Bonnie is a 70-year-old woman who lives alone. One evening, she felt lightheaded and dizzy. When her head began to ache, she decided to take an analgesic and go to bed early. The following morning, upon awakening, she was unable to move the bed sheets with her right arm. At this point, she was experiencing tingling sensations in her limbs, and she had difficulty keeping her balance. She dialed 911 for help, and by the time the ambulance arrived, she was confused and unable to articulate her words although she knew what information he was asking of her. In the hospital, she was examined and treated for ischemic stroke.

1. Stroke, or brain attack, involves brain tissue injury. Describe ischemic penumbra and what factors contribute to the survival of the neurons involved. What happens if the cells of the penumbra are unable to be preserved? There are two zones of injury during an ischemic attack, the core ischemic zone and the ischemic penumbra, that is ischemic but still viable cerebral tissue [Gen19]. The cells within the penumbra, “a rim of mild to moderately ischemic tissue lying between tissue that is normally perfused and the area in which infraction is evolving, may remain viable for several hours[Gen19].” Early intervention of establishing reperfusion is necessary to save those cells. Cells in this region will die if reperfusion is not established.

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