Hello! Welcome to neuropathology.
I’d recommend that you have a formal grasp
of neuroanatomy before embarking upon
our lecture series together here in neuropathology.
We’ll begin our topic by looking at stroke,
the stroke itself in general as we
go through the various categories.
Strokes are a leading cause of death in the US, and
the second most common cause of mortality worldwide.
Now, as we go through stroke, I’m going to give you
some differentials, things that you want to keep in mind,
as we’ve been doing throughout our entire course.
Here, you want to be able to differentiate between
a stroke versus a transient ischemic attack.
And the reason for that is because the
symptoms that the patient is going to present
will be quite similar, won’t they?
However, the time course is extremely different.
We’ll talk about that in a second.
Now, how did the stroke take place?
How is there decrease in blood
supply taking place to the brain
in which all of a sudden
you’ve lost your functioning?
Well, if it is transient ischemic attack, well
usually now, define it as being stroke-like symptoms
but then, the symptoms go away and the
patient comes back to being normal.
For example, a family, husband and wife,
sitting in a living room, watching TV,
and they’re watching their favorite
show, maybe perhaps Full House.
And all of a sudden, the husband
is having a hard time with vision,
having a hard time speaking, slurred speech, and really
is having a hard time getting out of his recliner.
The wife gets extremely concerned and so therefore,
go to the doctor, and only to come to find out that
in a very transient amount of time, maybe
less than an hour, all the symptoms go away.
That’s transient ischemic attack.
The symptoms are extremely
similar to stroke, aren’t they?
But it goes away.
However, what you need to keep in mind is
that this is a risk factor for a stroke
or impending stroke about to happen.
And so therefore, you need to quite aggressive with
your patient to make sure that if it is a microembolism
that is being set off into the circulation of the
brain then it has to be treated appropriately.
The pathophys, now 85% of strokes
that do occur are of ischemic nature
whereas 15% could be hemorrhagic.
And therefore, our time and your time
should be focused upon ischemic and then,
to make sure that we’re complete, I’d give you
a proper definition of a hemorrhagic stroke.