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__NOTOC__
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{{Stroke}}
{{Stroke}}
{{CMG}};{{AE}} {{MHP}},{{MehdiP}}{{AA}},{{TarekNafee}},{{SaraM}}


{{CMG}}
==Overview==
==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 [[neuron]]al function, and also initiates an [[ischemic cascade]] which causes neurons to die or be seriously damaged, further impairing brain function.  
There are several causes for stroke. Some may cause [[hemorrhage]] and some causes [[ischemia]]. Among all of them there are several lethal causes which we need to be more cautious about them.
==Causes==
==Causes==
===Life Threatening Causes===
The following table lists causes for stroke.<ref name="pmid17043443">{{cite journal |vauthors=Kishimoto M, Arakawa KC |title=A patient with wegener granulomatosis and intraventricular hemorrhage |journal=J Clin Rheumatol |volume=9 |issue=6 |pages=354–8 |year=2003 |pmid=17043443 |doi=10.1097/01.rhu.0000089967.51779.d7 |url=}}</ref><ref name="pmid7336321">{{cite journal |vauthors=Challa VR, Richards F, Davis CH |title=Intraventricular hemorrhage from pituitary apoplexy |journal=Surg Neurol |volume=16 |issue=5 |pages=360–1 |year=1981 |pmid=7336321 |doi= |url=}}</ref><ref name="pmid18320145">{{cite journal |vauthors=Flint AC, Roebken A, Singh V |title=Primary intraventricular hemorrhage: yield of diagnostic angiography and clinical outcome |journal=Neurocrit Care |volume=8 |issue=3 |pages=330–6 |year=2008 |pmid=18320145 |doi=10.1007/s12028-008-9070-2 |url=}}</ref><ref name="pmid21215656">{{cite journal |vauthors=Fukutake T |title=Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL): from discovery to gene identification |journal=J Stroke Cerebrovasc Dis |volume=20 |issue=2 |pages=85–93 |year=2011 |pmid=21215656 |doi=10.1016/j.jstrokecerebrovasdis.2010.11.008 |url=}}</ref><ref name="pmid22858729">{{cite journal| author=Meretoja A, Strbian D, Putaala J, Curtze S, Haapaniemi E, Mustanoja S et al.| title=SMASH-U: a proposal for etiologic classification of intracerebral hemorrhage. | journal=Stroke | year= 2012 | volume= 43 | issue= 10 | pages= 2592-7 | pmid=22858729 | doi=10.1161/STROKEAHA.112.661603 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22858729  }} </ref><ref name="Hart">Hart, Robert G., Bradley S. Boop, and David C. Anderson. "Oral anticoagulants and intracranial hemorrhage facts and hypotheses." Stroke 26.8 (1995): 1471-1477.</ref><ref name="Knudsen">Knudsen, Katherine A., et al. "Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria." Neurology 56.4 (2001): 537-539. </ref><ref name="Lovelock">Lovelock, C. E., A. J. Molyneux, and P. M. Rothwell. "Change in incidence and aetiology of intracerebral haemorrhage in Oxfordshire, UK, between 1981 and 2006: a population-based study." The Lancet Neurology 6.6 (2007): 487-493. </ref><ref name="pmid1117973">{{cite journal| author=Rümke CL| title=Letter: Implications of the statement: No side effects were observed. | journal=N Engl J Med | year= 1975 | volume= 292 | issue= 7 | pages= 372-3 | pmid=1117973 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1117973  }} </ref><ref name="pmid19246695">{{cite journal |vauthors=Hanley DF |title=Intraventricular hemorrhage: severity factor and treatment target in spontaneous intracerebral hemorrhage |journal=Stroke |volume=40 |issue=4 |pages=1533–8 |year=2009 |pmid=19246695 |pmc=2744212 |doi=10.1161/STROKEAHA.108.535419 |url=}}</ref>
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.


===Common Causes===
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
 
! colspan="4" align="center" style="background:#DCDCDC;" |Causes
===Causes by Organ System===
 
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
! align="center" style="background:#DCDCDC;" |Disease
|bgcolor="Beige"| No underlying causes
! align="center" style="background:#DCDCDC;" |Lethal causes
! align="center" style="background:#DCDCDC;" |Common causes
! align="center" style="background:#DCDCDC;" |Less common causes
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" |[[Transient ischemic attack]] (TIA)
| '''Dental'''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Emboli]] from cardiac source (mostly secondary to [[Atrial fibrillation|AF]])
|bgcolor="Beige"| No underlying causes
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Atherosclerotic plaque]]
* [[Thrombosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Arterial dissection]]
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" |[[Ischemic stroke]]
| '''Dermatologic'''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|bgcolor="Beige"| No underlying causes
* [[Atrial fibrillation]]
* [[Eclampsia]]
* [[Infective endocarditis]]
* [[Myocardial infarction]]
* [[Pulmonary embolism]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Aneurysm]]
* [[Arteriovenous malformations]]
* [[Atherosclerosis]]
* [[Atrial fibrillation]]
* [[Embolism]]
* [[Hypertension]]
* [[Subarachnoid hemorrhage]]
* [[Thrombosis]]
* [[Transient ischemic attack]]
* [[Traumatic brain injury]]
* [[Warfarin]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Takayasu arteritis]]
* [[Vasculitis]]
* [[Vasoconstriction]]
 
