Summary Neuroanatomy & Stroke Study Guide:

CHAPTER I

STROKE

Blood Supply of the Brain




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, Pathophysiology of stroke:
A- Cerebral infarction:
There are 4 types of ischemic injury to the brain:
1. Cerebral autolysis
2. Cerebral infarction
3. Selective ischemic necrosis of highly vulnerable neurons
4. Demyelination of the central hemispheric white matter
The pathologic causes of cerebral infarction include:
I. Arterial disease
II. Cardio-embolic causes
III. Hematological disorders
IV. Miscellaneous conditions

I. Arterial disease:
1. Atherothromboembolism
2. I.C. small vessel disease
3. Trauma
4. Dissection
5. Fibromuscular dysplasia
6. Congenital arterial anomalies
7. Moyamoya syndrome
8. Embolism from arterial aneurysm
9. Inflammatory vascular diseases
10. Benswanger’s disease
11. Irradiation
12. Infection

II. Cardioembolic causes:
1. Paradoxical embolism from venous system:
 Atrial septal defect (ASD)
 Ventricular septal defect (VSD)
 Patent foramen ovale (PFO)
 Pulmonary AV fistula
2. Left atrial embolism:
 Atrial fibrillation (AF)
 Sino-atrial (SA) disease
 Myxoma
 Interatrial septal aneurysm
3. Mitral valve disease:
 Rheumatic stenosis or regurgitation
 Infective endocarditis
 Non-bacterial thrombotic endocarditis
 Prosthetic valve
 Mitral annulus calcification
 Mitral leaflet prolapse
 Libmann-Sachs endocarditis
 Papillary fibroelastoma
4. Left ventricular mural thrombus:
 Acute MI

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