Predisposing Factors Etiologic Factors

• Sex (female)
Atherosclerosis
• Age (53)
Increase pressure in the
• Family History
blood going to the brain
of hypertension

• Patient is
Dilation of the walls of left
hypertensive
posterior communicating
artery

Compression on Weakness in the

the nearby cranial arterial wall
nerves and brain
tissues
Leaking of aneurysm
Continuous blood
pressure in the brain
Ruptured of aneurysm

Exposure of the brain to

blood

Disruption of normal brain

metabolism by an increase in
intracranial pressure

Gushing of blood into

the subarachnoid space

Vasospasm Obstruction on the

chorionic villi

Reduced perfusion
Communicating
hydrocephalus
Ischemia

Affected Systems with Signs and Symptoms

CNS Muscular
Headache, Senses G.I Hemiplegia,
LOC, dizziness, Right visual field Dysphagia hemiparesis,
drowsiness deficit, expressive
paresthesia aphasia
 Hypertension is a major risk factor for the occurrence of stroke. Advancing age is also an
issue which is putting the client vulnerable to many diseases and deterioration of bodily systems.
Hyperlipidemia coupled with an unhealthy lifestyle is another factor that plays an essential role.
Without exercise, the fats in the blood will not be burned and it causes narrowing of the vascular
system by sticking and hardening on the vascular walls generating an increase in vascular resistance
and high blood pressure. The patient likes to eat high fat, high salt diet that worsens hypertension.
Last is gender. Statistics revealed that women have higher risk of developing subarachnoid
hemorrhage than men. Combination of these factors predisposed our client for her condition.

With atherosclerosis and hypertension, there is an increased pressure of blood going to

the brain. It caused the left posterior communicating artery to dilate which resulted in the compression
of the nearby cranial nerves and brain tissues. With the dilation, it yields weakness of the arterial wall.
High pressure passing in the artery and dilation caused leaking of blood from the artery. Continuous
supplementation of blood in the brain with increased pressure made the aneurysm to rupture. The
brain is now bathed in blood. Normal brain metabolism is disrupted by the large amount of blood in
the brain that caused intracranial pressure to increase. It is said that if one of the brain components
deviate from the normal, one of the other components must compensate in order to maintain
homeostasis. But in our client, the brain did not compensate which resulted to the increase of
intracranial pressure. High intracranial pressure resulted to the sudden entry of blood into the
subarachnoid space causing two events-an occlusion of the chorionic villi, and vasospasm. Chorionic
villi obstruction will result to increase in size of the ventricles.

After an aneurysm ruptures, narrowing of the arteries at the base of the brain occurs. This
vasospasm will cause perfusion reduction and ischemia and if not intervened immediately will result
to infarction.

With the dilation of the walls of the cerebral artery and vasospasm, various symptoms
were manifested by the patient. Severe headache is caused by the rupture of an aneurysm and
increase ICP. Dizziness, decreasing level of consciousness, and drowsiness is because of the
deprivation of blood, oxygen, and glucose in the brain. Hemiparesis and hemiplegia on the right side
of the body is the cause the damage in the left side of the brain. Expressive aphasia, dysphagia,
ataxia, paresthesia, and right visual deficit are the result of the obstruction of the cranial nerves.