Aetiology of thrombotic stroke

Affecting major arteries:

• atherosclerosis
• dissecting aneurysm } more common in younger patients
• fibromuscular dysplasia }

Affecting small vessels:

• hypertension
• arteriosclerosis
• diabetes mellitus

Hypercoagulable states:

• congestive cardiac failure
• polycythaemia
• thrombocythaemia
• malignancy - myeloma, leukaemia
• sickle cell disease
• pregnancy, oral contraceptives
• antiphospholipid syndrome - up to 20% of strokes in 'young' patients have antiphospholipid syndrome (1)

Reference:

• (1) Hughes G. Why 'sticky blood' syndrome has implications beyond thrombosis. Pulse (28/7/01), 29-31.