What is the pathophysiology of the disease process?
Ischemic stroke is a medical condition that occurs when there is a blockage in the blood vessels supplying blood to the brain. Therefore, the pathophysiology of Ischemic stroke begins with the disruption and blockage of blood flowing to the focal area of the brain tissue, leading to a limited supply of blood and oxygen to the brain, causing damage to its tissues. When blood flow is blocked in one of the arteries supplying blood to the brain, plaque formation occurs, constricting the vascular chamber (Kuriakose & Xiao, 2020). These constrictions on the vascular chamber lead to the formation of a blood clot within the blood vessel, and a thrombus is developed, causing thrombotic stroke. If blood blockage and clotting occur in different parts of the body, a decrease in blood supply to the brain region is registered, causing embolism. This obstruction leads to ischemia, wherein the affected brain region experiences an inadequate blood supply.
Neurons in the brain area face oxygen and glucose deprivation, resulting in energy failure and cellular damage. If the blood flow is not restored on time, the condition will lead to the occurrence of irreversible cell death. Another key contributing to Ischemic stroke is inflammation. The inflammatory response, marked by the release of inflammatory mediators and activation of immune cells, can contribute to the damage surrounding the brain tissues. Ischemia can also induce excitotoxicity, which involves the release of excitatory neurotransmitters like glutamate (Kuriakose & Xiao, 2020). Excessive stimulation of neurons by these neurotransmitters can lead to cellular damage and death. In addition, the brain may undergo organelle swelling in response to injury and leaking of cellular contents into extracellular space, which may increase the intracranial pressure, compromising blood flow.
How does the condition description match what you saw or know about your patient?
According to McCarty et al. (2019), Ischemic stroke can be characterized by various symptoms and signs, including numbness and weakness, which occur on one side of the body and may affect the face, arm, or leg. Other symptoms are sudden confusion, slurred speech, and difficulty understanding spoken language, where the person may not be able to communicate properly. It can also be characterized by vision problems such as sudden blurry and double vision or loss of vision in one or both eyes. and severe headaches. However, these symptoms may vary in different people.
Looking at my patient’s condition, I was able to identify symptoms such as numbness where the patient’s face was saggy, the patient’s inability to walk or raise one arm and could not communicate properly; the speech was slurred. Furthermore, the patient complained of having severe headaches and could not see things properly. Therefore, the patient’s condition matched the ischemia stroke description, and I could conclude that the patient was suffering from an ischemia stroke condition. Furthermore, the patient’s history shows that the patient has been experiencing transient ischemia attacks, which fade away after a few minutes.
To fully conclude that the patient was suffering from ischemic stroke, various assessments, labs, and diagnostic tests could be performed on the patient. These evaluations are essential for confirming the diagnosis and determining the extent of brain damage. When conducting the assessment, the finding that I should see is facial droop. Difficult speaking or recognition of speech and altered consciousness level. The lab and diagnostic test that I would likely see is the presence of a clot, the location of the ischemia, and the extent of brain damage from the CT Scan or MRI imaging(McCarty et al., 2019). Also, I would likely see and identify blockage of blood vessels, which CT and MR Angiography could visualize. Furthermore, I would see blood clotting and blood sugar factors from blood testing and identify conditions that may mimic stroke symptoms.
Kuriakose, D., & Xiao, Z. (2020). Pathophysiology and treatment of stroke: present status and future perspectives. International journal of molecular sciences, 21(20), 7609.
McCarty, J. L., Leung, L. Y., Peterson, R. B., Sitton, C. W., Sarraj, A., Riascos, R. F., & Brinjikji, W. (2019). Ischemic infarction in young adults: a review for radiologists. Radiographics, 39(6), 1629–1648.