CHAPTER VI

PATHOPHYSIOLOGY OF THE DISEASE

ACTUAL PATHOPHYSIOLOGY

Predisposing Factors: Precipitating Factors:

 Age (76 years old)  High blood pressure

.

Embolus Formed

Embolus travel to Cerebellum

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 Blood Vessels in Cerebellum ⬆️ Arterial Pressure
Occluded

Wear and Tear of Endothelial Narrowing of the

Cells Arteries

⬇️ Blood flow to Brain Tissue

⬆️ Afterload

Lack of Oxygen & Nutrients BP- 180/100

Supply mmHg

Hypoxia

Altered Cerebral Metabolism

Decreased Cerebral Perfusion

Swelling and Inflammation of

Brain Tissue

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Disruption of the Normal CSF Accumulation of
Flow the Fluid

⬇️Cerebral Blood Flow Increased in CSF

Pressure and
Volume

Brain Cell Death

Ischemia

CEREBELLAR INFARCTION HYDROCEPHALUS

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 B. NARRATIVE EXPLANATION OF THE PATHOPHYSIOLOGY

An embolus is a particle that moves about in our blood vessels, either in

the veins or arteries. Most emboli are composed of clotted blood cells. According

to WebMD, as people get older (especially older than age 70), they are more

likely to develop blood clots. A blood clot is called a thrombus and a moving

blood clot is called a thromboembolus. (MediResource Inc., 2017)

Embolus travels in the arterial bloodstream originating elsewhere. An

embolus is most frequently a thrombus, but it can also be several other

substances including fat (e.g. from bone marrow in a broken bone), air, cancer

cells or clumps of bacteria (usually from infectious endocarditis). (Levvett &

Millar, 2008)

As an embolus moves through the body's blood vessels, it's likely to come

to a passage it can't fit through. It lodges there, backing up blood behind it. A

blood clot will form in the brain blood vessel (artery). The cells that normally get

their blood supply via this passage are starved of oxygen and die. Because of the

pressure, the Endothelial Cells will be damaged. This condition is called an

embolism. (MediResource Inc., 2017)

High blood pressure, or hypertension, occurs when your blood pressure

increases to unhealthy levels. Your blood pressure measurement considers how

quickly blood is passing through your veins and the amount of resistance the

blood meets while it’s pumping. (Kimberly Holland, January 14, 2017)

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 Uncontrolled high blood pressure can lead to stroke by damaging and

weakening your brain's blood vessels, causing them to narrow, rupture or leak.

High blood pressure can also cause blood clots to form in the arteries leading to

your brain and potentially causing a stroke. (Alex Manfield, 19 Sep 2015)

High blood pressure can affect the ability of the arteries to open and close.

If your blood pressure is too high, the muscles in the artery wall will respond by

pushing back harder. This will make them grow bigger, which makes your artery

walls thicker. Thicker arteries mean that there is less space for the blood to flow

through. This will raise your blood pressure even further. (Blood Pressure

Association, 2008)

Hypoxia is a term used to describe a decrease of oxygen in bodily tissues.

This condition may also be referred to as hypoxemia. Hypoxia can occur in any

part of the human body; however, the brain, heart, liver, and lungs are the most

sensitive to a decrease in oxygen. These organs will experience the most

damage in the shortest amount of time without adequate oxygen. (Jenna Liphart,

2003)

Cerebral metabolism is linked to the consumption of resources and the

blood flow impact of the brain function associated with Cerebral blood flow

(ml/min), Cerebral O2 consumption (ml/min) and Cerebral glucose utilization

(mg/min). (Puneet Chandna, MD,PhD, Feb, 17)

Blood flow to the brain is called cerebral perfusion pressure. Blood

pressure and intracranial pressure affect the cerebral perfusion pressure. If the

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blood pressure is low and/or the intracranial pressure is high, the blood flow to

the brain may be limited. This causes decreased cerebral perfusion pressure. It

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

cause brain tissue to become ischemic. (University of Iowa Hospitals and Clinics,

2017)

Ischemic occurs when an artery to the brain is blocked. The brain

depends on its arteries to bring fresh blood from the heart and lungs. The blood

carries oxygen and nutrients to the brain, and takes away carbon dioxide and

cellular waste. If an artery is blocked, the brain cells (neurons) cannot make

enough energy and will eventually stop working. (The Internet Stroke Center,

2017)

Hydrocephalus is a condition characterized by excessive accumulation of

fluid in the brain. Noncommunicating hydrocephalus, also called "obstructive"

hydrocephalus, occurs when the flow of CSF is blocked along one or more of the

narrow passages connecting the ventricles. (Jon Glass, MD, 2011)

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