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Wallerian degeneration occurs after axonal injury in both the peripheral nervous system (PNS) and central nervous system (CNS). It occurs in the section of the axon distal to the site of injury and usually begins within 24–36 hours of a lesion. Prior to degeneration, the distal section of the axon tends to remain electrically excitable.
This leads to poor oxygen supply or cerebral hypoxia and thus leads to the death of brain tissue or cerebral infarction/ischemic stroke. [2] It is a sub-type of stroke along with subarachnoid hemorrhage and intracerebral hemorrhage. [3] Ischemia leads to alterations in brain metabolism, reduction in metabolic rates, and energy crisis. [4]
The most common presentation of cerebrovascular disease is an ischemic stroke or mini-stroke and sometimes a hemorrhagic stroke. [2] Hypertension (high blood pressure) is the most important contributing risk factor for stroke and cerebrovascular diseases as it can change the structure of blood vessels and result in atherosclerosis . [ 5 ]
When a nerve axon is severed, the end still attached to the cell body is labeled the proximal segment, while the other end is called the distal segment. After injury, the proximal end swells and experiences some retrograde degeneration, but once the debris is cleared, it begins to sprout axons and the presence of growth cones can be detected.
Since stroke is an essential part of vascular dementia, [13] the goal is to prevent new strokes. This is attempted through reduction of stroke risk factors, such as high blood pressure, high blood lipid levels, atrial fibrillation, or diabetes mellitus. [2] [5] Medications for high blood pressure are used to prevent pre-stroke dementia. [19]
When the axon is torn, Wallerian degeneration, in which the part of the axon distal to the break degrades, takes place within one to two days after injury. [26] The axolemma disintegrates, [ 26 ] myelin breaks down and begins to detach from the cell in an anterograde direction (from the body of the cell toward the end of the axon), [ 27 ] and ...
The outlook for someone with lateral medullary syndrome depends upon the size and location of the area of the brain stem damaged by the stroke. [2] Some individuals may see a decrease in their symptoms within weeks or months, while others may be left with significant neurological disabilities for years after the initial symptoms appear. [4]
It is more likely to result in death or major disability than ischemic stroke or subarachnoid hemorrhage, and therefore constitutes an immediate medical emergency. Intracerebral hemorrhages and accompanying edema may disrupt or compress adjacent brain tissue, leading to neurological dysfunction.
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