Cerebrovascular Pathophysiology and its Diagnosis

Tanina Maximiliano
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Abstract

Stroke is a type of cerebrovascular disease involves central nervous system. It occurs with sudden due to the burst of cerebral arteries, haemorrhage, or other particles which leads to ischemia and to focal brain dysfunction [1]. Nerve cells depleted oxygen in the involved vascular territory will be functionally disturbed and die if the circulation is not promptly restored. Two main mechanisms leads to ischemic stroke are occlusion and haemodynamic impairment. These two situations reduce the cerebral perfusion pressure and leads to cellular death. The blood flow in the brain can be maintained by auto-regulation of cerebral arteries and collateral circulation within certain limits. When occlusion of an artery develops, blood flow in the periphery of the infarct core is reduced but still it remains sufficient to avoid structural damage, so that the functional modifications of cells may be reversible if circulation is restored. This ringlike area of reduced blood flow around the ischaemic centre of infarct has been termed penumbra as an analogy of the half-shaded part around the centre of a solar eclipse. It explained the functional improvement occurring after stroke. The neurons which are surviving in this critical area of infarct are reduced at blood flow and may function again as soon as the blood flow and oxygen delivery is restored.
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脑血管病理生理学及其诊断
中风是一种累及中枢神经系统的脑血管疾病。它是由于脑动脉破裂、出血或其他颗粒导致缺血和局灶性脑功能障碍而突然发生的。如果不及时恢复循环,受累血管区域内缺氧的神经细胞将功能紊乱并死亡。导致缺血性脑卒中的两个主要机制是闭塞和血流动力学损伤。这两种情况降低脑灌注压,导致细胞死亡。脑内血流可通过脑动脉和侧支循环在一定范围内的自动调节来维持。当动脉闭塞时,梗死核心周围的血流量减少,但仍足以避免结构损伤,因此,如果循环恢复,细胞的功能改变可能是可逆的。缺血中心周围血流量减少的环状区域被称为半影,类似于日食中心周围的半阴影部分。它解释了中风后的功能改善。存活在这个关键梗死区域的神经元在血流时减少,一旦血流和氧气输送恢复,它们就可能再次发挥作用。
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