PATHOGENESIS OF ISCHEMIC STROKE AND MODERN SOLUTIONS FOR CLINICAL DIAGNOSIS

Abstract

Ischemic stroke is a sudden neurological deficit resulting from focal cerebral ischemia with persistent cerebral infarction (e.g., positive findings on diffusion-weighted MRI). The most common causes are: atherothrombotic occlusion of large arteries; embolism of cerebral vessels (embolic infarction); nonthrombotic occlusion of small, deep cerebral arteries (lacunar infarction); and proximal arterial stenosis with hypotension that reduces cerebral blood flow in arterial bifurcation zones (hemodynamic stroke). In one-third of ischemic strokes, the cause is not identified when the patient is discharged from the hospital; such strokes are classified as cryptogenic. The diagnosis is made on the basis of clinical findings, but CT or MRI is performed to exclude hemorrhage and confirm the infarct size. In some patients, thrombolytic therapy is effective in the acute phase. Depending on the cause of the stroke, carotid endarterectomy or stenting, as well as the use of antiplatelet or anticoagulant drugs, can help reduce the risk of subsequent strokes.