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PATHOPHYSIOLOGY OF CEREBROVASCULAR DISEASE Definition: Cerebrovascular disease is a group of brain dysfunctions related to disease of the blood vessels supplying

the brain. Hypertension is the most important cause; it damages the blood vessel lining, endothelium, exposing the underlying collagen where platelets aggregate to initiate a repairing process which is not always complete and perfect.

PREDISPOSING FACTORS: - Age (48 years old) - Gender (Male)

PRECIPITATING FACTORS: - Hypertension - Obese (BMI: 33.51) - Increased cholesterol in diet

Obstruction of blood vessels

Decreased cerebral blood flow

Decreased O2 supply Stimulation of mitochondria Production of lactic acid Change in pH level (acidic) Anaerobic environment Decreased production of ATP by neurons Decreased depolarization Increase cellular death

Infarction

Medial aspect of one frontal lobe or both

Lateral hemisphere and deeper structures of frontal, parietal and temporal

Occipital lobe; anterior and medial portion of temporal lobe, thalamus involvement

Cerebral penducle; cerebellum and brainstem

Paralysis of foot/leg; impaired gait; problems in decision making or performing acts voluntarily; slowness of thought; urinary incontinence; cognitive and affective disorders

Contralateral hemiplegia (face and arm); aphasia; homonymous hemianopsia; altered consciousness; left- right confusion

Homonymous hemianopsia and other visual defects like color blindness; loss of central vision and visual hallucinations; memory deficits; loss of sensory modalities; spontaneous pain; aphasia

Oculomotor nerve palsy; visual disturbance such as diplopia; dystaxia; vertigo; dysphagia

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