Define stroke medical terms
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Understanding Stroke: Medical Terms and Definitions
Introduction to Stroke Terminology
Stroke, also known as cerebrovascular accident (CVA), is a medical condition characterized by the sudden onset of neurological deficits due to an interruption in the blood supply to the brain. This interruption can be caused by either ischemia (lack of blood flow) or hemorrhage (bleeding) . The term "stroke" has evolved over centuries, with its origins dating back to Hippocrates who described it as a sudden impairment of cerebral functions.
Types of Stroke: Ischemic and Hemorrhagic
Ischemic Stroke
Ischemic stroke is the most common type, accounting for approximately 85% of all stroke cases . It occurs when a blood clot obstructs a blood vessel supplying the brain, leading to brain cell death due to lack of oxygen and nutrients. This type of stroke can be further classified based on the underlying cause, such as small vessel arteriolosclerosis, cardioembolism, and large artery athero-thromboembolism. In younger patients, ischemic strokes can also result from extracranial dissection.
Hemorrhagic Stroke
Hemorrhagic stroke, although less common, is the deadliest form of stroke and accounts for about 15% of all cases . It occurs when a blood vessel in the brain ruptures, causing bleeding within or around the brain. Hemorrhagic strokes can be categorized into intracerebral hemorrhage and subarachnoid hemorrhage. Intracerebral hemorrhage can be further divided into deep (basal ganglia, brainstem), cerebellar, or lobar hemorrhages, with causes ranging from hypertensive arteriopathy to cerebral amyloid angiopathy.
Clinical and Diagnostic Criteria
Central Nervous System Infarction
Central nervous system infarction is defined as brain, spinal cord, or retinal cell death attributable to ischemia, based on neuropathological, neuroimaging, and/or clinical evidence of permanent injury. This definition encompasses both symptomatic ischemic strokes and silent infarctions, which do not present with overt symptoms.
Diagnostic Imaging
Advances in diagnostic imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), have significantly improved the ability to differentiate between ischemic and hemorrhagic strokes. These imaging techniques are crucial for effective treatment and prophylaxis of ischemic stroke.
Historical Perspectives and Evolution of Stroke Treatment
Ancient and Medieval Definitions
The understanding and treatment of stroke have evolved significantly over centuries. Ancient physicians, including Ibn Sina (Avicenna), provided early descriptions of stroke, which were based on humoral theories and have since been refined with modern medical knowledge.
Modern Treatment Approaches
In the 20th century, stroke treatment was primarily symptomatic, with limited options for intervention. The introduction of aspirin and intravenous thrombolysis using recombinant tissue plasminogen activator (rtPA) marked significant advancements in ischemic stroke therapy. More recently, mechanical thrombectomy has emerged as a promising treatment for selected patients, offering hope for more effective stroke management.
Conclusion
Stroke is a complex medical condition with diverse etiologies and significant implications for patient health. Understanding the different types of stroke, their clinical presentations, and advancements in diagnostic and treatment methods is crucial for improving patient outcomes. The evolution of stroke terminology and treatment reflects ongoing efforts to enhance the precision and effectiveness of medical care for this critical condition.
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