Stroke

Stroke

A cerebrovascular accident where blood supply to the brain is disrupted, leading to brain cell death.

Ischaemic Stroke

A type of stroke caused by inadequate blood supply to the brain, resulting in decreased oxygen (hypoxia) and nutrients to brain tissue. Occlusive - thrombotic and embolic strokes. strokes make up 70% - 80% of all strokes.

Within minutes to hours, an area of irreversible damage develops – infarct core.

Ischaemic penumbra – area surrounding infarct core (potentially viable brain tissue if blood flow restored quickly)

Haemorrhagic Stroke

A type of stroke characterized by bleeding from intracranial vessels into the brain or subarachnoid space, often leading to increased pressure in the brain. 20% - 30%. Cerebral and subarachnoid haemorrhages.

Ischaemic Penumbra

The area surrounding the infarct core in an ischaemic stroke, potentially viable brain tissue if blood flow is restored quickly.

Thrombolysis

Management approach for ischaemic strokes aiming to re-establish blood supply to the ischaemic penumbra using drugs like tPA (Alteplase).

Hemiparesis

Weakness on one side of the body, often seen in stroke patients due to brain damage affecting motor function.

Hemianopsia

Visual field loss on one side, commonly associated with strokes affecting the optic nerve or brain regions responsible for vision.

Spasticity

Combination of paralysis, increased muscle tone, and reflex activity, leading to muscle stiffness and involuntary movements.

Balance and Gait Deficits

Common issues post-stroke, including chronic balance problems, increased falls risk, and impaired motor control.

Exercise Assessments

Evaluations like aerobic capacity testing, muscle strength assessments, and functional ability tests to guide exercise prescription for stroke patients.

Clinical risk factors

• Hypertension.

• Lifestyle – Smoking, poor diet, obesity, physical inactivity.

• History of TIA (Transient Ischaemic Attack)

• Diabetes.

• Cardiac disease

• Vascular conditions e.g. peripheral arterial or vascular disease.

Causes of Haemorrhagic stroke:

• Hypertension: 80 % due to HTN.

• Cerebral amyloid angiopathy (amyloid protein builds up on the walls of the arteries in the brain and weakens them).

• Aneurysm.

• Arteriovenous Malformation (AVM).

• Neoplasm (tumour).

• Coagulation disorder 

2 Types of Haemorrhage:

 Intracerebral haemorrhage – occurs within the brain substance, but a rupture through to the cortical surface may produce associated subarachnoid bleeding.

 Subarachnoid haemorrhage– Bleeding from the intracranial vessels into subarachnoid space.

Both occur mostly in thalamus, patamen, cerebellum (involved with voluntary movement and coordination), Brainstem (responsible for respiration & heartbeat).

Affected side neglect

Loss of sense of position, attention to or awareness of the affected side.
Visual symptoms:

• The stroke injures the optic nerve, (information from eyes to the brain). Called a "visual field deficit" or "hemianopsia," - the person only sees out of a part of each eye, instead of the whole eye.

Sensory symptoms:

• Loss of sensation in the face, arm or leg. May be temporary, or more severe.

Perceptual symptoms:

• The inability to take in information & make sense of the surrounding world. Inability