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</li> <li id="toc-Ischemic" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ischemic"> <div class="vector-toc-text"> 1.2 Ischemic </div> </a> <ul id="toc-Ischemic-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hemorrhagic" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Hemorrhagic"> <div class="vector-toc-text"> 1.3 Hemorrhagic </div> </a> <ul id="toc-Hemorrhagic-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Signs_and_symptoms" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Signs_and_symptoms"> <div class="vector-toc-text"> 2 Signs and symptoms </div> </a> <button aria-controls="toc-Signs_and_symptoms-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Signs and symptoms subsection </button> <ul id="toc-Signs_and_symptoms-sublist" class="vector-toc-list"> <li id="toc-Early_recognition" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Early_recognition"> <div class="vector-toc-text"> 2.1 Early recognition </div> </a> <ul id="toc-Early_recognition-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Associated_symptoms" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Associated_symptoms"> <div class="vector-toc-text"> 2.2 Associated symptoms </div> </a> <ul id="toc-Associated_symptoms-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Subtypes" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Subtypes"> <div class="vector-toc-text"> 2.3 Subtypes </div> </a> <ul id="toc-Subtypes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Preceding_signs_and_symptoms" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Preceding_signs_and_symptoms"> <div class="vector-toc-text"> 2.4 Preceding signs and symptoms </div> </a> <ul id="toc-Preceding_signs_and_symptoms-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Causes" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Causes"> <div class="vector-toc-text"> 3 Causes </div> </a> <button aria-controls="toc-Causes-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Causes subsection </button> <ul id="toc-Causes-sublist" class="vector-toc-list"> <li id="toc-Thrombotic_stroke" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Thrombotic_stroke"> <div class="vector-toc-text"> 3.1 Thrombotic stroke </div> </a> <ul id="toc-Thrombotic_stroke-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Embolic_stroke" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Embolic_stroke"> <div class="vector-toc-text"> 3.2 Embolic stroke </div> </a> <ul id="toc-Embolic_stroke-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Cerebral_hypoperfusion" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cerebral_hypoperfusion"> <div class="vector-toc-text"> 3.3 Cerebral hypoperfusion </div> </a> <ul id="toc-Cerebral_hypoperfusion-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Venous_thrombosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Venous_thrombosis"> <div class="vector-toc-text"> 3.4 Venous thrombosis </div> </a> <ul id="toc-Venous_thrombosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Intracerebral_hemorrhage" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Intracerebral_hemorrhage"> <div class="vector-toc-text"> 3.5 Intracerebral hemorrhage </div> </a> <ul id="toc-Intracerebral_hemorrhage-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other"> <div class="vector-toc-text"> 3.6 Other </div> </a> <ul id="toc-Other-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Silent_stroke" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Silent_stroke"> <div class="vector-toc-text"> 3.7 Silent stroke </div> </a> <ul id="toc-Silent_stroke-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Pathophysiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Pathophysiology"> <div class="vector-toc-text"> 4 Pathophysiology </div> </a> <button aria-controls="toc-Pathophysiology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Pathophysiology subsection </button> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> <li id="toc-Ischemic_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ischemic_2"> <div class="vector-toc-text"> 4.1 Ischemic </div> </a> <ul id="toc-Ischemic_2-sublist" class="vector-toc-list"> <li id="toc-Collateral_flow" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Collateral_flow"> <div class="vector-toc-text"> 4.1.1 Collateral flow </div> </a> <ul id="toc-Collateral_flow-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Hemorrhagic_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Hemorrhagic_2"> <div class="vector-toc-text"> 4.2 Hemorrhagic </div> </a> <ul id="toc-Hemorrhagic_2-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> 5 Diagnosis </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Diagnosis subsection </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Physical_examination" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Physical_examination"> <div class="vector-toc-text"> 5.1 Physical examination </div> </a> <ul id="toc-Physical_examination-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Imaging" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Imaging"> <div class="vector-toc-text"> 5.2 Imaging </div> </a> <ul id="toc-Imaging-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Underlying_cause" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Underlying_cause"> <div class="vector-toc-text"> 5.3 Underlying cause </div> </a> <ul id="toc-Underlying_cause-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Misdiagnosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Misdiagnosis"> <div class="vector-toc-text"> 5.4 Misdiagnosis </div> </a> <ul id="toc-Misdiagnosis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> 6 Prevention </div> </a> <button aria-controls="toc-Prevention-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Prevention subsection </button> <ul id="toc-Prevention-sublist" class="vector-toc-list"> <li