ABSTRACT
It has occurred to us that one can achieve a better understanding of the pathogenesis of stroke from having had the personal experience of dealing with household plumbing problems, particularly those within an older house. Based on years of experience of at least one of the authors, such plumbing problems can be boiled down to two basic categories, namely, those problems which have to do with the ability of the pipes to carry water efficiently (i.e. clogged pipes) and those in which the pipes leak or burst and the water leaves the conduit, going to places where it should not be. In this analogy, the inability of the carrying capacity of the pipes may be either efferent or afferent. Of course, in the plumbing side of this analogy the more severe aspects of such problems are typically afferent in nature, whereas efferent problems end up being the more common concern for understanding stroke. The problems of leaking or bursting pipes are analogous to those hemorrhagic lesions where blood leaves the vascular compartment to accumulate in unintended places. Here we discuss the hemorrhagic forms of stroke. In a subsequent chapter we will discuss the nature of ischemic lesions, that is, those reflecting clogged pipes.
