Causes of ischaemic stroke or cerebral infarction

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A blood vessel with cholesterol in its walls that restricts blood flow.

Stroke secondary to arteriosclerosis. Arteriosclerosis is chronic inflammation and hardening of the arteries, leading to the accumulation of cholesterol plaques (atheromatous plaques) on artery walls and the increased risk of thrombus formation. Stroke may be the result of a blood clot that forms in either a cerebral artery or any other artery and then travels to the brain. A thrombus (stationary blood clot) can also form in smaller vessels leading to mini-strokes.

Heart with a blocked artery causing a heart attack

Cardioembolic stroke. Cardiac arrhythmias (particularly atrial fibrillation), dilated cardiomyopathy or heart valve abnormalities can produce blood clots inside the heart. The blood clot can travel through the arteries up to the brain; once there, it may block an artery and cause a stroke. Strokes of this type tend to be extensive as blood clots originating in the heart can be very large.

Rupture of the wall of an artery

Strokes due to other less common causes like arterial wall rupture or dissection. Rupture of the arterial wall produces coagulation inside the artery which may block circulation and cause a stroke. The burst is usually due to trauma but it can also occur spontaneously.

A blood vessel with cholesterol in its walls that restricts blood flow.

Cerebral venous thrombosis: although the majority of ischaemic strokes are caused by a blocked artery, blood clots can also form in the brain’s veins. Anything blocking blood’s return from the brain can lead to venous congestion and hinder drainage from the area. Occasionally this may result in a burst blood vessel and brain haemorrhage.

Question mark

Stroke of unknown origin (cryptogenic stroke). In some cases, even after a complete work-up, the underlying cause of stroke cannot be identified. These are classed as strokes of unknown origin.

Causes of haemorrhagic stroke or brain haemorrhage

Increased blood pressure

Arterial hypertension. High blood pressure (greater than 14/9) is a chronic arterial disease which not only leads to arterial obstruction but also rupture and, therefore, it can cause brain haemorrhages. These haemorrhages tend to occur in deep regions of the brain.

Brain with a marked area

Degenerative processes (cerebral amyloid angiography, CAA). CAA refers to a process in which a substance called amyloid is deposited in arteries. It is more commonly observed in elderly patients and causes cognitive impairment and haemorrhage in areas close to the brain’s surface.

Brain with secondary haemorrhages due to cerebral vascular malformations

Haemorrhages secondary to brain blood vessel (cerebrovascular) malformations. Although less frequent, intracranial haemorrhages can be caused by the rupture of abnormal blood vessels.

Substantiated information by:

Antonia Fernández
Arturo Renú Jornet
Xabier Urra Nuin
Ángel Chamorro Sanchez

Published: 20 February 2018
Updated: 8 August 2018

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