Neurological Disorders: Stroke Types and Clinical Manifestations

Overview

Cerebrovascular Disorders: Functional abnormality of CNS due to disrupted blood supply.
- Stroke: Primary cerebrovascular disorder in the US.
- 5th leading cause of death; significant cause of long-term disability.
- Financial impact in billions.
Stroke Definition: Inadequate blood flow to the brain causing death of brain cells.
- Symptoms depend on the affected brain area.

Ischemic Stroke (85% of strokes):
- Thrombotic Stroke:
  - Occurs from injury to a blood vessel wall and formation of a blood clot.
  - Account for ~60% of ischemic strokes.
  - Warning sign: Transient Ischemic Attack (TIA).
- Embolic Stroke:
  - Result of an embolus lodging in a cerebral artery.
  - Associated with cardiac dysrhythmias (e.g., atrial fibrillation).
Hemorrhagic Stroke (15% of strokes):
- Results from bleeding into brain tissue or subarachnoid space.
- Often caused by uncontrolled hypertension.
- Characterized by sudden onset, poor prognosis.

"Chest pain of the brain": A warning sign of a future stroke.
Neurologic dysfunction resolves within 24 hours.
Outcomes:
- 1/3 have no further events.
- 1/3 have more TIAs.
- 1/3 have a stroke.

Non-Modifiable: Age, sex, race, ethnicity.
Modifiable: Hypertension, diabetes, obesity, smoking.
- Similar to cardiovascular disease risk factors.

General Symptoms: Depend on affected brain area, can affect motor activity, intellectual function, spatial perception, personality, sensation, swallowing, and communication.
Left-Sided Stroke:
- Right-sided hemiplegia/hemiparesis.
- Impaired speech (aphasia), memory problems.
- Language centers (Wernicke's and Broca's areas) primarily affected.
Right-Sided Stroke:
- Left-sided hemiplegia/hemiparesis.
- Left-side neglect (failure to recognize left side of body).
- Perceptual sensory deficits, impulsivity, impaired judgment.

Understanding stroke types and clinical manifestations is crucial for patient care.
Upcoming discussion on management of stroke patients.