Sandbox Ochuko
Causes of Stroke
Ischemic Stroke
Thrombotic Stroke
Thrombotic stroke can be divided into two types depending on the type of vessel the thrombus is formed on:
- Large vessel disease involves the common and internal carotids, vertebral, and the Circle of Willis. Diseases that may form thrombi in the large vessels include (in descending incidence):
- Arteritis/vasculitis
- Atherosclerosis
- Dissection
- Fibromuscular dysplasia
- Giant cell arteritis
- Moyamoya syndrome
- Noninflammatory vasculopathy
- Takayasu arteritis
- Vasoconstriction
- Small vessel disease involves the intracerebral arteries, branches of the Circle of Willis, middle cerebral artery, stem, and arteries arising from the distal vertebral and basilar artery. Diseases that may form thrombi in the small vessels include (in descending incidence):
- Lipohyalinosis (lipid hyaline build-up secondary to hypertension and aging) and fibrinoid degeneration (stroke involving these vessels are known as lacunar infarcts)
- Microatheromas from larger arteries that extend into the smaller arteries (atheromatous branch disease)
Embolic Stroke
High Risk Cardiac Causes[1]
- Antiphospholipid syndrome
- Atrial fibrillation and paroxysmal atrial fibrillation
- Atrial or ventricular thrombus
- Bioprosthetic and mechanical heart valves
- Chronic myocardial infarction together with ejection fraction <28 percent
- Coronary artery bypass graft (CABG) surgery
- Dilated cardiomyopathy
- Infective endocarditis
- Left atrial myxoma
- Libman-Sacks endocarditis
- Marantic endocarditis from cancer
- Papillary fibroelastoma
- Recent myocardial infarction (within one month)
- Rheumatic mitral or aortic valve disease
- Sick sinus syndrome
- Sustained atrial flutter
- Symptomatic congestive heart failure with ejection fraction <30 percent
Potential Cardiac Causes
- Atrial septal aneurysm
- Atrial septal aneurysm with patent foramen ovale
- Complex atheroma in the ascending aorta or proximal arch
- Isolated left atrial smoke on echocardiography (no mitral stenosis or atrial fibrillation)
- Left ventricular aneurysm without thrombus
- Mitral annular calcification
- Patent foramen ovale
Systemic Hypoperfusion (Watershed stroke)
- Cardiac arrest
- Cardiac arrhythmias
- Reduced cardiac output as a result of
Hypoxemia (low blood oxygen content) may precipitate the hypo-perfusion.
Hemorrhagic Stroke
Intracerebral Hemorrhage
- Amyloid angiopathy
- Bleeding disorders
- Hypertension
- Illicit drug use (e.g., amphetamines or cocaine)
- Trauma
- Vascular malformations
References
- ↑ Ay H; Furie KL; Singhal A; Smith WS; Sorensen AG; Koroshetz WJ (2005). "An evidence-based causative classification system for acute ischemic stroke". Ann Neurol. 58 (5): 688–97. PMID 16240340.
The upper part of the GI tract will usually cause black stools due to:
- Abnormal blood vessels (vascular malformation)
- A tear in the esophagus from violent vomiting (Mallory-Weiss tear)
- Bleeding stomach or duodenal ulcer
- Inflammation of the stomach lining (gastritis)
- Lack of proper blood flow to the intestines (bowel ischemia)
- Trauma or foreign body
- Widened, overgrown veins (called varices) in the esophagus and stomach
| Primary treatment option Atropine
❑ Administer a first dose 0.5 mg IV bolus ❑ Repeat every 3-5 minutes ❑ Administer a maximum dose of 3 mg | |||||||||||||||||||
| Secondary treatment options If atropine ineffective: ❑ Administer dopamine infusion (2-10 mcg/kg/min) OR ❑ Administer epinephrine infusion (2-10 mcg/min) OR ❑ Proceed with transcutaneous pacing | |||||||||||||||||||
❑ Consult a cardiologist ❑ Consider transvenous pacing | |||||||||||||||||||
- Adenine phosphoribosyltransferase deficiency
- Allopurinol
- Aniline
- Behcet's disease
- Benign prostatic hyperplasia
- Benzidine
- Bladder incontinence
- Bladder stones
- Bleomycin
- Candida
- Carbenicillin
- Cetirizine
- Chemical cystitis
- Chlamydia
- Chlordimeform
- Congenital abnormalities of the urinary tract
- Crohn's disease
- Cyclophosphamide
- Cystoscopy
- Danazol
- Dehydration
- Diabetes
- Diabetic neuropathy
- Diaphragm
- Diarrhea
- Diverticulitis
- Doxorubicin
- Drug induced cystitis
- Endometriosis
- Enterobacter
- Episiotomy scar infection
- Escherichia coli
- Ether
- Foreign body cystitis
- Gonorrhea
- Gynecological cancers
- Hemorrhagic cystitis
- Honeymoon cystitis
- Hunner's ulcer
- Ifosfamide
- Immobility
- Interstitial cystitis
- Intravesical acetic acid
- Kidney stones
- Klebsiella
- Lupus
- Methaqualone
- Methenamine mandelate
- Methicillin
- Methotrexate
- Mucoepithelial dysplasia, Witkop type
- Nonoxynol-9 suppositories
- NSAIDS
- Penicillin VK
- Penicillins
- PID
- Piperacillin
- Posterior urethral valves
- Prostatitis
- Pseudomonas aeruginosa
- Radiotherapy
- Schistosomiasis
- Serratia
- Sexually transmitted diseases
- Spermicidal jellies
- Spinal cord injury
- Staphylococcus saprophyticus
- Tampon
- Temozolomide
- Tiaprofenic acid
- Ticarcillin
- Toluidine
- Trichomoniasis
- Tuberculosis
- Urachal cancer
- Urachal cyst
- Urethral syndrome
- Urethritis
- Urinary catheter
- Urinary obstruction
- Urinary stones
- Urofacial syndrome
- Vesicoenteric fistula
- Xanthinuria
References
Overview
Causes
Life Threatening Causes
Common Causes
Diagnosis
Focused Initial Rapid Evaluation
Complete Evaluation
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