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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]
The ischemic (ischaemic) cascade is a series of biochemical reactions that are initiated in the brain and other aerobic tissues after seconds to minutes of ischemia (inadequate blood supply). [1] This is typically secondary to stroke , injury, or cardiac arrest due to heart attack .
During ischemic stroke, blood supply to part of the brain is decreased, leading to dysfunction of the brain tissue in that area. There are four reasons why this might happen: Thrombosis (obstruction of a blood vessel by a blood clot forming locally) Embolism (obstruction due to an embolus from elsewhere in the body), [2]
Cerebral blood flow (CBF) is the blood supply to the brain in a given period of time. [8] In an adult, CBF is typically 750 millilitres per minute or 15.8 ± 5.7% of the cardiac output . [ 9 ] This equates to an average perfusion of 50 to 54 millilitres of blood per 100 grams of brain tissue per minute.
Brain ischemia has been linked to a variety of diseases or abnormalities. Individuals with sickle cell anemia, compressed blood vessels, ventricular tachycardia, plaque buildup in the arteries, blood clots, extremely low blood pressure as a result of heart attack, and congenital heart defects have a higher predisposition to brain ischemia in comparison to the average population.
Atrial fibrillation causes blood clots to form within the heart, which may travel to the arteries within the brain and cause an embolism. The embolism prevents blood flow to the brain, which leads to a stroke. [26] An aneurysm is an abnormal bulging of small sections of arteries, which increases the risk of artery rupture.
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Cerebral perfusion pressure, or CPP, is the net pressure gradient causing cerebral blood flow to the brain (brain perfusion).It must be maintained within narrow limits because too little pressure could cause brain tissue to become ischemic (having inadequate blood flow), and too much could raise intracranial pressure (ICP).