Etiology

  • Thrombotic (atherosclerosis)

  • Embolic (AFib, carotid disease)

  • Small vessel (lacunar)

Pathogenesis

  • Vascular occlusion → reduced cerebral blood flow → neuronal ischemia

  • Infarction develops within minutes

  • Penumbra = salvageable tissue

Clinical Features

  • Sudden focal neurological deficits (weakness, aphasia, vision loss)

  • FAST symptoms

  • Possible carotid bruit

Treatment

  • tPA within 4.5 hours

  • Mechanical thrombectomy (large vessel)

  • Antiplatelets (aspirin)

  • Statins

  • Control BP and glucose