id="toc-Risk_factors" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Risk_factors"> <div class="vector-toc-text"> 6.1 Risk factors </div> </a> <ul id="toc-Risk_factors-sublist" class="vector-toc-list"> <li id="toc-Blood_pressure" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Blood_pressure"> <div class="vector-toc-text"> 6.1.1 Blood pressure </div> </a> <ul id="toc-Blood_pressure-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Blood_lipids" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Blood_lipids"> <div class="vector-toc-text"> 6.1.2 Blood lipids </div> </a> <ul id="toc-Blood_lipids-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diabetes_mellitus" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Diabetes_mellitus"> <div class="vector-toc-text"> 6.1.3 Diabetes mellitus </div> </a> <ul id="toc-Diabetes_mellitus-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Anticoagulant_drugs" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Anticoagulant_drugs"> <div class="vector-toc-text"> 6.1.4 Anticoagulant drugs </div> </a> <ul id="toc-Anticoagulant_drugs-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> 6.1.5 Surgery </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diet" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Diet"> <div class="vector-toc-text"> 6.1.6 Diet </div> </a> <ul id="toc-Diet-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Women" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Women"> <div class="vector-toc-text"> 6.2 Women </div> </a> <ul id="toc-Women-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Previous_stroke_or_TIA" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Previous_stroke_or_TIA"> <div class="vector-toc-text"> 6.3 Previous stroke or TIA </div> </a> <ul id="toc-Previous_stroke_or_TIA-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> 7 Management </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Management subsection </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Ischemic_stroke" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ischemic_stroke"> <div class="vector-toc-text"> 7.1 Ischemic stroke </div> </a> <ul id="toc-Ischemic_stroke-sublist" class="vector-toc-list"> <li id="toc-Thrombolysis" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Thrombolysis"> <div class="vector-toc-text"> 7.1.1 Thrombolysis </div> </a> <ul id="toc-Thrombolysis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Endovascular_treatment" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Endovascular_treatment"> <div class="vector-toc-text"> 7.1.2 Endovascular treatment </div> </a> <ul id="toc-Endovascular_treatment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Craniectomy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Craniectomy"> <div class="vector-toc-text"> 7.1.3 Craniectomy </div> </a> <ul id="toc-Craniectomy-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Hemorrhagic_stroke" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Hemorrhagic_stroke"> <div class="vector-toc-text"> 7.2 Hemorrhagic stroke </div> </a> <ul id="toc-Hemorrhagic_stroke-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Stroke_unit" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Stroke_unit"> <div class="vector-toc-text"> 7.3 Stroke unit </div> </a> <ul id="toc-Stroke_unit-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Rehabilitation" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Rehabilitation"> <div class="vector-toc-text"> 8 Rehabilitation </div> </a> <button aria-controls="toc-Rehabilitation-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Rehabilitation subsection </button> <ul id="toc-Rehabilitation-sublist" class="vector-toc-list"> <li id="toc-Spatial_neglect" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Spatial_neglect"> <div class="vector-toc-text"> 8.1 Spatial neglect </div> </a> <ul id="toc-Spatial_neglect-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Automobile_driving" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Automobile_driving"> <div class="vector-toc-text"> 8.2 Automobile driving </div> </a> <ul id="toc-Automobile_driving-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Yoga" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Yoga"> <div class="vector-toc-text"> 8.3 Yoga </div> </a> <ul id="toc-Yoga-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Action_observation_physical_therapy_for_upper_limbs" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Action_observation_physical_therapy_for_upper_limbs"> <div class="vector-toc-text"> 8.4 Action observation physical therapy for upper limbs </div> </a> <ul id="toc-Action_observation_physical_therapy_for_upper_limbs-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Cognitive_rehabilitation_for_attention_deficits" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cognitive_rehabilitation_for_attention_deficits"> <div class="vector-toc-text"> 8.5 Cognitive rehabilitation for attention deficits </div> </a> <ul id="toc-Cognitive_rehabilitation_for_attention_deficits-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Motor_imagery_for_gait_rehabilitation" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Motor_imagery_for_gait_rehabilitation"> <div class="vector-toc-text"> 8.6 Motor imagery for gait rehabilitation </div> </a> <ul id="toc-Motor_imagery_for_gait_rehabilitation-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Physical_and_occupational_therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Physical_and_occupational_therapy"> <div class="vector-toc-text"> 8.7 Physical and occupational therapy </div> </a> <ul id="toc-Physical_and_occupational_therapy-sublist" class="vector-toc-list"> <li id="toc-Interventions_for_age-related_visual_problems_in_patients_with_stroke" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Interventions_for_age-related_visual_problems_in_patients_with_stroke"> <div