Extracranial and intracranial large artery atherosclerosis is often identified as a potential etiologic cause for ischemic stroke and transient ischemic attack (TIA). Given the high prevalence of large artery atherosclerosis in the general population, optimally treating each patient to minimize future stroke risk is paramount. To optimally define treatment, as based upon the individual patient’s history, examination, and anatomical imaging findings, clinicians can compartmentalize this disease entity into four distinct clinical scenarios: 1(a) asymptomatic and 1(b) symptomatic extracranial carotid stenosis, (2) intracranial atherosclerosis, and (3) atherosclerotic vertebrobasilar disease. In this chapter, we work to provide a framework for clinicians evaluating and treating such patients.
Part of the book: Ischemic Stroke
Cerebral venous thrombosis (CVT) is a less common cause of stroke that is an often under recognized entity in clinical practice. The goal of this chapter will be to provide clinicians with the knowledge to succinctly recognize the various presentations of CVT, emphasizing rapid diagnosis and the potential treatments necessary to produce optimal clinical outcomes. Detailed descriptions of the relevant anatomy and associated clinical syndromes will be discussed. Detailed sections regarding CVT epidemiology, pathophysiology, etiology, diagnosis and treatment will be provided. Prognosis and long-term follow-up will also be discussed. Relevant literature will be cited and clinical trials across the spectrum of CVT will be highlighted.
Part of the book: Ischemic Stroke of Brain
Thromboses of the cerebral arterial and venous systems are a common manifestation of antiphospholipid syndrome (APS) often leading to ischemic and hemorrhagic stroke. APS increases stroke risk via many mechanisms, including hypercoagulability and inflammation. These mechanisms, among others, must be considered by physicians when evaluating and treating such patients to achieve optimal short- and long-term outcomes. In this chapter, we will discuss the epidemiology of APS as it relates to neurological disease focusing on stroke, APS stroke mechanisms, suggested clinical evaluations, acute treatment strategies, and long-term secondary stroke prevention strategies. Current consensus statements and the most recent literature will be summarized.
Part of the book: Antiphospholipid Syndrome