stroke common categories

stroke_evaluation.md

@@ -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)