Stroke — Cerebrovascular Disease
Stroke — The Brain Attack
From cerebrovascular anatomy and ischemic-cascade molecules to thrombectomy in 2024 — eight integrating modules.
Why a course on stroke?
Stroke is the second-leading cause of death worldwide (~6.5 million deaths per year) and the leading cause of long-term adult disability. One in four adults will have a stroke in their lifetime. Yet stroke is also one of the most treatable acute neurological emergencies: every minute of large-vessel occlusion costs ~1.9 million neurons, and modern reperfusion therapy — intravenous thrombolysis and endovascular thrombectomy — can convert a devastating deficit into near-complete recovery if delivered in time.
This course works from epidemiology and cerebrovascular anatomy through the molecular ischemic cascade and the clinical syndromes, into modern imaging and the evidence-based acute interventions, and finishes with secondary prevention and neuroplastic recovery. It pulls together material from cell physiology, neuroscience, cardiovascular physiology, and pharmacology.
Course Parts
Overview & Epidemiology
Definitions, ischemic vs. haemorrhagic, global burden (~6.5 M deaths/yr, leading cause of disability), risk factors, “Time is brain”, FAST recognition.
Cerebrovascular Anatomy
Internal carotid & vertebrobasilar systems, the Circle of Willis, MCA/ACA/PCA territories, perforating vessels, the watershed zones.
Ischemic Pathophysiology
The ischemic cascade: energy failure, glutamate excitotoxicity, Ca²⁺ overload, ROS, mitochondrial collapse, apoptosis & necrosis. Penumbra biology.
Hemorrhagic Stroke
Intracerebral hemorrhage (hypertensive, amyloid, AVM), subarachnoid hemorrhage (aneurysmal), Cushing reflex, cerebral edema, ICP physiology.
Clinical Syndromes
Anatomy-driven syndromes: MCA, ACA, PCA, lacunar, Wallenberg, locked-in. NIHSS scoring. Crossed deficits and the clinico-anatomic localiser.
Imaging & Diagnosis
Non-contrast CT (early signs, ASPECTS), CTA, CT perfusion (core/penumbra), DWI/PWI MRI, the 4.5 h to 24 h window decision.
Acute Management
IV thrombolysis (alteplase, tenecteplase), endovascular thrombectomy (DAWN, DEFUSE-3), blood-pressure targets, neuro-ICU, decompressive hemicraniectomy.
Prevention & Rehabilitation
Antiplatelets, anticoagulation in AF (DOACs), statins, BP control, carotid revascularisation. Neuroplasticity, motor recovery, aphasia therapy, depression.
What you’ll learn
- Recognise stroke on history alone (FAST/BE-FAST) and predict the affected territory.
- Trace a perforating-artery occlusion to a specific lacunar syndrome.
- Score an NIHSS exam and predict thrombectomy eligibility.
- Read CT for early ischemic changes and ASPECTS scoring.
- Distinguish ischemic core from salvageable penumbra on perfusion imaging.
- Apply DAWN/DEFUSE-3 criteria for late-window thrombectomy.
- Reason about ICH expansion risk and Cushing physiology.
- Choose secondary-prevention regimen by mechanism (LAA, cardioembolic, lacunar).
Prerequisites
Working knowledge of CNS anatomy, action-potential physiology, and basic cardiovascular hemodynamics. The course cross-references Neuroscience, Cell Physiology, and Cardiovascular Physiology.