Exploration of a Pathophysiology Case

Running head: EXPLORATION OF A PATHOPHYSIOLOGY CASE
Assessment 1
Name of the Student
Name of the University
Author Note

1EXPLORATION OF A PATHOPHYSIOLOGY CASE
Stroke refers to the medical condition characterized by poor blood flow to the brain,
eventually resulting in death of the brain cells. According to research studies, stroke can be
defined as a neurological deficit that occurs due to cerebrovascular incidents, and persists beyond
24 hours (Jauch et al. 2013). At times, such incidents can get interrupted due to death within the
time frame. Cerebrovascular accident (CVA) is the medical term commonly used for stroke.
Rupture or blockage of a blood vessel results in disruption of blood flow to a part of the brain.
This directly creates a deficiency of oxygen in brain cells and leads to their immediate death
(Andrade et al. 2012). Hindered blood supply to the neuronal tissues often lead to an
extraordinary injury to the brain functions. This essay will focus on a case study of a 75 year-old
widow, Ms. Greta Balodis, following her deterioration in health and diagnosis of CVA.
Pathophysiology of cerebrovascular accident- Stroke is generally divided into two
categories namely, ischemic stroke and hemorrhagic stroke. An analysis of the case study
suggests that the patient Greta suffered from a possible ischemic attack in the year 2012.
Ischemic stroke generally occurs due to loss of blood supply to a part of the brain, thereby
initiating an ischemic cascade. Deprivation oxygen in the brain cells for more than 60- 90
seconds are found to exert damaging effects and irreversible injuries in the patient after three
hours. A similar incident probably occurred in the patient where oxygen deprivation led to
infarction in her brain (Xing et al. 2012). Furthermore, disruption of blood supply occurs due to
narrowing the blood vessel lumen and results in blood flow reduction. This in turn results in
blood clot formation in the vessels. Disintegration of atherosclerotic plaques are also found
responsible for emboli release. Occurrence of CVA in the patient can be correlated to embolic
infarction that might have occurred due to emboli formation in the heart due to atrial fibrillation
(Palm et al. 2012). Research evidences suggest that emboli from the carotid arteries or the heart

2EXPLORATION OF A PATHOPHYSIOLOGY CASE
are found to break off and enter the bloodstream through cerebral circulation, thereby lodging in
and blocking the blood vessels in the brain (Bailey et al. 2012). The fact that she suffers from
hypertension can also be linked to the pathophysiology of stroke. High blood pressure is found to
damage the arteries present throughout the body, thereby creating conditions that result in their
bursting or clogging. Such weakened arteries present in the human brain increased the likelihood
of the patient to suffer from stroke (Wang et al. 2013). Blockage of blood vessels in the brain
resulted in subsequent energy deprivation, which in turn made the brain resort to adopting an
anaerobic metabolism pathways within the regions containing affected brain tissues. According
to evidences such anaerobic metabolism is found to produce less ATP (Ji et al. 2013). However,
this results in accumulation of lactic acid. Depletion of oxygen or glucose in the brain are
directly responsible for release of glutamate, the excitatory neurotransmitter. Further
pathophysiology mechanism of the CVA suffered by Greta can be linked to producted of reactive
oxygen species and oxygen free radicals that damage the endothelium of the blood vessels, and
trigger an ischemic cascade (Rodrigo et al. 2013).
In addition to causing potential damage to the brain tissues, infarction and ischemia can
also be thought responsible for loss of neuronal structural integrity, facilitated by matrix
metalloprotease release. On the other hand, hemorrhagic strokes most commonly occur due to
ruptured aneurysm, prior ischemic formation, and hypertensive hemorrhage. Previous history of
TIA in the patient might have resulted in injury of the brain tissue, thereby leading to their
compression from an expanding hematoma (Aggarwal et al. 2012). This pressure is also
responsible for disrupting blood supply to the affected parts of the brain, with subsequent
infarction. Thus, the blood released from the part where hemorrhage occurred might have created
toxic effecrs on vasculature and the brain structure (Zis et al. 2013). Greta was reported to suffer