Pathology of Ischaemic Stroke

The pathology of ischaemic stroke is complex, but commonly involves the formation of a clot that travels in the blood to or within the brain and becomes lodged in the blood vessels of the brain (a thromboembolism), which can reduce or block blood flow (an occlusion).^1-3 The cause of this pathology can be arterial in nature:³

• Atherosclerosis – parts of built up plaque inside blood vessels can become dislodged and travel within the blood.
• Small vessel diseases – many different conditions can affect the way that small blood vessels function, including those in the brain, e.g., lacunar stroke.
• Arterial dissection (tear) – a dissection can release a thrombus from within the tissue.
• Vasculitis – although rare, vasculitis can lead to inflammation that narrows the blood vessels.
• Reversible cerebral vasoconstriction syndrome – a poorly understood cause of stroke, reversible cerebral vasoconstriction syndrome causes headaches and can lead to stroke.

However, rather than arterial, some specific cardiac conditions can predispose a person to stroke, including atrial fibrillation, patent foramen ovale, endocarditis, and certain blood disorders.³