Large vessel atherothrombotic stroke |
More common |
Bifurcation of the common carotid artery |
Siphon portion of the common carotid artery |
Middle cerebral artery stem |
Intracranial vertebral arteries proximal to middle basilar artery |
Origin of the vertebral arteries |
Less common |
Origin of the common carotid artery |
Posterior cerebral artery stem |
Origin of the major branches of the basilar-vertebral arteries |
Origin of the branches of the anterior, middle, and posterior cerebral arteries |
Small vessel (lacunar) stroke |
Mechanism |
Lipohyalinotic occlusion |
Less frequently proximal atherothrombotic occlusion |
Least likely embolic occlusion |
Most common locations |
Penetrating branches of the anterior, middle, and posterior cerebral and basilar arteries |
Cardioaortic embolic stroke |
Cardiac sources definite - antithrombotic therapy generally used |
Left atrial thrombus |
Left ventricular thrombus |
Atrial fibrillation and paroxysmal atrial fibrillation |
Sustained atrial flutter |
Recent myocardial infarction (within one month) |
Rheumatic mitral or aortic valve disease |
Bioprosthetic and mechanical heart valve |
Chronic myocardial infarction with ejection fraction <28 percent |
Symptomatic heart failure with ejection fraction <30 percent |
Dilated cardiomyopathy |
Cardiac sources definite - anticoagulation hazardous |
Bacterial endocarditis (exception nonbacterial) |
Atrial myxoma |
Cardiac sources possible |
Mitral annular calcification |
Patent foramen ovale |
Atrial septal aneurysm |
Atrial septal aneurysm with patent foramen ovale |
Left ventricular aneurysm without thrombus |
Isolated left atrial spontaneous echo contrast ("smoke") without mitral stenosis or atrial fibrillation |
Mitral valve strands |
Ascending aortic atheromatous disease (>4 mm) |
True unknown source embolic stroke |
Other |
Dissection |
Moyamoya |
Binswanger's disease |
Primary thrombosis |
Cerebral mass |
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