In this stage an amount of energy is set free, and a small part will be used to convert three NAD+ into three NADH, the acetil Ca suffers many modifications what it produces acid oxaloactico, that then recommences the cycle. These reactions liberate two Co2 molecules and produce three molecules of NADH and a FADH molecule. Soon after the electrons of high energy cover the transporting electron chain or respiratory, composed chain for enzymatic complexes where the electros go to yield 36 energy and to produce mols of consumed glucose. This process to give the name of oxidativa fosforilao, occurring in the internal membrane of the mitocndria (COAST, 2005). UPS will not settle for partial explanations. The change for the breath less efficient also becomes the neuron incapable to produce amounts adequate of trifosfato of adenosine (ATP) stops to supply the depolarization processes. In this way, the membrane bombs that keep the electrolytic balances present imperfections and thus the cells stop to function.
When if an area of low cerebral flow that is related as penumbra region, around of the area of infarto initiates the cascade ah. Penumbra is the cerebral region, that was attack for isquemia and that it can be saved with adequate intervention (SELTZER; BARE, 2004). ' ' The ischemic cascade threat the cells in the penumbra because the depolarization of the membrane of the cellular wall takes to an increase in intracellular calcium and the release of glutamato' ' (HOCK, 1999 apud SMELTZER; BARE, 2004). With the administration of activator of tecidual plasminogenio (t-Par) and chokes of the calcium canals (what it limits the calcium influx) the penumbra area can be revitalized. Smeltzer and Bare, (2004) collaborate placing that when continues the calcium influx and the release of glutamato, will occur the activation of enumerate ways harmful, which results in the destruction of the cellular membrane, release of more calcium and glutamato, vasoconstrio and generation of free radicals, what they increase the area of infarto for inside of the penumbra, extending the enceflico vascular accident. In each stage of the ischemic cascade, it has chances for the intervention that limits the extension of the secondary cerebral injury provoked by a BIRD. 5. HEMORRHAGIC VASCULAR ACCIDENT ENCEFLICO Approximately 15% of the Birds is hemorrhagic intracranianos.
The hemorrhagic BIRD can be classified as focal and diffuse. A BIRD hemorrhagic diffuse from the extravasation of blood of the subaracnideo vase occurs them spaces or to intraventricular, in the focal BIRD occurs intraparenquimatosa hemorrhage (GOLDMAN; AUSIELLO, 2005). The vascular aneurisms and malformations generally cause hemorrhage subaracnide, with bleed for the spaces of it eliminate cefalorraquidiano (LCR). The intracerebral hemorrhage can be caused by the rupture of the artery in the interior of substantiates cerebral to put they are not extended to the spaces of LCR (GOLDMAN; AUSIELLO, 2005). The patient victims of a hemorrhagic BIRD, present dficits more serious and its time of recovery if pr