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Cerebral infarction, also known as an ischemic stroke, is the pathologic process that results in an area of necrotic tissue in the brain (cerebral infarct). [1] In mid to high income countries, a stroke is the main reason for disability among people and the 2nd cause of death. [2]
Ischemic stroke is caused by interruption of the blood supply to the brain, while hemorrhagic stroke results from the rupture of a blood vessel or an abnormal vascular structure. About 87% of stroke is ischemic, with the rest being hemorrhagic. Bleeding can develop inside areas of ischemia, a condition known as "hemorrhagic transformation." It ...
Watershed stroke symptoms are due to the reduced blood flow to all parts of the body, specifically the brain, thus leading to brain damage. Initial symptoms, as promoted by the American Stroke Association, are FAST, representing F = Facial weakness (droop), A = Arm weakness (drift), S = Speech difficulty (slur), and T = Time to act (priority of intervention).
Pure motor stroke/hemiparesis (most common lacunar syndrome: 33–50%) posterior limb of the internal capsule , basilar part of pons , corona radiata It is marked by hemiparesis or hemiplegia that typically affects the face, arm, or leg of the side of the body opposite the location of the infarct.
In pathology and anatomy the penumbra is the area surrounding an ischemic event such as thrombotic or embolic stroke.Immediately following the event, blood flow and therefore oxygen transport is reduced locally, leading to hypoxia of the cells near the location of the original insult.
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]
When watershed stroke occurs in the brain, it produces unique focal neurologic symptoms that aid clinicians in diagnosis and localization. For example, a cerebral watershed area is situated in the dorsal prefrontal cortex; when it is affected on the left side, this can lead to transcortical motor aphasia .
Evidence from subcortical small infarcts suggests that motor fibers are somatotopically arranged in the human corona radiata. Following subtotal brain damage, localization of the corticofugal projection in the corona radiata and internal capsule can assist in evaluating a patient's residual motor capacity and predicting their potential for functional restitution.
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