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[WEB PAGE] Resources for Stroke Patients – European Stroke Organisation

Frequently Asked Questions on Stroke Management

1. Introduction to the Management of Stroke

What Is a Stroke?

Stroke is a type of cerebrovascular disease that involves the vessels of the central nervous system. It usually occurs with sudden onset due to a burst of cerebral arteries, hemorrhage or occlusion by a thrombus or other particles ischemia, leading to focal brain dysfunction. Immediately, nerve cells depleted of oxygen in the involved vascular territory will be functionally disturbed and die if the circulation is not promptly restored. Two main mechanisms may lead to ischemic stroke: occlusive or hemodynamic. These two situations decrease the cerebral perfusion pressure and eventually lead to cellular death. But within certain limits, the brain blood flow can be maintained by autoregulation of cerebral arteries and collateral circulation. When occlusion of an artery develops, blood flow in the periphery of the infarct core is usually reduced but still sufficient to avoid structural damage, so that the functional modifications of cells may be reversible if circulation is restored. This ring-like area of reduced blood flow around the ischemic center of infarct has been termed penumbra as an analogy of the half-shaded part around the center of a solar eclipse. It may largely explain the functional improvement occurring after stroke. Indeed, the neurons surviving in this critical area of infarct at reduced blood flow may again function as soon as blood flow and oxygen delivery is restored.

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