Strokes Term paper

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Strokes

Though the ultimate result of a stroke or intracranial accident is neurological damsage, the primary cause of this condition stemms from a catastrophy of vascular origin affecting intracranial blood flow. From a technical perspective, a stroke is defined by the World Health Orgaisation as rapidly developing clinical sighn of cerebral function, lasting more then 24 hours or leading to death, with no apparent cause other then of vascular origin. Without a supply of oxygen rich blood to the brain, perminant damage to the tissue occurs within 3-4 minuites (Bickerstaff 1987). Connsequently, the effects of a stroke may range from recovery to perminant damage to an area of the brain (infartion ) or may even result in death. Intracranial accidents are multifaceted diseases which concern many areas of the medical sciences; however, it is the clinical manifestations of the condition which include acute symptoms, diagnosis, treatment and prognosis which will be the main topic of the following discussion as they are problems which are frequently of interest in everyday practice.

Aetiology

At a general level, strokes are classified into two catagories namely ishemic and hemorrhagic strokes. In ishemic strokes, the blood supply to an area of the brain has been obstructed due to a clot in an intracranial blood vessle. The obstruction may be thrombolytic origin whereby an intractanial clot originated within a diseased vessle and increases in size until the vessle is totally occluded. Alternativly, a small ebolus originating from a source outside the brain, ie. coronary artery, may become lodged in the narrow intracranial vessles causing an obstruction. In both scenerios however, the result of an ishemic attack if sustained for a period longer then 3-4 minuites will be perminant damage to an area of the brain producing a loss of function. Of a less serious nature, when the brain is temorarily deprived of oxygen due to generalised narrowing of the intracranial vessles in conditions such as athlerosclerosis a transient ishemic attack will result. In this case no actual clot is present and function may be restored when the primary cause has been resolved. Furthermore many ishemic attacks (both obstructive and transient) will be asymptomatic because the blood supply at the base to the brain, namely the cerebral and vertebral arteries are cooncted at the brain stem by the Circle of Willis which is designed...

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