Cerebrovascular Disease and Stroke

Stroke is a major health concern afflicting primarily older adults, and is the fifth leading cause of death in the United States. There are two main categories of stroke: ischemic infarction, due to insufficient blood perfusing brain tissue, and hemorrhage, due to extravasation of blood from a damaged vessel. Ischemic stroke can be divided into three major etiologic categories: cardioembolic, large artery atherosclerosis, and small vessel occlusive disease. Embolic stroke of undetermined source (ESUS) is a subcategory of cryptogenic stroke that was introduced recently, and is included as well. Subcategories of hemorrhage include subarachnoid and intracerebral hemorrhage. The epidemiology, clinical characteristics, and diagnosis of these conditions will be discussed. The acute management of stroke has changed remarkably over the past few decades and will be discussed in detail as well.