Health Dictionary

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

Patent foramen ovale is a potential cause of stroke through paradoxical embolism, in which embolic material from the venous circulation enters the arterial system via a right-to-left intracardiac shunt, resulting in ischemic stroke.^[1]

The following table lists causes for stroke.^[2]^[3]^[4]^[5]^[6]^[7]^[8]^[9]^[10]^[11]

Causes
Disease	Lethal causes	Common causes	Less common causes
Transient ischemic attack (TIA)	Emboli from cardiac source (mostly secondary to AF)	Atherosclerotic plaque Thrombosis	Arterial dissection
Ischemic stroke	Atrial fibrillation Eclampsia Infective endocarditis Myocardial infarction Pulmonary embolism	Aneurysm Arteriovenous malformations Atherosclerosis Atrial fibrillation Embolism Hypertension Subarachnoid hemorrhage Thrombosis Transient ischemic attack Traumatic brain injury Warfarin	Takayasu arteritis Vasculitis Vasoconstriction Infective endocarditis Lacunar infarcts Left atrial myxoma
Intracerebral hemorrhage	—	Long-standing hypertension Cerebral amyloid angiopathy	Arteriovenous malformations (AVMs) Aneurysms Cocaine Amphetamines Vasculitis Liver disease Anticoagulant medication Thrombolytic therapy Brain tumor Hemorrhagic transformation of an ischemic stroke Moyamoya disease Tumors Encephalitis
Subarachnoid hemorrhage	Rupture of an aneurysm Saccular aneurysms (most common cause) Fusiform aneurysms Mycotic aneurysms	Rupture of an aneurysm Saccular aneurysms (most common cause) Fusiform aneurysms Mycotic aneurysms	Arteriovenous malformation Dural arteriovenous fistula Perimesencephalic Intracranial arterial dissection Amyloid angiopathy Cerebral venous thrombosis Cerebral vasculitis Reversible vasoconstriction syndrome Cerebral hyperperfusion syndrome after carotid endarterectomy Reversible posterior leukoencephalopathy syndrome Brain or cervical tumors Illicit drug use (cocaine, amphetamines)
Subdural hemorrhage	Rupture of bridging vessels	Trauma (motor vehicle accidents, falls, and assaults)	Aneurysmal subarachnoid hemorrhage Arteriovenous malformation Meningioma Dural metastases Coagulopathy Neurosurgical procedures Cocaine abuse
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 Saccular aneurysms (most common cause) Fusiform aneurysms Mycotic aneurysms Arteriovenous malformation
Intraventricular hemorrhage (IVH)	—	Secondary to intracerebral hemorrhage Trauma (motor vehicle accidents, falls, and assaults) Vascular malformations (usually arteriovenous malformations or arteriovenous fistulae)	Intraventricular tumors (papilloma, neurocytoma, meningioma, metastases, astrocytoma, ependymoma) Intraventricular aneurysms Moyamoya disease Pituitary apoplexy Vasculitis

References

↑ Saver JL, Mattle HP, Thaler D. Patent Foramen Ovale Closure Versus Medical Therapy for Cryptogenic Ischemic Stroke: A Topical Review. Stroke. 2018 Jun;49(6):1541-1548. doi: 10.1161/STROKEAHA.117.018153. Epub 2018 May 14. PMID: 29760277.
↑ 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.
↑ Challa VR, Richards F, Davis CH (1981). “Intraventricular hemorrhage from pituitary apoplexy”. Surg Neurol. 16 (5): 360–1. PMID 7336321.
↑ 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.
↑ 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.
↑ 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.
↑ Hart, Robert G., Bradley S. Boop, and David C. Anderson. “Oral anticoagulants and intracranial hemorrhage facts and hypotheses.” Stroke 26.8 (1995): 1471-1477.
↑ Knudsen, Katherine A., et al. “Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria.” Neurology 56.4 (2001): 537-539.
↑ 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.
↑ Rümke CL (1975). “Letter: Implications of the statement: No side effects were observed”. N Engl J Med. 292 (7): 372–3. PMID 1117973.
↑ 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.

[1] Saver JL, Mattle HP, Thaler D. Patent Foramen Ovale Closure Versus Medical Therapy for Cryptogenic Ischemic Stroke: A Topical Review. Stroke. 2018 Jun;49(6):1541-1548. doi: 10.1161/STROKEAHA.117.018153. Epub 2018 May 14. PMID: 29760277.

[pmid17043443-2] 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.

[pmid7336321-3] Challa VR, Richards F, Davis CH (1981). “Intraventricular hemorrhage from pituitary apoplexy”. Surg Neurol. 16 (5): 360–1. PMID 7336321.

[pmid18320145-4] 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.

[pmid21215656-5] 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.

[pmid22858729-6] 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.

[Hart-7] Hart, Robert G., Bradley S. Boop, and David C. Anderson. “Oral anticoagulants and intracranial hemorrhage facts and hypotheses.” Stroke 26.8 (1995): 1471-1477.

[Knudsen-8] Knudsen, Katherine A., et al. “Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria.” Neurology 56.4 (2001): 537-539.

[Lovelock-9] 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.

[pmid1117973-10] Rümke CL (1975). “Letter: Implications of the statement: No side effects were observed”. N Engl J Med. 292 (7): 372–3. PMID 1117973.

[pmid19246695-11] 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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Health Dictionary

Stroke causes

Introduction

Overview

Causes

References