Stroke: causes and clinical features

Stroke is a clinical syndrome rather than a specific disease. This article reviews risk factors for stroke, and the different pathologies that can cause stroke. Approximately 20% of strokes are due to cerebral haemorrhage, most of which is intracerebral, with a significant minority caused by subarachnoid haemorrhage. The remaining 80% are ischaemic, including large artery disease, cardioembolic and small vessel disease. Differentiation of cerebral ischaemia from haemorrhage is impossible without brain imaging. Assessment of a patient with ischaemic stroke requires knowledge of the cerebral arterial supply and cerebral anatomy to differentiate anterior and posterior territory involvement.