Ischemic Stroke: Characteristics

00:01 What are the characteristics of our ischemic stroke? Well, it's important to understand where did my stroke take place? We call it a Cerebral Vascular Accident, don't we? A CVA.

00:11 In the cerebral vascular accident, where was the location of this particular stroke? Which blood vessel was it affecting? Was it a large blood vessel? Was it a little blood vessel? What part of the brain was affected? Was it a dominant or non-dominant side? Do you understand that at this juncture, it would be a really good idea for you have a firm handle of the neuroanatomy, right? Make sure you know where all the important significant blood vessels are located.

00:39 What part of the brain that they are supplying? And make sure you understand that part of the brain, what is it responsible for? What kind of activity? Is a motor or sensory? So on and so forth.

00:53 Those kind of questions become important for us.

00:55 And it's important that you understand what part of the brain is responsible for what kind of function? Maximal at onset.

01:04 Remember that husband of sitting on a recliner chair, watching TV and all of a sudden boom...

01:11 it happen quickly.

01:12 Slurring of the speech, was unable to walk, maybe blurring of the vision.

01:17 That's characteristic of a stroke.

01:20 May have a stepwise progression depending on the etiology.

01:23 Now, you've heard of multi infarct dementia may be perhaps.

01:27 So therefore, as you have more and more of the blood vessels that are being blocked and blocked and blocked.

01:33 And then the dementia that is setting in takes a step wise like well, deterioration.

01:41 Stop further about risk factors.

01:44 Hypertension, being one of the most common common risk factors for ischemic stroke.

01:50 And if it is hypertension, then what made them happen to the blood vessel focally? Good.

01:56 Talking about benign, chronic type hypertension.

01:59 And you know, about Hyaline arteriosclerosis.

02:02 That could be a possible risk factor.

02:05 What about diabetes itself? Diabetes...

02:08 most of the time accompanied by hyperlipidemia, resulting in atherosclerosis.

02:13 Stroke.

02:14 Tobacco with history of stroke or TIA.

02:17 Now, smoking itself or tobacco is a injurious agent.

02:21 Heart disease.

02:22 For example, we talked about atrial fibrillation.

02:25 What if there was valvular disease or cardiomyopathy? Take a look at those conditions, please.

02:30 All those conditions are the perfect environment to develop a thrombus and then eventually embolize, resulting in a type of focal stroke.

02:40 Patient has hypercholesterolemia and age.

02:43 These are common sense type of risk factors, but nonetheless, important ones that you want to keep in mind.

02:49 Genetic conditions.

02:50 Now these you may or may not be too familiar with, but I would recommend that you have a pretty good idea, as to some of these conditions genetically.

02:59 There's something called CADASIL, which is your Cerebral Autosomal Dominant Arteriopathy with subcortical infarct and leukoencephalopathy.

03:09 And specifically, this gene is called Notch3 gene.

03:13 CADASIL.

03:14 So this patient unfortunately, develops a stroke, and risk factors are not present, but genetically is prone to have one.

03:24 Sickle cell disease, hypercoagulable state, for example, cancer is almost always associated with a hypercoagulable state.

03:32 Pregnancy.

03:33 Hypercoagulable states.

03:36 What else? How about antiphospholipid syndrome? Protein C deficiency.

03:41 So think about protein C.

03:43 Think about protein S.

03:45 These are little proteins that come from the liver.