| dc.description.abstract | Stroke is a clinically defined syndrome of acute, focal neurological
deficit attributed to vascular injury (infarction, haemorrhage) of the
central nervous system. Stroke is the second leading cause of death
and disability worldwide. Stroke is not a single disease but can be
caused by a wide range of risk factors, disease processes and mechanisms. Hypertension is the most important modifiable risk factor for
stroke, although its contribution differs for different subtypes. Most
(85%) strokes are ischaemic, predominantly caused by small vessel
arteriolosclerosis, cardioembolism and large artery atherothromboembolism. Ischaemic strokes in younger patients can result
from a different spectrum of causes such as extracranial dissection.
Approximately 15% of strokes worldwide are the result of intracerebral
haemorrhage, which can be deep (basal ganglia, brainstem), cerebellar
or lobar. Deep haemorrhages usually result from deep perforator (hypertensive) arteriopathy (arteriolosclerosis), while lobar haemorrhages
are mainly caused by cerebral amyloid angiopathy or arteriolosclerosis. A minority (about 20%) of intracerebral haemorrhages are caused
by macrovascular lesions (vascular malformations, aneurysms, cavernomas), venous sinus thrombosis or rarer causes; these are particularly
important in young patients (<50 years). Knowledge of vascular and cerebral anatomy is important in localizing strokes and understanding their
mechanisms. This guides rational acute management, investigation, and
secondary prevention. | |