* [[Infective endocarditis]]
* [[Lacunar infarcts]]
* [[Left atrial myxoma]]
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" |[[Intracerebral hemorrhage]]
| '''Drug Side Effect'''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | ---
|bgcolor="Beige"| No underlying causes
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Hypertension|Long-standing hypertension]]
 
* [[Cerebral amyloid angiopathy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Arteriovenous malformation|Arteriovenous malformations (AVMs)]]
* [[Aneurysms]]
 
* [[Cocaine]]
* [[Amphetamines]]
 
* [[Vasculitis]]
 
* [[Liver disease]]
* [[Anticoagulant]] medication
* [[Thrombolytic therapy]]
 
* [[Tumor|Brain tumor]]
* Hemorrhagic transformation of an [[ischemic stroke]]
* [[Moyamoya disease]]
* [[Tumor|Tumors]]
 
* [[Encephalitis]]
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" |[[Subarachnoid hemorrhage]]
| '''Ear Nose Throat'''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|bgcolor="Beige"| No underlying causes
Rupture of an aneurysm
|-
* [[Aneurysm|Saccular aneurysms]] (most common cause)
|-bgcolor="LightSteelBlue"
* Fusiform [[Aneurysm|aneurysms]]
| '''Endocrine'''
* Mycotic [[Aneurysm|aneurysms]]
|bgcolor="Beige"| No underlying causes
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
Rupture of an aneurysm
|-bgcolor="LightSteelBlue"
* [[Aneurysm|Saccular aneurysms]] (most common cause)
| '''Environmental'''
* Fusiform [[Aneurysm|aneurysms]]
|bgcolor="Beige"| No underlying causes
* Mycotic [[Aneurysm|aneurysms]]
|-
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-bgcolor="LightSteelBlue"
* [[Arteriovenous malformation]]
| '''Gastroenterologic'''
* [[Dural arteriovenous fistula]]
|bgcolor="Beige"| No underlying causes
* [[Perimesencephalic nonaneurysmal subarachnoid hemorrhage|Perimesencephalic]]
|-
* [[Arterial dissection|Intracranial arterial dissection]]
|-bgcolor="LightSteelBlue"
* [[Amyloid angiopathy]]
| '''Genetic'''
* Cerebral [[venous thrombosis]]
|bgcolor="Beige"| No underlying causes
* Cerebral [[vasculitis]]
|-
* Reversible vasoconstriction syndrome
|-bgcolor="LightSteelBlue"
 
| '''Hematologic'''
* Cerebral hyperperfusion syndrome after [[carotid endarterectomy]]
|bgcolor="Beige"| No underlying causes
* Reversible posterior leukoencephalopathy syndrome
|-
* Brain or cervical [[Tumor|tumors]]
|-bgcolor="LightSteelBlue"
* Illicit drug use ([[cocaine]], [[amphetamines]])
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" |[[Subdural hematoma|Subdural hemorrhage]]
| '''Infectious Disease'''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Rupture of bridging vessels
|bgcolor="Beige"| No underlying causes
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Trauma (motor vehicle accidents, falls, and assaults)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Aneurysmal [[subarachnoid hemorrhage]]
* [[Arteriovenous malformation]]
* [[Meningioma]]
* Dural metastases
* [[Coagulopathy]]
* Neurosurgical procedures
* [[Cocaine abuse]]
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" |[[Epidural hemorrhage]]
| '''Musculoskeletal/Orthopedic'''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Rupture of middle meningeal arteries
|bgcolor="Beige"| No underlying causes
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Trauma (motor vehicle accidents, falls, and assaults)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" |[[Intraparenchymal hemorrhage]]
| '''Neurologic'''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | ---
|bgcolor="Beige"| No underlying causes
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Trauma (motor vehicle accidents, falls, and assaults)
|-
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | Rupture of an aneurysm
|-bgcolor="LightSteelBlue"
* [[Aneurysm|Saccular aneurysms]] (most common cause)
| '''Nutritional/Metabolic'''
* Fusiform [[Aneurysm|aneurysms]]
|bgcolor="Beige"| No underlying causes
* Mycotic [[Aneurysm|aneurysms]]
|-
[[Arteriovenous malformation]]
|-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
|-
|-
| align="center" style="background:#DCDCDC;" |[[Intraventricular hemorrhage]] (IVH)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | ---
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Secondary to [[intracerebral hemorrhage]]
* Trauma (motor vehicle accidents, falls, and assaults)
* Vascular malformations (usually [[Arteriovenous malformation|arteriovenous malformations]] or [[Arteriovenous fistula|arteriovenous fistulae]])
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Intraventricular tumors ([[papilloma]], neurocytoma, [[meningioma]], metastases, [[astrocytoma]], [[ependymoma]])
* Intraventricular aneurysms
* [[Moyamoya disease]]
* [[Pituitary apoplexy]]
* [[Vasculitis]]
|}
|}
===Causes in Alphabetical Order===
==References==
==References==
{{Reflist|2}}
{{reflist|2}}
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Latest revision as of 05:00, 30 August 2023

