PATHOPHYSIOLOGY OF CEREBROVASCULAR DISEASE

PREDISPOSING FACTORS
Age(50 and above) Sex (male) Race ( Africanamerican) History of hypertension

ETIOLOGY

PRECIPITATING FACTORS
Hypertension Atherosclerosis Cigarette Smoking Obesity Excessive Alcohol Consumption Hyperlipidemia Diabetes Mellitus Diet

UNKNOWN

Narrowed blood vessel Increased pressure in the blood vessel

Prolonged elevation of blood pressure

Forceful flow of blood against arterial wall

Increased pressure in the b Weakening Weakening of blood vessel

Ruptured intracerebral artery

Intracerebral hemorrhage

Inflammatory response

Decreased blood supply to the affected brain tissue

Vasoconstriction Release of chemical mediators

Decreased oxygen supply Tissue Ischemia

Vasodilation Aerobic metabolism converted to Anaerobic metabolism Increase permeability minimal ATP production lactic acid formation

Out pouring of Blood components Cerebral edema

Increased intracranial pressure

further tissue ischemia

Pressure to the nerve endings

Increased pressure in the vagal motor center in the fourth ventricles

increased pressure on the brain stem

compression of cranial nerves

Compression of reticular formation

death

headache

vomiting

changes on LOC(drowsy) -increase systolic BP: 150/100mmhg -widened pulse pressure

Cranial nerve deficit

Motor deficit - Contralateral - hemiplegia - hemiparesis - left facial paresis - dysarthia - unilateral neglect - slurred speech

sensory deficit - Confusion - dizziness - tinnitus