Types of a Stroke

There are two main types of stroke: Ischemic, which occurs due to the clogged blood vessels (thrombosis of the vessels in the brain) and hemorrhagic, which occurs due to the ruptured blood vessels (bleeding into the brain, under the meninges and into the brain ventricles).

Ischemic stroke

Blood coagulation is a protective mechanism that prevents blood loss in case of vascular injuries. When the wall of the vessel is destroyed, platelets gather at the site of the injury and release thromboplastin, which helps stop the bleeding. However, in the case of a stroke, the formation of such blood clots can adversely affect the functioning of the body, because they block arteries and lead to a blockage of a vessel that feeds a certain part of the brain. This process is called ischemia.

There are different classifications of ischemic strokes, depending on the etiopathogenetic and clinical aspects, localization of the infarction area. According to the pathogenetic classification, there are 2 types of ischemic stroke: cardioembolic and atherothrombotic strokes.

Embolic stroke

An embolic stroke is the cause of 20-30% of ischemic strokes and develops due to cardiogenic embolism (cardioembolic stroke) or embolism from the aorta and large extra- or intracranial arteries (arterio-arterial embolism), rarely embolism from the veins (paradoxical embolism).

The blood clots get into the brain through bloodstream. When they appear in very small blood vessels, blood clots can block blood circulation. When blocking the movement of blood, they provoke the development of a stroke. The medical term for denoting such thrombi is embolus. This is the particle brought with the bloodstream: the detached blood clot. The blocking of blood vessels causes a stroke.

Thrombotic stroke

Atherothrombotic stroke accounts for approximately 30-40% of ischemic strokes and is caused by thrombosis, which usually develops on the site of an atherosclerotic plaque in the extra- or intracranial artery.

The blockage of one or more arteries supplying blood to the brain results in disordered blood flow. The process leading to this blockage is called thrombosis. Strokes caused by thrombosis are classified as thrombotic. This type of stroke develops in a staged manner, with the increase in symptoms for several hours or days, often makes its debut in a dream. The atherothrombotic stroke is often accompanied by transient ischemic attacks. The size of the focus of ischemic damage varies.

The ischemic stroke also occurs as a result of damage to the blood vessels caused by fat deposits and high cholesterol levels. The body reacts to the formation of these deposits as to small microtraumas, just as if it were bleeding from a wound. As a result, there are blood clots formed, which lead to thrombosis and then to the development of a stroke.

There are two types of thrombosis that can cause stroke: thrombosis of the large arteries and small arterial vessels (lacunar thrombosis).

Thrombosis of large arteries. The thrombotic stroke most commonly occurs in large arteries. This is the most common and studied type of the thrombotic stroke. This type of thrombosis develops due to long-term atherosclerosis with the subsequent rapid formation of blood clots. In most cases, stroke survivors suffer from coronary artery disease. Heart attack is often the cause of death in patients suffering from this disease.

Lacunar stroke. Lacunar stroke is ischemic cerebral infarction, limited to the territory of the blood supply of one of the small perforating arteries located in the deeper parts of the hemispheres and the brain stem. The process of organizing a lacunar infarct involves the formation of a round shaped cavity filled with liquor - a lacuna.

Not everyone is aware of the causes of this disease, but it is closely related to hypertension (high blood pressure). Also, see about rehabilitation after ischemic stroke

Hemorrhagic stroke

The bleeding in the brain ( parenchymal hemorrhage) and in the submeningeal spaces (subarachnoid, subdural and epidural) is related to the hemorrhagic stroke. There is a combination of several forms – subarachnoid and parenchymal, parenchymal and subarachnoid, parenchymal and ventricular hemorrhage.

The bleedings can be caused by a number of disorders that affect the functioning of the blood vessels: high blood pressure and cerebral aneurysms. Brain aneurysm (also known as intracranial aneurysm) is a small formation on the cerebral blood vessel, which rapidly grows and is filled with blood. There is a protrusion of the artery wall due to its thinning or stretching. As a rule, these weak areas are congenital. Aneurysms develop for several years and usually do not cause any problems until they are ruptured. The protruded area of the aneurysm exerts pressure on the nerve or on the surrounding brain tissue. However, the aneurysm rupture is particularly dangerous, which results in blood leakage into the surrounding brain tissues (this is called a hemorrhage). The blood from the ruptured vessel gets into the brain tissue. Within a few minutes, it can soak and squeeze the brain matter, which will lead to its swelling and death.

There are two types of hemorrhagic stroke: subarachnoid and intracerebral.

In case of intracerebral hemorrhage, there is a hemorrhage into the brain matter and into the brain itself. There is a rupture of pathologically altered walls of the cerebral vessels or diapedesis. The mortality rate due to intracerebral hemorrhages reaches 40%. It occupies the second place in the prevalence among strokes (after ischemic one), outstripping non-traumatic subarachnoid hemorrhage. Hypertension (high blood pressure) is the main cause of this type of hemorrhage.

In case of subarachnoid hemorrhage, there is a rupture of aneurysms, which are usually localized in the arterial circle of the brain. The blood leaks into the area around the brain, which is filled with a special protective fluid. As a result, this area becomes filled with blood. More rarely, the cause of the development of such a disorder is hypertension, hemorrhagic syndromes.

Here you can also read other articles on this topic:

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• Cholesterol levels

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