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Maryam Hadipour, M.D.[2],Seyedmahdi Pahlavani, M.D. [3]Aysha Anwar, M.B.B.S[4],Tarek Nafee, M.D. [5],Sara Mehrsefat, M.D. [6]

Overview

There are several causes for stroke. Some may cause hemorrhage and some causes ischemia. Among all of them there are several lethal causes which we need to be more cautious about them.

Causes

The following table lists causes for stroke.[1][2][3][4][5][6][7][8][9][10]

Causes
Disease Lethal causes Common causes Less common causes
Transient ischemic attack (TIA) Emboli from cardiac source (mostly secondary to AF) Arterial dissection
Ischemic stroke
Intracerebral hemorrhage ---
Subarachnoid hemorrhage

Rupture of an aneurysm

Rupture of an aneurysm

Subdural hemorrhage Rupture of bridging vessels Trauma (motor vehicle accidents, falls, and assaults)
Epidural hemorrhage Rupture of middle meningeal arteries Trauma (motor vehicle accidents, falls, and assaults)
Intraparenchymal hemorrhage --- Trauma (motor vehicle accidents, falls, and assaults) Rupture of an aneurysm

Arteriovenous malformation

Intraventricular hemorrhage (IVH) ---

References

  1. ↑ Kishimoto M, Arakawa KC (2003). "A patient with wegener granulomatosis and intraventricular hemorrhage". J Clin Rheumatol. 9 (6): 354–8. doi:10.1097/01.rhu.0000089967.51779.d7. PMID 17043443.
  2. ↑ Challa VR, Richards F, Davis CH (1981). "Intraventricular hemorrhage from pituitary apoplexy". Surg Neurol. 16 (5): 360–1. PMID 7336321.
  3. ↑ Flint AC, Roebken A, Singh V (2008). "Primary intraventricular hemorrhage: yield of diagnostic angiography and clinical outcome". Neurocrit Care. 8 (3): 330–6. doi:10.1007/s12028-008-9070-2. PMID 18320145.
  4. ↑ Fukutake T (2011). "Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL): from discovery to gene identification". J Stroke Cerebrovasc Dis. 20 (2): 85–93. doi:10.1016/j.jstrokecerebrovasdis.2010.11.008. PMID 21215656.
  5. ↑ Meretoja A, Strbian D, Putaala J, Curtze S, Haapaniemi E, Mustanoja S; et al. (2012). "SMASH-U: a proposal for etiologic classification of intracerebral hemorrhage". Stroke. 43 (10): 2592–7. doi:10.1161/STROKEAHA.112.661603. PMID 22858729.
  6. ↑ Hart, Robert G., Bradley S. Boop, and David C. Anderson. "Oral anticoagulants and intracranial hemorrhage facts and hypotheses." Stroke 26.8 (1995): 1471-1477.
  7. ↑ Knudsen, Katherine A., et al. "Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria." Neurology 56.4 (2001): 537-539.
  8. ↑ Lovelock, C. E., A. J. Molyneux, and P. M. Rothwell. "Change in incidence and aetiology of intracerebral haemorrhage in Oxfordshire, UK, between 1981 and 2006: a population-based study." The Lancet Neurology 6.6 (2007): 487-493.
  9. ↑ Rümke CL (1975). "Letter: Implications of the statement: No side effects were observed". N Engl J Med. 292 (7): 372–3. PMID 1117973.
  10. ↑ Hanley DF (2009). "Intraventricular hemorrhage: severity factor and treatment target in spontaneous intracerebral hemorrhage". Stroke. 40 (4): 1533–8. doi:10.1161/STROKEAHA.108.535419. PMC 2744212. PMID 19246695.

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