Brain ischemia
Brain ischemia | |
---|---|
Other names | Cerebral ischemia, Cerebrovascular ischemia |
hemispheric cerebral infarct (left side of image). | |
Specialty | Vascular surgeon |
Brain ischemia is a condition in which there is insufficient bloodflow to the
Ischemia leads to alterations in brain metabolism, reduction in metabolic rates, and energy crisis.[4]
There are two types of ischemia: focal ischemia, which is confined to a specific region of the brain; and global ischemia, which encompasses wide areas of brain tissue.
The main symptoms of brain ischemia involve impairments in
An interruption of blood flow to the brain for more than 10 seconds causes unconsciousness, and an interruption in flow for more than a few minutes generally results in irreversible brain damage.
Symptoms and signs
The symptoms of brain ischemia reflect the anatomical region undergoing blood and oxygen deprivation. Ischemia within the arteries branching from the
Similar to
Multiple cerebral ischemic events may lead to subcortical ischemic depression, also known as vascular depression. This condition is most commonly seen in elderly depressed patients.[citation needed] Late onset depression is increasingly seen as a distinct sub-type of depression, and can be detected with an MRI.[11]
Causes
Brain ischemia has been linked to a variety of diseases or abnormalities. Individuals with
Compression of blood vessels may also lead to brain ischemia, by blocking the arteries that carry oxygen to the brain.
Ventricular tachycardia represents a series of
Blockage of arteries due to plaque buildup may also result in ischemia. Even a small amount of plaque build up can result in the narrowing of passageways, causing that area to become more prone to blood clots.[citation needed] Large blood clots can also cause ischemia by blocking blood flow.[citation needed]
A heart attack can also cause brain ischemia due to the correlation that exists between heart attack and low blood pressure. Extremely low blood pressure usually represents the inadequate oxygenation of tissues. Untreated heart attacks may slow blood flow enough that blood may start to clot and prevent the flow of blood to the brain or other major organs. Extremely low blood pressure can also result from drug
Other
Recently,
Pathophysiology
During brain ischemia, the brain cannot perform
Diagnosis
Classification
The broad term, "
Focal brain ischemia
Focal brain ischemia occurs when a
Global brain ischemia
Global brain ischemia occurs when blood flow to the brain is halted or drastically reduced. This is commonly caused by cardiac arrest. If sufficient circulation is restored within a short period of time, symptoms may be transient. However, if a significant amount of time passes before restoration, brain damage may be permanent. While reperfusion may be essential to protecting as much brain tissue as possible, it may also lead to reperfusion injury. Reperfusion injury is classified as the damage that ensues after restoration of blood supply to ischemic tissue.[16]
Due to different susceptibility to ischemia of various brain regions, a global brain ischemia may cause focal
Biomarker
Use of biomarker is one method that has been evaluated to predict the risk of stroke, diagnose stroke and its causes, predict stroke severity and outcome, and guide prevention therapy.
Blood Biomarkers: Many proteins and RNA biomarkers identified are connected to ischemic stroke pathophysiology includes
Inflammatory Biomarkers - c-reactive protein, Interleukin 6, Tumor necrosis factor α,VCAM-1.
Coagulation / Thrombosis Biomarkers - Fibrinogen, D-dimer, Von Willebrand factor
Other Biomarkers-
Treatment
Alteplase (t-PA) is an effective medication for acute ischemic stroke. When given within 3 hours, treatment with tpa significantly improves the probability of a favourable outcome versus treatment with placebo.[citation needed]
The outcome of brain ischemia is influenced by the quality of subsequent supportive care. Systemic blood pressure (or slightly above) should be maintained so that cerebral blood flow is restored. Also,
Management
When someone presents with an ischemic event, treatment of the underlying cause is critical for prevention of further episodes.[citation needed]
Operative procedures such as carotid endarterectomy and carotid stenting may be performed if the patient has a significant amount of plaque in the carotid arteries associated with the local ischemic events.[citation needed]
Research
A closely related disease to brain ischemia is
See also
References
- ^ Sullivan, Jonathon. "What is Brain Ischemia?". WSU Emergency Medicine Cerebral Resuscitation Laboratory. Archived from the original on 2009-01-06. Retrieved 2008-11-11.
- ^ "Brain Ischemia (Cerebral Ischemia)". Cure Hunter Incorporated. 2003. pp. Relationship Network. Retrieved 2008-11-11.
- ^ a b "Clinical diagnosis of stroke subtypes".
- PMID 15716852.
- ^ a b Raichle, Marcus (1983). "The Pathophysiology of Brain Ischemia" (PDF). Neurological Progress. Archived from the original (PDF) on 2009-02-19. Retrieved 2008-11-11.
- PMID 4434196.
- ^ Raichle, Marcus; Ann Neurol (1983). "The pathophysiology of brain ischemia" (PDF). Neurological Process. Archived from the original (PDF) on 2009-02-19. Retrieved 2009-04-22.
- ^ ISBN 84-494-3359-2.
- ^ Caplan, Louis; Scott Kasner; John Dashe. "Differential diagnosis of brain ischemia". Up to Date For Patients. UpToDate. Retrieved 2008-11-11.
- PMID 10508238.
- S2CID 19083813.
- ^ Sparks, Gareth (2002). "What is Moyamoya disease?". eSSORTMENT. Archived from the original on 2009-03-27. Retrieved 2009-04-13.
- ^ Sullivan, Jonathon. "Bad Things Happen in Ischemia". WSU Emergency Medicine Cerebral Resuscitation Laboratory. Emergency Medicine Cerebral Resuscitation Lab. Retrieved 2008-11-11.
- ^ "Ischemic and Hemorrhagic". Archived from the original on 2009-02-16. Retrieved 2008-11-11.
- S2CID 44452236.
- ^ a b Sullivan, Jonathon. "Two Flavors of Ischemia". Brain Ischemia 101. Emergency Medicine Cerebral Resuscitation Lab. Retrieved 2008-10-13.
- PMID 9177247.
- ^ Dimitri P. Agamanolis, M.D. "Neuropathology - Chapter 2: Cerebral ischemia and stroke". Updated: October, 2017
- ISBN 978-16054-7390-1.
- PMID 21671123.
- PMID 3929929.
- ^ a b "Cerebral Hypoxia Information Page". National Institute of Neurological Disorders and Stroke. National Institutes of Health. 2008-05-07. Archived from the original on 2009-05-05. Retrieved 2009-04-28.
Bibliography
- Gusev, Eugene I.; Skvortsova, Veronica I. (2003). Brain ischemia. New York: Kluwer Academic/Plenum Publishers. ISBN 0-306-47694-0.
Further reading
- Chang, Steven; Doty, James; Skirboll, Stephen; Steinberg, Gary. Cerebral ischemia . cgi.stanford.edu. URL last accessed February 26, 2006.[dead link]