Pathophysiology and Pharmacology

This causes blood to accumulate compressing the brain. There are two types of haemorrhagic strokes. Which include intracerebral, and subarachnoid categorized based on the disease aetiology (Ewan et al. 2010).
Ischemic Cerebrovascular Accident is caused by the interruption of blood supply to the cerebral tissue. It has multiple etiologic mechanisms and clinical manifestations. The ischemia is caused by thrombosis, embolism, arterial luminal obliteration, venous congestion and systemic hypoperfusion (Laredo et al. 2011). An Ischemic thrombotic stroke is caused by the development of a clot that obstructs the blood vessel. Pathology in the local endothelium is the common trigger of thrombosis. The most common pathological feature of vascular obstruction is the chronic inflammation disease Atherosclerosis.
Atherosclerotic plaques usually form at bifurcation points of vessels and high shear stress points. They overexpress plasminogen activator inhibitor-1 that inhibits the enzyme plasminogen activator, which converts plasminogen to plasmin that degrades plasma proteins (Jorge et al. 2010). Plasmin is essential in fibrinolysis. Therefore, inhibition of activation promotes the formation of blood clots. Endothelial surface injury triggers an inflammatory reaction recruiting cytokines and peroxides. These substances trigger the expression of P-selectin, E-selectin and intercellular adhesion molecule-1 by the endothelial cells molecules necessary for the adhesion of recruited leukocytes to the endothelial wall. They migrate into the intima forming a fatty streak that are then infiltrated by macrophages forming plaques and accumulating lipids to form foam cells (Santos et al. 2012). Plaques can enlarge and occlude blood vessels, become ulcerated, calcify, develop thrombosis, form embolus or lead to the formation of an aneurysm. Ulceration occurs when the atherosclerotic plaques