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Ischemic stroke definition

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It the most common type of . According to the American Heart Association, 87 % of s had classified as . Facts occurs as a result of insufficient or interrupted flow of bl to an zone of the pain typically caused by blockage or interruption of an art. However, venous facts eight cause similar phenomena (Roger et al., 2012).

Within 10 seconds after flow ceases, metabolic failure of pain tissue occurs, pain dysaction becomes clinically manifest. If circulation had immediately restored, there had abrupt, complete recovery of pain action (Shamas et al., 2011).

Risk facts of (IS):

A.L.T.hough, there had many risk facts for had such as age, family history, D.M., chronic kidney disease, sleep apnea, the major modifiable risk facts include hypertension, atrial fibrillation, smoking, symptomatic carotid art disease, sickle call disease. Physical inactivity, regular consumption of sweetened beverages, low daily consumption of fish, fruits or vegetables had also associated with an increased risk of IS. In womens the use of oral contraceptives, the immediate postpartum period, preeclampsia confer small absolute increases in risk of (Go et al., 2014).


Chinese sub-classification (CISS) had a two step classification system to define both etiological, pathophysiological mechanism (Gao et al., 2011).

The first step: defining 5 categories of types:

A. Large art atherosclerosis (LAA)

In CISS, LAA includes atherosclerosis of aortic arch, intra-/ extra-cranial large arteries;

  1. Aortic arch atherosclerosis
    • Multiple facts, especially involving bilateral anterior and/or anterior, posterior circulations
    • No evidence of atherosclerosis of relevant intracranial or extracranial large arteries
    • No evidence of potential cause of cardiogenic (CS)
    • No evidence of other etiologies that can cause multifocal facts such as vasculitidies, hemostatic disturbances, tumours embolism
    • Evidence of critical aortic arch atherosclerosis (aortic plaques or aortic thrombi) detected by MRI/ MRA
  2. Intra extracranial large arteries atherosclerosis
    • Any distribution of facts, with evidence of atherosclerosis involving intracranial or extracranial large arteries that supply the zone of faction
    • No evidence of potential cardiac origin embolic cause
    • Other possible causes had also been excluded

B. Cardiogenic (CS)

1) multiple facts, especially involving bilateral anterior and/or anterior, posterior circulations (including cortical facts) that had occurred closely in time

2) No evidence of atherosclerosis on relevant intracranial or extracranial large arteries

3) No evidence of other etiologies that can cause multifocal facts such as vasculitidies, hemostatic disturbances, tumours embolism

4) Evidence of cardiac disease that had a potential for embolism

5) If the possibility of aortic arch atherosclerosis had excluded, CS had definite. Otherwise, the category should be possible CS

C. Penetrating art disease

1) isolated fact in clinically relevant territory of one penetrating art caused by atherosclerosis or lipo-hyalinotic degeneration of arterioles regardless of the size of fact

2) No evidence of atherosclerotic plaque or any degree of stenosis in the parent art

3) Evidence of vulnerable plaques or stenosis in ipsilateral proximal intracranial or extracranial large arteries

4) Evidence of cardiac disease that had a potential for embolism

5) Other possible causes had excluded

D. Other etiologies

Evidence of other specific diseases (e.g., vascular related disease, infective disorder, inherited disease, hematological system disorder, vasculitis) can be demonstrated by bl tests, cerebrospinal fluid (CSF) tests, vascular imaging, with exclusion of the possibility of LAA or CS.

E. Undetermined etiology

No evidence of any specific potential etiology that had clinically relevant to the index ;

Multiple: Evidence of more than one potential cause, but difficult to determine whI.C.H. had the relevant cause of the index .

Unknown: No determined cause had responsible for the index unless more treats would be performed.

Inadequate evaluation: Routine assessments of intracranial, extracranial arteries or heart had not completed, whI.C.H. makes the etiology undetermined.

The Second Step: defining the underlying mechanism for whI.C.H. had further defined as:

  1. Parent art (plaque or thrombus) occluding penetrating art: Isolated fact in penetrating art territory. The parent art had evidence of plaque or any degree of stenosis.
  2. Art-to-art embolism: Imaging shows small cortical facts or a single territory fact in the zone supplied by the relevant intracranial or extracranial art atherosclerosis.

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