class="vector-toc-text"> 8.7.1 Interventions for age-related visual problems in patients with stroke </div> </a> <ul id="toc-Interventions_for_age-related_visual_problems_in_patients_with_stroke-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Speech_and_language_therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Speech_and_language_therapy"> <div class="vector-toc-text"> 8.8 Speech and language therapy </div> </a> <ul id="toc-Speech_and_language_therapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Devices" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Devices"> <div class="vector-toc-text"> 8.9 Devices </div> </a> <ul id="toc-Devices-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Physical_fitness" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Physical_fitness"> <div class="vector-toc-text"> 8.10 Physical fitness </div> </a> <ul id="toc-Physical_fitness-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_therapy_methods" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_therapy_methods"> <div class="vector-toc-text"> 8.11 Other therapy methods </div> </a> <ul id="toc-Other_therapy_methods-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Orthotics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Orthotics"> <div class="vector-toc-text"> 8.12 Orthotics </div> </a> <ul id="toc-Orthotics-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Self-management" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Self-management"> <div class="vector-toc-text"> 8.13 Self-management </div> </a> <ul id="toc-Self-management-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> 9 Prognosis </div> </a> <button aria-controls="toc-Prognosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Prognosis subsection </button> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> <li id="toc-Physical_effects" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Physical_effects"> <div class="vector-toc-text"> 9.1 Physical effects </div> </a> <ul id="toc-Physical_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Emotional_and_mental_effects" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Emotional_and_mental_effects"> <div class="vector-toc-text"> 9.2 Emotional and mental effects </div> </a> <ul id="toc-Emotional_and_mental_effects-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> 10 Epidemiology </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> 11 History </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> 12 Research </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> 13 See also </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 14 References </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> 15 Further reading </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> 16 External links </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Stroke</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 119 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-119" aria-hidden="true" > 119 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Beroerte" title="Beroerte – Afrikaans" lang="af" hreflang="af" data-title="Beroerte" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target">Afrikaans</a></li><li class="interlanguage-link interwiki-als mw-list-item"><a href="https://als.wikipedia.org/wiki/Schlaganfall" title="Schlaganfall – Alemannic" lang="gsw" hreflang="gsw" data-title="Schlaganfall" data-language-autonym="Alemannisch" data-language-local-name="Alemannic" class="interlanguage-link-target">Alemannisch</a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B3%D9%83%D8%AA%D8%A9_%D8%AF%D9%85%D8%A7%D8%BA%D9%8A%D8%A9" title="سكتة دماغية – Arabic" lang="ar" hreflang="ar" data-title="سكتة دماغية" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-an mw-list-item"><a href="https://an.wikipedia.org/wiki/Accident_vascular_cerebral" title="Accident vascular cerebral – Aragonese" lang="an" hreflang="an" data-title="Accident vascular cerebral" data-language-autonym="Aragonés" data-language-local-name="Aragonese" class="interlanguage-link-target">Aragonés</a></li><li class="interlanguage-link interwiki-as mw-list-item"><a href="https://as.wikipedia.org/wiki/%E0%A6%B7%E0%A7%8D%E0%A6%9F%E0%A7%8D%E0%A7%B0%27%E0%A6%95" title="ষ্ট্ৰ'ক – Assamese" lang="as" hreflang="as" data-title="ষ্ট্ৰ'ক" data-language-autonym="অসমীয়া" data-language-local-name="Assamese" class="interlanguage-link-target">অসমীয়া</a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Accidente_cerebrovascular" title="Accidente cerebrovascular – Asturian" lang="ast" hreflang="ast" data-title="Accidente cerebrovascular" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target">Asturianu</a></li><li class="interlanguage-link interwiki-gn mw-list-item"><a href="https://gn.wikipedia.org/wiki/Apytu%27%C5%A9soro" title="Apytu'ũsoro – Guarani" lang="gn" hreflang="gn" data-title="Apytu'ũsoro" data-language-autonym="Avañe'ẽ" data-language-local-name="Guarani" class="interlanguage-link-target">Avañe'ẽ</a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/%C4%B0nsult" title="İnsult – Azerbaijani" lang="az" hreflang="az" data-title="İnsult" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target">Azərbaycanca</a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%B3%DA%A9%D8%AA%D9%87" title="سکته – South Azerbaijani" lang="azb" hreflang="azb" data-title="سکته" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target">تۆرکجه</a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%B8%E0%A7%8D%E0%A6%9F%E0%A7%8D%E0%A6%B0%E0%A7%8B%E0%A6%95" title="স্ট্রোক – Bangla" lang="bn" hreflang="bn" data-title="স্ট্রোক" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target">বাংলা</a></li><li class="interlanguage-link interwiki-zh-min-nan mw-list-item"><a href="https://zh-min-nan.wikipedia.org/wiki/Ti%C3%B2ng-hong" title="Tiòng-hong – Minnan" lang="nan" hreflang="nan" data-title="Tiòng-hong" data-language-autonym="閩南語 / Bân-lâm-gú" data-language-local-name="Minnan" class="interlanguage-link-target">閩南語 / Bân-lâm-gú</a></li><li class="interlanguage-link interwiki-ba mw-list-item"><a href="https://ba.