BIOPHYSICAL MECHANISMS OF STROKE

Background Stroke is the third leading cause of death and the leading cause of long-term disability in the United States. Although a host of genetic, biochemical, physiological, anatomic, and histological facto rs have been implicated, to varying degrees, in the pathogenesis of st roke, biophysical factors are believed to play a significant role in t he development, diagnosis, and therapy of stroke. The purpose of this review article is to identify, describe, and illustrate these causes a nd biophysical and hemodynamic mechanisms predisposing a person to str oke, which often form the basis for novel methods of diagnosis and the rapy. Summary of Review This mini-review begins by describing the phys ical principles that govern the flow of blood through normal and steno sed carotid artery bifurcations. In addition to the tortuosity, curvat ure, and tensile forces of the carotid artery bifurcation, the effects of biophysical phenomena from flowing blood such as viscous forces, p ressure forces, velocity, kinetic energy; momentum, impulse, shear str ess, and vibrational displacements exerted by the flowing blood on the vessel wall are conducive to abnormal flow behavior and patterns, deg rading the vessel wall and creating the potential for stroke. Conclusi ons Recent advances in the treatment of stroke are based on increasing knowledge of its underlying biophysical mechanisms, as well as on bet ter-publicized advances in imaging instrumentation and procedures for the management and treatment of patients.