Commit d13f113b authored by deepthought's avatar deepthought

stroke common categories

parent 4fa9a19e
......@@ -29,8 +29,8 @@ for non-emergent management (i.e. post brain attack)
* taking into account CHADSVASC vs. HASBLED
* initiation time based on comorbidities & size of stroke re bleed risk
* antiplatelet
* if naive and no anticoagulation: ASA 81
* if intracranial stenosis: dual antiplatelet for 90 days then single antiplatelet
* naive and no anticoagulation: ASA 81
* intracranial stenosis: dual antiplatelet for 90 days then single antiplatelet
* followup: neuro return visit, smoking cessation, dietary changes, exercise, consider sleep apnea evaluation, 30-day heart rhythm monitor (if indicated)
## history / risk factors
......@@ -57,14 +57,21 @@ for non-emergent management (i.e. post brain attack)
### most common stroke mechanisms:
Three most prevalent categories:
* cardioembolic/a-fib (~20-30% of ischemic strokes)
* artery-artery
* thrombus (i.e. atheromatous stenosis, ~15% of ischemic strokes)
* small vessel diseaes (~1/3)
* large artery atherosclerosis / thrombotic disease (~15% of ischemic strokes)
* two main mechanisms: thrombotic stenosis & athero-emboli (artery-artery)
* location categories:
* extracranial:
* asymptomatic & symptomatic carotid stenosis
* vertebral disease
* intracranial
* small vessel disease (~1/3)
* note usually involves also above mechanisms
* parenchymal or leptomeningeal vessels diameter ~5um to 2mm
* lipohyalinosis (lipid hyaline buildup secondary to HTN) & fibrinoid degeneration
* atheromatous disease (at origin or parent artery)
* cryptogenic - mechanism not clearly identified (historically ~30%)
(percentages primarily based on Continuum 2017)
......
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