STROKE (BRAIN ATTACK) - William A. Tosches, MD; Michael Previti, MD6

STROKE (BRAIN ATTACK) - William A. Tosches, MD; Michael Previti, MD

ETIOLOGY

· Ischemic: Carotid atherosclerotic disease with artery-to-artery thromboembolism

· Cardiac

  - Cardioembolism secondary to valvular (mitral valve) pathology

  - Mural hypokinesias or akinesias with thrombosis (acute anterior myocardial infarctions (MIs) or congestive cardiomyopathies)

  - Cardiac arrhythmia (atrial fibrillation)

· Hypercoagulable states

  - Antiphospholipid antibodies, factor V Leiden deficiency, deficiency of protein S, protein C, antithrombin III deficiency

  - Estrogen use (HRT, OCP, etc.)

· Other causes

  - Spontaneous and posttraumatic (i.e., chiropractic manipulation) artery dissection

  - Fibromuscular dysplasia

  - Vasculitis

  - Drugs (cocaine, amphetamines)

· Hemorrhagic

· Hypertension: May cause damage to putamen, internal capsule, cerebellum, brainstem, corona radiata

· Amyloid (congophilic) angiopathy: Lobar (cortical) hemorrhages in the elderly

· Vascular malformations: Arteriovenous malformation, cavernous angioma, venous angioma and capillary angioma