Question

Mr. Quinn, age 64 years, developed a severe headache several hours ago that has not responded to acetaminophen. Now his speech is slurred, and his right arm and the right side of his face feel numb. He is very anxious and is transported to the hospital. Mr. Quinn has a history of smoking and arteriosclerosis, and there is family history of CVA and diabetes. Assessment at the hospital indicated weakness on the right side, including facial asymmetry and a blood pressure of 220/110 Hg mm. A CT scan showed damaged tissue on the left side of the brain, and an angiogram indicated narrowing of the carotid arteries and middle cerebral arteries, with occlusion of the left middle cerebral artery.
Discuss the pathophysiology related to CVA due to thrombus vs. embolus. Describe the stages in the development of an atheroma.

Answer 1

Answer:

1. Stroke of thrombotic origin originates from the formation of clots, associated with the chronic process of atherosclerosis and platelet aggregation, which occlude the vessels and when the stroke originates from embolism, it is associated with the migration of a material called a embolus that can migrate from Another place in the body and generate, wander through the blood circulation and when it finds a vessel where its diameter no longer allows it to advance, it will generate occlusion and plug it, producing the clinic.

2. Atheroma is defined as the accumulation of fat plaques on the walls of the arteries, this process begins with increased permeability to lipoproteins which adhere to the intimate wall of the arteries, generating inflammation, later this process attracts the presence of macrophages that consume lipoproteins and increases the inflammatory response, becoming foam cells, when they burst, the association of fatty plaques and the inflammatory process generate a decrease in arterial light and progressively less circulatory volume, predisposing the tissue to heart attacks .