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VI.

Patho-physiology
A. Theoretical Based
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.

Sustained

hypertension

permanently changes the architecture of the blood vessels making them


narrow, stiff, deformed, uneven and more vulnerable to fluctuations in blood
pressure.
A stroke is caused by the interruption of the blood supply to the brain,
usuallybecause a blood vessel bursts or is blocked by a clot. This cuts off the
supplyof oxygen and nutrients, causing damage to the brain tissue.
The most common symptom of a stroke is sudden weakness or numbness of
the face, arm or leg, most often on one side of the body. Other symptoms
include: confusion, difficulty speaking or understanding speech; difficulty
seeing with one or both eyes; difficulty walking, dizziness, loss of balance or
coordination;
severe
headache
with
no
known
cause;
fainting
or
unconsciousness.
The effects of a stroke depend on which part of the brain is injured and how
severely it is affected. A very severe stroke can cause sudden death. The 1990
Global
estimate

Burden
on

the

of

Disease
burden

of

(GBD)
135

study
diseases,

provided

the

first

and cerebrovascular

global
diseases

ranked as the second leading cause of death after ischemic heart disease.
During the past decade the quantity of especially routine mortality data has
increased,
and
is
now
covering
approximately
one-third
of
the
worlds population. The increase in data availability provides the possibility
for updating the estimated global burden of stroke.
Additionally, cerebrovascular disease is the leading cause of disability in
adults and each year millions of stroke survivors has to adapt to a life with
restrictions in activities of daily living as a consequence of cerebrovascular
disease. Many surviving stroke patients will often depend on other peoples
continuous support to survive

B. Client Based

Modifiable:

Non-modifiable:

Sedentary lifestyle
Smoking: 30 sticks/day
Alcohol intake:
occasional
Food and diet

Age: 63 years old


Gender: Male

Triglycerides: 242.48
mg/dL

Carotid stenosis
Decreased Cardiac Output

Compensatory rennin-aldosterone, ADH


Adequate or increased blood volume

Catecholamine compensatory r

Increased SVR

Systemic and pulmonary edema


Increased Preload, stroke volume, and Heart rate

Dyspnea

Increased Myocardial oxygen requirements

Decreased Cardiac output, Decreased ejection fraction


Increased Blood pressure

Decreased tissue perfusion

Impaired cellular metabolism