cerebral artery
What percentage of strokes are haemorrhagic?
About 15% of strokes are haemorrhagic
What causes a haemorrhagic stroke?
Rupture of a cerebral artery
What happens during ischaemic brain damage?
Interruption of blood supply causes excitotoxicity
What is excitotoxicity?
Neuronal damage caused by excessive excitatory neurotransmitter activity such as glutamate
What happens in the central core during ischaemic stroke?
Irreversible necrosis occurs
What is the penumbra in stroke?
The surrounding region of damaged but potentially salvageable tissue
Why is the penumbra clinically important?
It may be rescued with treatment
What can reperfusion after ischaemia cause?
Production of reactive oxygen species (ROS)
Why are ROS harmful after stroke?
They cause oxidative damage to cells
Why is there a therapeutic opportunity after ischaemic stroke?
Brain damage develops over hours
What processes contribute to further stroke damage?
Inflammation and cell death
What is alteplase?
A plasminogen activator used to dissolve thrombi
How does alteplase work?
It activates plasminogen to break down blood clots
What is the main benefit of alteplase?
Improves functional outcome after stroke
Does alteplase significantly reduce mortality?
No
When must alteplase be given?
Within 3 hours of stroke onset
Why is alteplase not used in haemorrhagic stroke?
It would worsen bleeding
Why is CT scanning required before alteplase treatment?
To distinguish ischaemic from haemorrhagic stroke
Why is the use of alteplase limited?
Short treatment window and bleeding risk
What surgical treatment may be used in stroke?
Removal of clot or obstruction
What are future stroke therapies aiming to develop?
Neuroprotective agents
What is the aim of neuroprotective agents in stroke?
To rescue cells in the penumbral region