STROKE

Stroke (United Kingdom: stroke, cerebrovascular accident, CVA) is a condition that occurs when the blood supply to a part of the brain is suddenly interrupted. In brain tissue, the lack of blood flow causes a series of biochemical reactions, which can damage or shut down the nerve cells in the brain. The death of brain tissue can lead to loss of function which is controlled by that network. Stroke is the third leading cause of death in the United States and many other industrialized countries in Europe (Jauch, 2005). If it can be saved, sometimes patients experience paralysis of limbs, loss of a portion of memory or the ability of speech. In recent years more and more popular the term brain attack. The term is in accord with the terms that are already widely known, ' heart attack '.

A Stroke occurs because blood vessel branch hampered by emboli. Cholesterol Emboli can be or the air.

Classification

Strokes are divided into two types, ischemic strokes and stroke hemorragik. A prognosis results of a study in Korea stated that, 75,2% ischemic strokes suffered by men with the prevalence of hypertension, smoking and alcohol consumption. Based on the system of the TOAST, the composition is divided into 20.8% 17.4% of LAAS, LAC, 18,1% 16.8% CEI, UDE and 26.8% ODE.

Stroke Hemorragik

In a stroke, blood vessel rupture hemorragik so that impedes normal blood flow and blood seeping into an area in the brain and ruin it. Bleeding can occur in all parts of the brain such as the caudate putamen; talamus; the hippocampus; frontal, parietal, and occipital cortex; the hypothalamus; area suprakiasmatik; cerebellum; pons; and midbrain.Nearly 70 percent of cases of stroke hemorrhagik attack sufferers of hypertension. Stroke hemorragik divided into subtypes of intracerebral bleeding (ICH), subarachnoid space bleeding (legitimate), cerebral venous thrombosis, stroke and spinal cord. ICH is further divided into parenchymal hemorrhagic infarction, bleeding, and punctate bleeding.

In Ischemic Stroke

Ischemic strokes blockage can happen along the blood vessels arteries leading to the brain. Blood to the brain is supplied by two international and two arteria karotis artery of vertebral fracture. This artery-artery is a branch of the aortic arch (arcus aorta), heart failure.

Handling

Acute stroke patients are usually given BC-20302, or microplasmin, oxygen infusions, mounted to enter food substances, liquids and then given manitol or corticosteroid to reduce swelling and pressure on the brain, due to infiltration of white blood cells. A recent study shows that other symptoms of paralysis and could have been prevented or recovered if recombinan tissue plasminogen motivator for (rtPA) or streptokinase that function destroys the emboli are given in a time of 3 hours, [61] after the onset of a stroke. Trombolisis with proven beneficial in the management of rtPA stroke acute, although it can increase the risk of bleeding of the brain, especially in the area of brain blood barrier open.

Some compounds are given in conjunction with the rtPA to reduce risk include batimastat (BB-94) and marimastat (BB-2555), which inhibits the enzyme MMP, the spin trap agent compounds such as α-phenyl-N-t-butylnitrone (PBN) and disodium-[tert-butylimino) methyl] benzene-1,3-N-oxide disulfonate (NXY-059), and the compound of anti-ICAM-1. Method of treatment of hemodilusi with the use of albumin is still controversial, however research by The Amsterdam Stroke Study gives the prognosis in the form of a decrease in the death rate of 27% to 16%, increased self-reliance activities of 35% to 48%, at 3 months since going on the attack of acute stroke.

Recovery

Stroke related to limitations of pulihnya brain function, though the area of fairy-neuroplastik myocardial becomes more acidic, allowing improvements to sensorimotorik functions do the mapping in the area of the brain that is damaged. Cellular level, going on two processes of regeneration in the cortex of the fairies-myocardial, Axon will experience changes in the phenotype of the neurotransmitter into the status of the regenerative, and poked the stem to make a new connection under the influence of trombospondin, laminin, and NGF secretion cells Schwann, results and cell migration occurred into the cortex neuron progenitor peri-myocardial. Almost all 1 month since going on the attack, stroke-fairy area will experience decreased myocardial molecular barrier to growth. In this span of time, neuron will activate genes that stimulate the growth, in the undulating rhythms. Neurogenesis intertwined with angiogenesis is also going on a bumpy beginning with the migration of GFAP expression with neuroblas, which is in a zone subventrikular into the cortex of the fairies-myocardial. This migration is mediated by several compounds, among others, of erythropoietin, stromal-derived factor-1 (SDF-1) and angiopoietin-1, to generate migration neuroblas with mileage and longer time span shorter cytokinesis.

Impaired function of the GABA in ekstrasinaptik absorbent fairies-by myocardial dysfunction occurs due to GABA transporter GAT GAT-3/-4, in the rat, an animal can be recovered by administering benzodiazepina.

Prevention

In humans without risk factors stroke with aged under 65 years, the risk of the occurrence of stroke in 1 year revolves around the figure of 1%. After the mild stroke or TIA, the use of anti-coagulant compounds such as warfarin, a drug used for people with atrial fibrillation, would lower the risk of stroke from 12% to 4% in one year. Whereas the use of anti-platelet compounds such as aspirin, typically on a daily dose of 30 mg or more, will only provide protection with a 10.4% reduction in risk. A combination of aspirin and dipyridamole provide protection even further with a decreased risk of annual be 9.3%.

The best way to prevent the occurrence of stroke is to identify people who are high risk and control risk factors stroke as much as possible, such as smoking, hypertension, and spinal stenosis in the carotid vessels, set a healthy diet and avoid foods that contain bad cholesterol (LDL), and olaraga on a regular basis. Spinal Stenosis is vasodilation effect (edrf) is generally caused by a decrease in the secretion of NO by endothelial cells, the cells can be muted Ascorbic acid that increases the secretion of NO by endothelial cells through cell pathways NO synthase or siklase nitrita be guanilat, reduce and inhibit LDL oxidation of NO in the trajectory of atherosclerosis.

Some health institutions such as the American Heart Association or the American Stroke Association Council, the Council on Cardiovascular Radiology and Intervention provides a guide to prevention starts with careful handling of the various diseases that can be caused by atherosclerosis, the use of a compound of anti-trombotik for kardioembolisme and anti-platelet compounds for cases of non-kardioembolisme, followed by the control of risk factors such as arterial dissection, patent foramina ovale, hiperhomosisteinemia, hypercoagulable states, sickle cell disease; cerebral venous sinus thrombosis; stroke, stroke during pregnancy hormones resulting from the use of post menopause, use of anti-coagulant compounds after the occurrence of cerebral bleeding; hypertension, hypertension, smoking, diabetes, atrial fibrillation, carotid stenosis, Dyslipidemia, obesity, metabolic syndrome, excessive alcohol consumption, excessive consumption of drugs, consumption of drugs, birth control, migraines, enhancement of snoring lipoprotein and phospholipase.

Source: www.wikipedia.com