Ischemic Stroke - Etiology, pathophysiology, symptoms, signs, diagnosis & prognosis from the MSD Manuals - Medical Professional Version. The pathogenic process leading from the development of cerebrovascular or extracranial atherosclerosis to the occurrence of acute ischemic stroke and. Ischemic stroke (see the image below) is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery and is more common than hemorrhagic stroke.


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Pathology | Internet Stroke Center

Abstract Preventing death and limiting handicap from ischaemic stroke are major goals that can be achieved only if the pathophysiology of infarct expansion is properly understood. Physiological quantitative PET imaging ischemic stroke pathophysiology translated this knowledge in man and revealed the presence of considerable pathophysiological heterogeneity from patient to patient, largely unpredictable from elapsed time since onset or clinical deficit.

While these observations underpinned key trials of thrombolysis, they also indicate that only patients who are likely to benefit should be exposed to its risks. Accordingly, imaging-based diagnosis is rapidly becoming an essential component of stroke assessment, replacing the clock by individually customized management.

Additional Resources The pathogenic process leading from the development of cerebrovascular or extracranial atherosclerosis to the occurrence of acute ischemic stroke and consequent cell damage is complex.

Much of the intermediary damage is complex and many of the intermediary steps are not ischemic stroke pathophysiology understood. Ischemic stroke may arise from the atherosclerotic large cerebral arteries eg, carotid, middle cerebral, and basilar arteries or atherosclerotic small cerebral arteries eg, lenticulostriate, basilar penetrating, and medullary arteries ; ischemic stroke may also be cardioembolic in origin.

Most investigations of atherogenesis have focused on the coronary arteries, but, with some possible exceptions, similar processes occur in the cerebral circulation.

Ischemic stroke pathophysiology the brain, the process is better characterized in the larger arteries than in small arteries supplying deep cerebral white matter. Some evidence suggests that the underlying pathogenetic process in small arteries may differ from that described in larger arteries [DeGraba TJ, et al.

Barnett HJM, et al eds. Emboli may dislodge spontaneously or after invasive cardiovascular procedures eg, catheterization.


Rarely, thrombosis of the subclavian artery results in embolic stroke in the vertebral artery or its branches. Lacunar infarcts Ischemic ischemic stroke pathophysiology can also result from lacunar infarcts. Whether emboli cause lacunar infarcts is controversial.

Lacunar infarcts tend to occur in elderly patients with ischemic stroke pathophysiology or poorly controlled hypertension. Other causes Any factor that impairs systemic perfusion eg, carbon monoxide toxicity, severe anemia or hypoxia, polycythemia, hypotension increases risk of all types of ischemic strokes.

Ischemic Stroke - Neurologic Disorders - MSD Manual Professional Edition

Less commonly, ischemic stroke results from vasospasm eg, during migraine, after subarachnoid hemorrhage, after use of sympathomimetic drugs such as cocaine ischemic stroke pathophysiology amphetamines or venous sinus thrombosis eg, during intracranial infection, postoperatively, peripartum, secondary to a hypercoagulability disorder.

Pioglitazone after ischemic stroke or ischemic stroke pathophysiology ischemic attack. N Engl J Med Stroke while on long-term left ventricular assist device support: Pathophysiology Ischemic stroke pathophysiology blood flow in a single brain artery can often be compensated for by an efficient collateral system, particularly between the carotid and vertebral arteries via anastomoses at the circle of Willis and, to a lesser extent, between major arteries supplying the cerebral hemispheres.

However, normal variations in the circle of Willis and in the caliber of various collateral vessels, atherosclerosis, and other acquired arterial lesions can interfere with collateral flow, increasing the chance that blockage of one artery will cause brain ischemia.

  • Ischemic Stroke Imaging