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Stroke

Date: 2018-01-10
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Definition and Classification

Stroke is a general term for acute cerebrovascular diseases, such as cerebral thrombosis, cerebral infarction or cerebral hemorrhage. It is featured with acute onset, critical condition, serious sequelae, high morbidity and mortality, becoming one of the most common causes of death.

Stroke is a medical condition of blood circulation disorder, which can be divided as hemorrhagic and ischemic.

Stroke refers to a series of disease related with cerebral blood circulation disorders. The clinical manifestations may include as temporary or permanent brain injury and dysfunction. Stoke is the most important factor leading to morbidity and mortality in adults. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due tobleeding, the former accounted for 70-80%.

 

Cardiogenic Stroke

Clinically, if the thrombus or embolus is generated from the heart and fall off into the blood circulation, and cause cerebral artery embolism, it is referred to as cardiogenic stroke. Cardiogenic stroke is accounting for 25-30% of ischemic stroke. Beside this, there are about 25% of ischemic stroke patients, the reason cannot be find through all diagnostic methods, it is called cryptogenic stroke. In fact, most of these patients are still suspected to be related to cardiogenic stroke. So the cardiogenic stroke patients may account for nearly 50% of ischemic stroke patients. The major risk factor for cardiogenic stroke is atrial fibrillation. Atrial fibrillation can result in decreased atrial systolic function, blood stasis, and thrombogenesis in atria cavity or left atrial appendage. Then the thrombus could lead to recurrent stroke. Atrial fibrillation patients are associated with 5-17 fold cerebral embolism risk compared with non-AF patients.

 

Cardiogenic Stroke Prevention

As reported, about 91% of thrombi were originated in the left atrial appendage in patients with non-valvular heart disease; about 57% of thrombi were present in the left atrial appendage in patients with valvular heart disease. Since 1948 the first resection of the left atrial appendage, surgical exclusion of the left atrial appendage has been developed for 70 years. Mechanical closure of the left atrial appendage, as a preferred surgical method to prevent stroke in patients with atrial fibrillation, it is easy to perform through open surgery or minimally invasive surgery. Mechanical closure of the left atrial appendage is more effective than oral warfarin in the reduction the stroke related to atrial fibrillation. So Professor James L. Cox proposed it should be widely applied, becoming one of the best solutions to prevent stroke in patients with atrial fibrillation.


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