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82" title="Инсульт – Bashkir" lang="ba" hreflang="ba" data-title="Инсульт" data-language-autonym="Башҡортса" data-language-local-name="Bashkir" class="interlanguage-link-target">Башҡортса</a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%86%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82" title="Інсульт – Belarusian" lang="be" hreflang="be" data-title="Інсульт" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target">Беларуская</a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%86%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82" title="Інсульт – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Інсульт" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target">Беларуская (тарашкевіца)</a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D1%82" title="Инсулт – Bulgarian" lang="bg" hreflang="bg" data-title="Инсулт" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target">Български</a></li><li class="interlanguage-link interwiki-bo mw-list-item"><a href="https://bo.wikipedia.org/wiki/%E0%BD%82%E0%BE%B2%E0%BD%B2%E0%BD%96%E0%BC%8B%E0%BD%93%E0%BD%91%E0%BC%8B" title="གྲིབ་ནད་ – Tibetan" lang="bo" hreflang="bo" data-title="གྲིབ་ནད་" data-language-autonym="བོད་ཡིག" data-language-local-name="Tibetan" class="interlanguage-link-target">བོད་ཡིག</a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Mo%C5%BEdani_udar" title="Moždani udar – Bosnian" lang="bs" hreflang="bs" data-title="Moždani udar" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target">Bosanski</a></li><li class="interlanguage-link interwiki-br mw-list-item"><a href="https://br.wikipedia.org/wiki/Gwallzarvoud_eus_gwazhied_an_empenn" title="Gwallzarvoud eus gwazhied an empenn – Breton" lang="br" hreflang="br" data-title="Gwallzarvoud eus gwazhied an empenn" data-language-autonym="Brezhoneg" data-language-local-name="Breton" class="interlanguage-link-target">Brezhoneg</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Accident_vascular_cerebral" title="Accident vascular cerebral – Catalan" lang="ca" hreflang="ca" data-title="Accident vascular cerebral" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cv mw-list-item"><a href="https://cv.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82" title="Инсульт – Chuvash" lang="cv" hreflang="cv" data-title="Инсульт" data-language-autonym="Чӑвашла" data-language-local-name="Chuvash" class="interlanguage-link-target">Чӑвашла</a></li><li class="interlanguage-link interwiki-ceb mw-list-item"><a href="https://ceb.wikipedia.org/wiki/Estrok" title="Estrok – Cebuano" lang="ceb" hreflang="ceb" data-title="Estrok" data-language-autonym="Cebuano" data-language-local-name="Cebuano" class="interlanguage-link-target">Cebuano</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/C%C3%A9vn%C3%AD_mozkov%C3%A1_p%C5%99%C3%ADhoda" title="Cévní mozková příhoda – Czech" lang="cs" hreflang="cs" data-title="Cévní mozková příhoda" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Str%C3%B4c" title="Strôc – Welsh" lang="cy" hreflang="cy" data-title="Strôc" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target">Cymraeg</a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Apopleksi" title="Apopleksi – Danish" lang="da" hreflang="da" data-title="Apopleksi" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Schlaganfall" title="Schlaganfall – German" lang="de" hreflang="de" data-title="Schlaganfall" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%90%DE%B0%DE%93%DE%B0%DE%83%DE%AF%DE%86%DE%B0_%DE%96%DE%AC%DE%80%DE%AA%DE%82%DE%B0" title="ސްޓްރޯކް ޖެހުން – Divehi" lang="dv" hreflang="dv" data-title="ސްޓްރޯކް ޖެހުން" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target">ދިވެހިބަސް</a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Insult" title="Insult – Estonian" lang="et" hreflang="et" data-title="Insult" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target">Eesti</a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%95%CE%B3%CE%BA%CE%B5%CF%86%CE%B1%CE%BB%CE%B9%CE%BA%CF%8C_%CE%B5%CF%80%CE%B5%CE%B9%CF%83%CF%8C%CE%B4%CE%B9%CE%BF" title="Εγκεφαλικό επεισόδιο – Greek" lang="el" hreflang="el" data-title="Εγκεφαλικό επεισόδιο" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target">Ελληνικά</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Accidente_cerebrovascular" title="Accidente cerebrovascular – Spanish" lang="es" hreflang="es" data-title="Accidente cerebrovascular" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Apopleksio" title="Apopleksio – Esperanto" lang="eo" hreflang="eo" data-title="Apopleksio" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target">Esperanto</a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Istripu_zerebrobaskular" title="Istripu zerebrobaskular – Basque" lang="eu" hreflang="eu" data-title="Istripu zerebrobaskular" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target">Euskara</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B3%DA%A9%D8%AA%D9%87_%D9%85%D8%BA%D8%B2%DB%8C" title="سکته مغزی – Persian" lang="fa" hreflang="fa" data-title="سکته مغزی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-hif mw-list-item"><a href="https://hif.wikipedia.org/wiki/Stroke" title="Stroke – Fiji Hindi" lang="hif" hreflang="hif" data-title="Stroke" data-language-autonym="Fiji Hindi" data-language-local-name="Fiji Hindi" class="interlanguage-link-target">Fiji Hindi</a></li><li class="interlanguage-link interwiki-fo mw-list-item"><a href="https://fo.wikipedia.org/wiki/Apopleksi" title="Apopleksi – Faroese" lang="fo" hreflang="fo" data-title="Apopleksi" data-language-autonym="Føroyskt" data-language-local-name="Faroese" class="interlanguage-link-target">Føroyskt</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Accident_vasculaire_c%C3%A9r%C3%A9bral" title="Accident vasculaire cérébral – French" lang="fr" hreflang="fr" data-title="Accident vasculaire cérébral" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Str%C3%B3c" title="Stróc – Irish" lang="ga" hreflang="ga" data-title="Stróc" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target">Gaeilge</a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Ictus" title="Ictus – Galician" lang="gl" hreflang="gl" data-title="Ictus" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target">Galego</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%87%8C%EC%A1%B8%EC%A4%91" title="뇌졸중 – Korean" lang="ko" hreflang="ko" data-title="뇌졸중" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Bugun_jini" title="Bugun jini – Hausa" lang="ha" hreflang="ha" data-title="Bugun jini" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target">Hausa</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%BF%D5%A1%D5%A9%D5%BE%D5%A1%D5%AE" title="Կաթված – Armenian" lang="hy" hreflang="hy" data-title="Կաթված" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%B8%E0%A5%8D%E0%A4%9F%E0%A5%8D%E0%A4%B0%E0%A5%8B%E0%A4%95" title="स्ट्रोक – Hindi" lang="hi" hreflang="hi" data-title="स्ट्रोक" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target">हिन्दी</a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Mo%C5%BEdani_udar" title="Moždani udar – Croatian" lang="hr" hreflang="hr" data-title="Moždani udar" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target">Hrvatski</a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Vaskulala_cerebrala_stroko" title="Vaskulala cerebrala stroko – Ido" lang="io" hreflang="io" data-title="Vaskulala cerebrala stroko" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target">Ido</a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Strok" title="Strok – Indonesian" lang="id" hreflang="id" data-title="Strok" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/Heilabl%C3%B3%C3%B0fall" title="Heilablóðfall – Icelandic" lang="is" hreflang="is" data-title="Heilablóðfall" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target">Íslenska</a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Ictus" title="Ictus – Italian" lang="it" hreflang="it" data-title="Ictus" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%A9%D7%91%D7%A5_%D7%9E%D7%95%D7%97%D7%99" title="שבץ מוחי – Hebrew" lang="he" hreflang="he" data-title="שבץ מוחי" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-jv mw-list-item"><a href="https://jv.wikipedia.org/wiki/Strok" title="Strok – Javanese" lang="jv" hreflang="jv" data-title="Strok" data-language-autonym="Jawa" data-language-local-name="Javanese" class="interlanguage-link-target">Jawa</a></li><li class="interlanguage-link interwiki-pam mw-list-item"><a href="https://pam.wikipedia.org/wiki/Stroke" title="Stroke – Pampanga" lang="pam" hreflang="pam" data-title="Stroke" data-language-autonym="Kapampangan" data-language-local-name="Pampanga" class="interlanguage-link-target">Kapampangan</a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%98%E1%83%9C%E1%83%A1%E1%83%A3%E1%83%9A%E1%83%A2%E1%83%98" title="ინსულტი – Georgian" lang="ka" hreflang="ka" data-title="ინსულტი" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target">ქართული</a></li><li class="interlanguage-link interwiki-csb mw-list-item"><a href="https://csb.wikipedia.org/wiki/Szlach_m%C3%B9sk%C3%B9" title="Szlach mùskù – Kashubian" lang="csb" hreflang="csb" data-title="Szlach mùskù" data-language-autonym="Kaszëbsczi" data-language-local-name="Kashubian" class="interlanguage-link-target">Kaszëbsczi</a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82" title="Инсульт – Kazakh" lang="kk" hreflang="kk" data-title="Инсульт" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target">Қазақша</a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Kiharusi" title="Kiharusi – Swahili" lang="sw" hreflang="sw" data-title="Kiharusi" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target">Kiswahili</a></li><li class="interlanguage-link interwiki-kv mw-list-item"><a href="https://kv.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82" title="Инсульт – Komi" lang="kv" hreflang="kv" data-title="Инсульт" data-language-autonym="Коми" data-language-local-name="Komi" class="interlanguage-link-target">Коми</a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82" title="Инсульт – Kyrgyz" lang="ky" hreflang="ky" data-title="Инсульт" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target">Кыргызча</a></li><li class="interlanguage-link interwiki-lo mw-list-item"><a href="https://lo.wikipedia.org/wiki/%E0%BB%80%E0%BA%AA%E0%BA%B1%E0%BB%89%E0%BA%99%E0%BB%80%E0%BA%A5%E0%BA%B7%E0%BA%AD%E0%BA%94%E0%BA%95%E0%BA%B1%E0%BA%99%E0%BB%83%E0%BA%99" title="ເສັ້ນເລືອດຕັນໃນ – Lao" lang="lo" hreflang="lo" data-title="ເສັ້ນເລືອດຕັນໃນ" data-language-autonym="ລາວ" data-language-local-name="Lao" class="interlanguage-link-target">ລາວ</a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Apoplexia_cerebri" title="Apoplexia cerebri – Latin" lang="la" hreflang="la" data-title="Apoplexia cerebri" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target">Latina</a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Smadze%C5%86u_insults" title="Smadzeņu insults – Latvian" lang="lv" hreflang="lv" data-title="Smadzeņu insults" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target">Latviešu</a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Insultas" title="Insultas – Lithuanian" lang="lt" hreflang="lt" data-title="Insultas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target">Lietuvių</a></li><li class="interlanguage-link interwiki-li mw-list-item"><a href="https://li.wikipedia.org/wiki/Slaagaanval" title="Slaagaanval – Limburgish" lang="li" hreflang="li" data-title="Slaagaanval" data-language-autonym="Limburgs" data-language-local-name="Limburgish" class="interlanguage-link-target">Limburgs</a></li><li class="interlanguage-link interwiki-ln mw-list-item"><a href="https://ln.wikipedia.org/wiki/AVC" title="AVC – Lingala" lang="ln" hreflang="ln" data-title="AVC" data-language-autonym="Lingála" data-language-local-name="Lingala" class="interlanguage-link-target">Lingála</a></li><li class="interlanguage-link interwiki-lmo mw-list-item"><a href="https://lmo.wikipedia.org/wiki/Ictus" title="Ictus – Lombard" lang="lmo" hreflang="lmo" data-title="Ictus" data-language-autonym="Lombard" data-language-local-name="Lombard" class="interlanguage-link-target">Lombard</a></li><li class="interlanguage-link interwiki-hu badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://hu.wikipedia.org/wiki/Agyi_%C3%A9rkatasztr%C3%B3fa" title="Agyi érkatasztrófa – Hungarian" lang="hu" hreflang="hu" data-title="Agyi érkatasztrófa" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target">Magyar</a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9C%D0%BE%D0%B7%D0%BE%D1%87%D0%B5%D0%BD_%D1%83%D0%B4%D0%B0%D1%80" title="Мозочен удар – Macedonian" lang="mk" hreflang="mk" data-title="Мозочен удар" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target">Македонски</a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%AE%E0%B4%B8%E0%B5%8D%E0%B4%A4%E0%B4%BF%E0%B4%B7%E0%B5%8D%E0%B4%95%E0%B4%BE%E0%B4%98%E0%B4%BE%E0%B4%A4%E0%B4%82" title="മസ്തിഷ്കാഘാതം – Malayalam" lang="ml" hreflang="ml" data-title="മസ്തിഷ്കാഘാതം" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target">മലയാളം</a></li><li class="interlanguage-link interwiki-xmf mw-list-item"><a href="https://xmf.wikipedia.org/wiki/%E1%83%98%E1%83%9C%E1%83%A1%E1%83%A3%E1%83%9A%E1%83%A2%E1%83%98" title="ინსულტი – Mingrelian" lang="xmf" hreflang="xmf" data-title="ინსულტი" data-language-autonym="მარგალური" data-language-local-name="Mingrelian" class="interlanguage-link-target">მარგალური</a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Angin_ahmar" title="Angin ahmar – Malay" lang="ms" hreflang="ms" data-title="Angin ahmar" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target">Bahasa Melayu</a></li><li class="interlanguage-link interwiki-min mw-list-item"><a href="https://min.wikipedia.org/wiki/Stroke" title="Stroke – Minangkabau" lang="min" hreflang="min" data-title="Stroke" data-language-autonym="Minangkabau" data-language-local-name="Minangkabau" class="interlanguage-link-target">Minangkabau</a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%9C%E1%80%B1%E1%80%96%E1%80%BC%E1%80%90%E1%80%BA%E1%80%81%E1%80%BC%E1%80%84%E1%80%BA%E1%80%B8" title="လေဖြတ်ခြင်း – Burmese" lang="my" hreflang="my" data-title="လေဖြတ်ခြင်း" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target">မြန်မာဘာသာ</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Cerebrovasculair_accident" title="Cerebrovasculair accident – Dutch" lang="nl" hreflang="nl" data-title="Cerebrovasculair accident" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ne mw-list-item"><a href="https://ne.wikipedia.org/wiki/%E0%A4%AE%E0%A4%B8%E0%A5%8D%E0%A4%A4%E0%A4%BF%E0%A4%B7%E0%A5%8D%E0%A4%95%E0%A4%BE%E0%A4%98%E0%A4%BE%E0%A4%A4" title="मस्तिष्काघात – Nepali" lang="ne" hreflang="ne" data-title="मस्तिष्काघात" data-language-autonym="नेपाली" data-language-local-name="Nepali" class="interlanguage-link-target">नेपाली</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%84%B3%E5%8D%92%E4%B8%AD" title="脳卒中 – Japanese" lang="ja" hreflang="ja" data-title="脳卒中" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Hjerneslag" title="Hjerneslag – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Hjerneslag" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Hjerneslag" title="Hjerneslag – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Hjerneslag" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target">Norsk nynorsk</a></li><li class="interlanguage-link interwiki-oc mw-list-item"><a href="https://oc.wikipedia.org/wiki/Accident_vascular_cerebral" title="Accident vascular cerebral – Occitan" lang="oc" hreflang="oc" data-title="Accident vascular cerebral" data-language-autonym="Occitan" data-language-local-name="Occitan" class="interlanguage-link-target">Occitan</a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%B7%E0%AD%8D%E0%AC%9F%E0%AD%8D%E0%AC%B0%E0%AD%8B%E0%AC%95" title="ଷ୍ଟ୍ରୋକ – Odia" lang="or" hreflang="or" data-title="ଷ୍ଟ୍ରୋକ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target">ଓଡ଼ିଆ</a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Insult" title="Insult – Uzbek" lang="uz" hreflang="uz" data-title="Insult" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target">Oʻzbekcha / ўзбекча</a></li><li class="interlanguage-link interwiki-pa mw-list-item"><a href="https://pa.wikipedia.org/wiki/%E0%A8%B8%E0%A8%9F%E0%A8%B0%E0%A9%8B%E0%A8%95" title="ਸਟਰੋਕ – Punjabi" lang="pa" hreflang="pa" data-title="ਸਟਰੋਕ" data-language-autonym="ਪੰਜਾਬੀ" data-language-local-name="Punjabi" class="interlanguage-link-target">ਪੰਜਾਬੀ</a></li><li class="interlanguage-link interwiki-pnb mw-list-item"><a href="https://pnb.wikipedia.org/wiki/%D8%B3%DA%A9%D8%AA%DB%81" title="سکتہ – Western Punjabi" lang="pnb" hreflang="pnb" data-title="سکتہ" data-language-autonym="پنجابی" data-language-local-name="Western Punjabi" class="interlanguage-link-target">پنجابی</a></li><li class="interlanguage-link interwiki-blk mw-list-item"><a href="https://blk.wikipedia.org/wiki/%E1%80%90%E1%80%9C%E1%80%AE%EA%A9%BB%E1%80%96%E1%80%BB%E1%80%90%E1%80%BA%E1%80%9B%E1%80%B1%E1%80%AC%E1%82%8F%E1%80%82%E1%80%AB%E1%82%8F" title="တလီꩻဖျတ်ရောႏဂါႏ – Pa'O" lang="blk" hreflang="blk" data-title="တလီꩻဖျတ်ရောႏဂါႏ" data-language-autonym="ပအိုဝ်ႏဘာႏသာႏ" data-language-local-name="Pa'O" class="interlanguage-link-target">ပအိုဝ်ႏဘာႏသာႏ</a></li><li class="interlanguage-link interwiki-jam mw-list-item"><a href="https://jam.wikipedia.org/wiki/Schruok" title="Schruok – Jamaican Creole English" lang="jam" hreflang="jam" data-title="Schruok" data-language-autonym="Patois" data-language-local-name="Jamaican Creole English" class="interlanguage-link-target">Patois</a></li><li class="interlanguage-link interwiki-nds mw-list-item"><a href="https://nds.wikipedia.org/wiki/Slaganfall" title="Slaganfall – Low German" lang="nds" hreflang="nds" data-title="Slaganfall" data-language-autonym="Plattdüütsch" data-language-local-name="Low German" class="interlanguage-link-target">Plattdüütsch</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Udar_m%C3%B3zgu" title="Udar mózgu – Polish" lang="pl" hreflang="pl" data-title="Udar mózgu" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Acidente_vascular_cerebral" title="Acidente vascular cerebral – Portuguese" lang="pt" hreflang="pt" data-title="Acidente vascular cerebral" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Accident_vascular_cerebral" title="Accident vascular cerebral – Romanian" lang="ro" hreflang="ro" data-title="Accident vascular cerebral" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target">Română</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82" title="Инсульт – Russian" lang="ru" hreflang="ru" data-title="Инсульт" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82_-_%D1%82%D1%8B%D0%BC%D1%8B%D1%80_%D0%B1%D1%8B%D2%BB%D0%B0_%D0%B1%D0%B0%D1%80%D1%8B%D1%8B%D1%82%D0%B0" title="Инсульт - тымыр быһа барыыта – Yakut" lang="sah" hreflang="sah" data-title="Инсульт - тымыр быһа барыыта" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target">Саха тыла</a></li><li class="interlanguage-link interwiki-scn mw-list-item"><a href="https://scn.wikipedia.org/wiki/Ictus" title="Ictus – Sicilian" lang="scn" hreflang="scn" data-title="Ictus" data-language-autonym="Sicilianu" data-language-local-name="Sicilian" class="interlanguage-link-target">Sicilianu</a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B6%86%E0%B6%9D%E0%B7%8F%E0%B6%AD%E0%B6%BA" title="ආඝාතය – Sinhala" lang="si" hreflang="si" data-title="ආඝාතය" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target">සිංහල</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Stroke" title="Stroke – Simple English" lang="en-simple" hreflang="en-simple" data-title="Stroke" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-sd mw-list-item"><a href="https://sd.wikipedia.org/wiki/%D8%A7%DA%8C_%D8%B1%D9%86%DA%AF" title="اڌ رنگ – Sindhi" lang="sd" hreflang="sd" data-title="اڌ رنگ" data-language-autonym="سنڌي" data-language-local-name="Sindhi" class="interlanguage-link-target">سنڌي</a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Cievna_mozgov%C3%A1_pr%C3%ADhoda" title="Cievna mozgová príhoda – Slovak" lang="sk" hreflang="sk" data-title="Cievna mozgová príhoda" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target">Slovenčina</a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Mo%C5%BEganska_kap" title="Možganska kap – Slovenian" lang="sl" hreflang="sl" data-title="Možganska kap" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target">Slovenščina</a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D8%AC%DB%95%DA%B5%D8%AF%DB%95%DB%8C_%D9%85%DB%8E%D8%B4%DA%A9" title="جەڵدەی مێشک – Central Kurdish" lang="ckb" hreflang="ckb" data-title="جەڵدەی مێشک" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target">کوردی</a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%9C%D0%BE%D0%B6%D0%B4%D0%B0%D0%BD%D0%B8_%D1%83%D0%B4%D0%B0%D1%80" title="Мождани удар – Serbian" lang="sr" hreflang="sr" data-title="Мождани удар" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target">Српски / srpski</a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Mo%C5%BEdani_udar" title="Moždani udar – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Moždani udar" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target">Srpskohrvatski / српскохрватски</a></li><li class="interlanguage-link interwiki-fi badge-Q70893996 mw-list-item" title=""><a href="https://fi.wikipedia.org/wiki/Aivohalvaus" title="Aivohalvaus – Finnish" lang="fi" hreflang="fi" data-title="Aivohalvaus" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target">Suomi</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Stroke" title="Stroke – Swedish" lang="sv" hreflang="sv" data-title="Stroke" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Stroke" title="Stroke – Tagalog" lang="tl" hreflang="tl" data-title="Stroke" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target">Tagalog</a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%AA%E0%AE%95%E0%AF%8D%E0%AE%95%E0%AE%B5%E0%AE%BE%E0%AE%A4%E0%AE%AE%E0%AF%8D" title="பக்கவாதம் – Tamil" lang="ta" hreflang="ta" data-title="பக்கவாதம்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target">தமிழ்</a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82" title="Инсульт – Tatar" lang="tt" hreflang="tt" data-title="Инсульт" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target">Татарча / tatarça</a></li><li class="interlanguage-link interwiki-shn mw-list-item"><a href="https://shn.wikipedia.org/wiki/%E1%80%90%E1%81%A2%E1%82%86%E1%81%BD%E1%81%A2%E1%81%B5%E1%80%BA%E1%82%87%E1%81%8A_%E1%80%90%E1%81%A2%E1%80%84%E1%80%BA%E1%80%B8%E1%80%95%E1%80%B5%E1%81%BC%E1%80%BA" title="တၢႆၽၢၵ်ႇ၊ တၢင်းပဵၼ် – Shan" lang="shn" hreflang="shn" data-title="တၢႆၽၢၵ်ႇ၊ တၢင်းပဵၼ်" data-language-autonym="ၽႃႇသႃႇတႆး " data-language-local-name="Shan" class="interlanguage-link-target">ၽႃႇသႃႇတႆး </a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B9%82%E0%B8%A3%E0%B8%84%E0%B8%AB%E0%B8%A5%E0%B8%AD%E0%B8%94%E0%B9%80%E0%B8%A5%E0%B8%B7%E0%B8%AD%E0%B8%94%E0%B8%AA%E0%B8%A1%E0%B8%AD%E0%B8%87%E0%B9%80%E0%B8%89%E0%B8%B5%E0%B8%A2%E0%B8%9A%E0%B8%9E%E0%B8%A5%E0%B8%B1%E0%B8%99" title="โรคหลอดเลือดสมองเฉียบพลัน – Thai" lang="th" hreflang="th" data-title="โรคหลอดเลือดสมองเฉียบพลัน" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target">ไทย</a></li><li class="interlanguage-link interwiki-chr mw-list-item"><a href="https://chr.wikipedia.org/wiki/%E1%8E%A0%E1%8E%B8%E1%8F%93%E1%8E%B3%E1%8F%8D%E1%8E%A9" title="ᎠᎸᏓᎳᏍᎩ – Cherokee" lang="chr" hreflang="chr" data-title="ᎠᎸᏓᎳᏍᎩ" data-language-autonym="ᏣᎳᎩ" data-language-local-name="Cherokee" class="interlanguage-link-target">ᏣᎳᎩ</a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/%C4%B0nme" title="İnme – Turkish" lang="tr" hreflang="tr" data-title="İnme" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target">Türkçe</a></li><li class="interlanguage-link interwiki-tyv mw-list-item"><a href="https://tyv.