Pathophysiology of ischemic stroke.

A. Diagram illustrating the three major mechanisms that underlie ischemic stroke:

(1) occlusion of an intracranial vessel by an embolus that arises at a distant site (e.g., cardiogenic sources such as atrial fibrillation or artery-to-artery emboli from carotid atherosclerotic plaque), often affecting the large intracranial vessels;

(2) in situ thrombosis of an intracranial vessel, typically affecting the small penetrating arteries that arise from the major intracranial arteries;

(3) hypoperfusion caused by flow-limiting stenosis of a major extracranial (e.g., internal carotid) or intracranial vessel, often producing "watershed" ischemia. B and C. Diagram and reformatted CT angiogram of the common, internal, and external carotid arteries. High-grade stenosis of the internal carotid artery, which may be associated with either cerebral emboli or flow-limiting ischemia, was identified in this patient.

Risk Factors for stroke ::

Atrial fibrillation
Asymptomatic carotid stenosis
Symptomatic carotid stenosis