Lectures 18-21 Flashcards
what is acute and chronic?
acute - sudden
chronic - long term
what is a stroke?
reduced blood flow and oxygen to the brain.
build up of CO2 since not removed via blood.
What causes a stroke?
athero-thrombo-embolism (clot)
embolism from heart.
intracranial small vessel disease.
brain artery blocked. brain artery bleeds. poor circulation. heart failure. drowning. low oxygen at birth.
what are risk factors for a stroke?
inflammation, either in the brain or outside. atherosclerosis. age. diabetes. ethnicity - african caribbean alcohol. family history. heart disease. high bp. high cholesterol. obesity or unfit. smoking.
what can reduce the risk of a stroke?
statins yo.
what are the symptoms of a stroke?
sudden headache - usually bleeding. dizziness/sudden falls. difficulty speaking/understanding. loss of vision, particularly in one eye. weakness on one side of body.
FAST
can occur during sleep.
what damage does a stroke do?
every minute loses 2 million brain cells.
death isnt immediate however.
what is a “mini stroke”
TIA - transient ischaemic attack
no real damage.
what is the risk from atherosclerosis?
produces toxins.
can break off and block arteries - thrombus.
What is TPA?
breaks down blood clots.
quickly restores blood flow.
What are the side effects of TPA?
it can lead to bleeding.
need to be sure the stroke is caused by a clot, not by bleeding or it exacerbates it.
can cause reperfusion injury.
can cause hyperoxemia (high o2) which leads to inflammation and oxidative stress.
what is the ischaemic core?
low blood flow, affected early on, damage occurs quickly.
beyond rescuing.
surrounded by the ischaemic penumbra, slightly higher blood flow, this region will be damaged if left untreated.
it’s the dead tissue which spread toxins and causes other tissue to die.
Why do dead cells spread toxins?
K inside and Na out normally, maintained by pumps.
no o2 causes pumps to fail, cells depolarise. pumps breakdown and toxins damage healthy neurones/other cells.
what is damaging to the brain that’s released from neurones?
glutamate.
na and ca ions.
free radicals - superoxide (o2 radical).
slide on lecture 18 summarising.
what is inflammation?
response usually to infection, can occur in sterile conditions though.
heat/redness/swelling/pain/loss of function.
name some inflammatory mediators in the brain.
glial cells - astrocytes and microglia.
cytokines, free radicals and prostaglandins.
describe cytokines.
small proteins involved in all forms of disease and injury.
you don’t find them in healthy tissues, they are produced by damaged cells.
they can act on the brain, communicate between cells and activate inflammation.
how do cytokines effect the brain?
hormonal change, sympathetic NS activated, altered immune system, sleepiness, fatigue, altered appetite, weight loss, fever.
what is IL-1?
interleukin 1, cytokine.
key inflammatory mediator.
major disease target.
produced rapidly in the brain in response to an injury.
IL-1beta
IL-1alpha
acts on glia to release toxins.
active at tiny concentrations.
naturally occuring and highly selective competitive antagonist - IL-1Ra (receptor antagonist)