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Table 17-4

Causes of Ischemic Stroke

Common CausesUncommon Causes

Thrombosis

Lacunar stroke (small vessel)

Large-vessel thrombosis

Dehydration

Embolic occlusion

Artery-to-artery

Carotid bifurcation

Aortic arch

Arterial dissection

Cardioembolic

Atrial fibrillation

Mural thrombus

Myocardial infarction

Dilated cardiomyopathy

Valvular lesions

Mitral stenosis

Mechanical valve

Bacterial endocarditis

Paradoxical embolus

Atrial septal defect

Patent foramen ovale

Atrial septal aneurysm

Spontaneous echo contrast

Stimulant drugs: cocaine, amphetamine

Hypercoagulable disorders

Protein C deficiencya

Protein S deficiencya

Antithrombin III deficiencya

Antiphospholipid syndrome

Factor V Leiden mutationa

Prothrombin G20210 mutationa

Systemic malignancy

Sickle cell anemia

β Thalassemia

Polycythemia vera

Systemic lupus erythematosus

Homocysteinemia

Thrombotic thrombocytopenic purpura

Disseminated intravascular coagulation

Dysproteinemiasa

Nephrotic syndromea

Inflammatory bowel diseasea

Oral contraceptives

Venous sinus thrombosisb

Fibromuscular dysplasia

Vasculitis

Systemic vasculitis (PAN, granulomatosis with polyangiitis [Wegener's], Takayasu's, giant cell arteritis)

Primary CNS vasculitis

Meningitis (syphilis, tuberculosis, fungal, bacterial, zoster)

Noninflammatory vasculopathy

Reversible vasoconstriction syndrome

Fabry's disease

Angiocentric lymphoma

Cardiogenic

Mitral valve calcification

Atrial myxoma

Intracardiac tumor

Marantic endocarditis

Libman-Sacks endocarditis

Subarachnoid hemorrhage vasospasm

Moyamoya disease

Eclampsia

aChiefly cause venous sinus thrombosis.

bMay be associated with any hypercoagulable disorder.

Abbreviations: PAN, polyarteritis nodosa.