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The cause of stroke is an interruption in the blood supply, with a resulting depletion of oxygen and [[glucose]] in the affected area. This immediately reduces or abolishes [[neuron]]al function, and also initiates an [[ischemic cascade]] which causes neurons to die or be seriously damaged, further impairing brain function.  
The cause of stroke is an interruption in the blood supply, with a resulting depletion of oxygen and [[glucose]] in the affected area. This immediately reduces or abolishes [[neuron]]al function, and also initiates an [[ischemic cascade]] which causes neurons to die or be seriously damaged, further impairing brain function.  
==Causes==
==Causes==
===Ischemic Stroke===
===Life Threatening Causes===
====Thrombotic Stroke====
Thrombotic stroke can be divided into two types depending on the type of vessel the thrombus is formed on:


* '''Large vessel disease''' involves the common and [[internal carotid artery|internal carotids]], [[vertebral artery|vertebral]], and the [[Circle of Willis]]. Diseases that may form thrombi in the large vessels include (in descending incidence):
===Common Causes===
** [[Arteritis]]/[[vasculitis]]
** [[Atherosclerosis]]
** [[Aortic dissection|Dissection]]
** [[Fibromuscular dysplasia]]
** [[Giant cell arteritis]]
** [[Moyamoya syndrome]]
** Noninflammatory vasculopathy
** [[Takayasu arteritis]]
** [[Vasoconstriction]]
   
* '''Small vessel disease''' involves the intracerebral arteries, branches of the Circle of Willis, [[middle cerebral artery]], stem, and arteries arising from the distal vertebral and [[basilar artery]]. Diseases that may form thrombi in the small vessels include (in descending incidence):
** Lipohyalinosis (lipid hyaline build-up secondary to hypertension and aging) and fibrinoid degeneration (stroke involving these vessels are known as lacunar infarcts)
** Microatheromas from larger arteries that extend into the smaller arteries (atheromatous branch disease)


====Embolic Stroke====
===Causes by Organ System===
=====High Risk Cardiac Causes<ref name="ay">{{cite journal | author=  Ay H; Furie KL; Singhal A; Smith WS; Sorensen AG; Koroshetz WJ | title=  An evidence-based causative classification system for acute ischemic stroke | journal=  Ann Neurol | year=2005 | pages=688-97 | volume=58 | issue=5 | id=PMID 16240340}}</ref>=====
* [[Antiphospholipid syndrome]]
* [[Atrial fibrillation]] and [[paroxysmal atrial fibrillation]]
* Atrial or ventricular thrombus
* Bioprosthetic and [[Artificial heart|mechanical heart]] valves
* Chronic myocardial infarction together with [[ejection fraction]] <28 percent
* [[Coronary artery bypass graft]] ([[CABG]]) surgery
* [[Dilated cardiomyopathy]]
* [[Infective endocarditis]]
* [[Left atrial myxoma]]
* [[Libman-Sacks endocarditis]]
* [[Marantic endocarditis]] from cancer
* [[Papillary fibroelastoma]]
* Recent [[myocardial infarction]] (within one month)
* Rheumatic mitral or [[aortic valve]] disease
* [[Sick sinus syndrome]]
* Sustained [[atrial flutter]]
* Symptomatic [[congestive heart failure]] with ejection fraction <30 percent


=====Potential Cardiac Causes=====
{|style="width:80%; height:100px" border="1"
* Atrial septal [[aneurysm]]
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
* Atrial septal aneurysm with patent foramen ovale
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
* Complex atheroma in the [[ascending aorta]] or proximal arch
|-
* Isolated left atrial smoke on echocardiography (no [[mitral stenosis]] or atrial fibrillation)
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
* Left ventricular aneurysm without thrombus
|bgcolor="Beige"| No underlying causes
* Mitral annular calcification
|-
* [[Patent foramen ovale]]
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}


====Systemic Hypoperfusion (Watershed stroke)====
* [[Cardiac arrest]]
* Cardiac arrhythmias
* Reduced [[cardiac output]] as a result of
** Bleeding
** [[Myocardial infarction]]
** [[Pericardial effusion]]
** [[Pulmonary embolism]]


[[Hypoxia (medical)|Hypoxemia]] (low blood oxygen content) may precipitate the hypo-perfusion.
===Causes in Alphabetical Order===
 
===Hemorrhagic Stroke===
====Intracerebral Hemorrhage====
* [[Amyloid angiopathy]]
* [[Haemophilia|Bleeding disorders]]
* [[Hypertension]]
* [[Drug use|Illicit drug use]] (e.g., [[amphetamines]] or [[cocaine]])
* Trauma
* Vascular malformations


==References==
==References==

Revision as of 12:47, 28 July 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The cause of stroke is an interruption in the blood supply, with a resulting depletion of oxygen and glucose in the affected area. This immediately reduces or abolishes neuronal function, and also initiates an ischemic cascade which causes neurons to die or be seriously damaged, further impairing brain function.

Causes

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes


Causes in Alphabetical Order

References

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