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Ischemic Stroke ll: Pathophysiology

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...

Ischemic Stroke l: Introduction

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.

Hemorrhagic Stroke ll: Pathophysiology

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...

Transient Ischemic Attack l: Introduction

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...

Stroke: Introduction and Types

Stroke: Introduction and Types

A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...

Hemorrhagic Stroke l: Introduction

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...

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Updated: Jun 23, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

Endothelial dysfunction in lacunar stroke: a systematic review.

Iris L H Knottnerus¹, Hugo Ten Cate, Jan Lodder

¹Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands. iris.knottnerus@neurologie.azm.nl

Cerebrovascular Diseases (Basel, Switzerland)

|April 18, 2009

Summary

This summary is machine-generated.

Endothelial dysfunction is implicated in lacunar stroke pathogenesis. Impaired vascular tone, elevated hemostatic markers, and increased adhesion molecules suggest a significant role for endothelial dysfunction in stroke progression.

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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

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Published on: August 17, 2022

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Last Updated: Jun 23, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

Published on: August 17, 2022

Area of Science:

Neurology
Vascular Biology
Stroke Research

Background:

Endothelial dysfunction is a key factor in the development and progression of cerebral small-vessel disease.
Lacunar stroke patients often exhibit signs of endothelial dysfunction.

Purpose of the Study:

To systematically review and synthesize evidence on endothelial activation and dysfunction in lacunar stroke.
To explore the role of endothelial dysfunction in the pathogenesis of lacunar stroke.

Main Methods:

Systematic literature search of MEDLINE and EMBASE databases.
Assessment of 29 eligible articles using a predefined checklist for quality.
Categorization of findings based on endothelial functions and endothelial toxins.

Main Results:

Impaired endothelial regulation of vascular tone observed post-stroke.
Elevated levels of hemostatic markers (e.g., von Willebrand factor) and adhesion molecules (e.g., E-selectin) noted.
Elevated homocysteine, an endothelial toxin, found in patients.

Conclusions:

Endothelial dysfunction is likely involved in lacunar stroke pathogenesis, particularly with co-occurring silent infarcts and white matter lesions.
Future research should focus on long-term clinical and radiological follow-up using combined methods to assess endothelial function in lacunar stroke.