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Overview:
Ischemic stroke is one of the major neurologic diseases in the world, which can cause paralysis or even death. The main cause of ischemic stroke is the irregular blood flow supply to brain tissue. The reduction of oxygen concentration level in the arterial supply leading to severe damage to the brain tissue. Strokes contributes to many social, medical, economical impacts on people’s lives. To achieve a good medical practice and better prevent stroke, scientists and medical practitioners tryto better understand the underlying pathophysiology mechanism of stroke. Pathophysiology of ischemic stroke is complicated and includes different aspects such as the effects of ischemia at the tissue level, the concept of ischemic penumbra, the effects of cerebral edema and effects of ischaemic stroke on the brain structural integrity.
1. Effects of ischemia at the cellular level:
Reduced supply of blood to the brain tissue leads to a massive decrease in energy production. ATP is the main energy generator at the cellular level, which can keep the brain tissue in a functional state. Improper blood flow due to a stroke, causes reduction of cellular power, distribution in cytoplasmic ion pumping system and increases the release of cytotoxic substances in the brain cavity such as glutamate and aspartate, which affect neuronal membranes. In addition, damaging the cell membrane leading to the production of different reactive oxygen classes. Finally, declining of oxygen supply activates neuroapoptosis process in the neurons.
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References:
1. A. Bakhai, The burden of coronary, cerebrovascular and peripheral arterial disease, PharmacoEconomics 22 (Suppl. 4) (2004) 11–18.
2. P.U. Heuschmann, K. Berger, B. Misselwitz, P. Hermanek, C. Leffmann, M. Adelmann, H.J. Buecker-Nott, J. Rother, B. Neundoerfer, P.L. Kolominsky-Rabas, Frequency of thrombolytic therapy in patients with acute ischemic stroke and the risk of in-hospital mortality: the German Stroke Registers Study Group, Stroke 34 (2003) 1106–1113.
3. Deb, Prabal, Suash Sharma, and K. M. Hassan. “”Pathophysiologic mechanisms of acute ischemic stroke: An overview with emphasis on therapeutic significance beyond thrombolysis.”” Pathophysiology 17, no. 3 (2010): 197-218.”
Written by Burhan Fakhurji.