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D1%8C%D1%82" title="Инсульт – Tuvinian" lang="tyv" hreflang="tyv" data-title="Инсульт" data-language-autonym="Тыва дыл" data-language-local-name="Tuvinian" class="interlanguage-link-target">Тыва дыл</a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a 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class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> <div id="mw-indicator-pp-default" class="mw-indicator"><div class="mw-parser-output"><a href="/wiki/Wikipedia:Protection_policy#semi" title="This article is semi-protected."><img alt="Page semi-protected" src="//upload.wikimedia.org/wikipedia/en/thumb/1/1b/Semi-protection-shackle.svg/20px-Semi-protection-shackle.svg.png" decoding="async" width="20" height="20" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/1/1b/Semi-protection-shackle.svg/30px-Semi-protection-shackle.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/1/1b/Semi-protection-shackle.svg/40px-Semi-protection-shackle.svg.png 2x" data-file-width="512" data-file-height="512" /></a></div></div> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle">(Redirected from <a href="/w/index.php?title=Hemorrhagic_stroke&redirect=no" class="mw-redirect" title="Hemorrhagic stroke">Hemorrhagic stroke</a>)</div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Death of a region of brain cells due to poor blood flow</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For other uses, see <a href="/wiki/Stroke_(disambiguation)" class="mw-disambig" title="Stroke (disambiguation)">Stroke (disambiguation)</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Stroke</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Cerebrovascular accident (CVA), cerebrovascular insult (CVI), cerebrovascular lesion (CVL), brain attack</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><a href="/wiki/File:MCA_Territory_Infarct.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/49/MCA_Territory_Infarct.svg/220px-MCA_Territory_Infarct.svg.png" decoding="async" width="220" height="275" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/49/MCA_Territory_Infarct.svg/330px-MCA_Territory_Infarct.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/49/MCA_Territory_Infarct.svg/440px-MCA_Territory_Infarct.svg.png 2x" data-file-width="327" data-file-height="409" /></a></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/CT_scan" title="CT scan">CT scan</a> of the brain showing a massive, prior right-sided <a href="/wiki/Ischemic" class="mw-redirect" title="Ischemic">ischemic</a> stroke from blockage of an artery. Changes on a CT may not be visible early on.<a href="#cite_note-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Neurology" title="Neurology">Neurology</a>, stroke medicine</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><a href="/wiki/Hemiplegia" class="mw-redirect" title="Hemiplegia">Inability to move or feel</a> on one side of the body, <a href="/wiki/Receptive_aphasia" title="Receptive aphasia">problems understanding</a> or <a href="/wiki/Expressive_aphasia" title="Expressive aphasia">speaking</a>, <a href="/wiki/Dizziness" title="Dizziness">dizziness</a>, <a href="/wiki/Homonymous_hemianopsia" title="Homonymous hemianopsia">loss of vision to one side</a><a href="#cite_note-Donnan2008-2">[2]</a><a href="#cite_note-HLB2014S-3">[3]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><a href="/wiki/Persistent_vegetative_state" class="mw-redirect" title="Persistent vegetative state">Persistent vegetative state</a><a href="#cite_note-4">[4]</a></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data"><a href="/wiki/Brain_ischemia" title="Brain ischemia">Ischemic</a> (blockage) and <a href="/wiki/Intracranial_hemorrhage" title="Intracranial hemorrhage">hemorrhagic</a> (bleeding)<a href="#cite_note-HLB2014W-5">[5]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data">Age,<a href="#cite_note-6">[6]</a> <a href="/wiki/Hypertension" title="Hypertension">high blood pressure</a>, <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">tobacco smoking</a>, <a href="/wiki/Obesity" title="Obesity">obesity</a>, <a href="/wiki/Hypercholesterolemia" title="Hypercholesterolemia">high blood cholesterol</a>, <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a>, previous <a href="/wiki/Transient_ischemic_attack" title="Transient ischemic attack">TIA</a>, <a href="/wiki/End-stage_kidney_disease" class="mw-redirect" title="End-stage kidney disease">end-stage kidney disease</a>, <a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a><a href="#cite_note-Donnan2008-2">[2]</a><a href="#cite_note-HLB2014C-7">[7]</a><a href="#cite_note-Hu2018-8">[8]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Based on symptoms with <a href="/wiki/Medical_imaging" title="Medical imaging">medical imaging</a> typically used to rule out bleeding<a href="#cite_note-HLB2014D-9">[9]</a><a href="#cite_note-AFP2009-10">[10]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Low_blood_sugar" class="mw-redirect" title="Low blood sugar">Low blood sugar</a><a href="#cite_note-HLB2014D-9">[9]</a></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Based on the type<a href="#cite_note-Donnan2008-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">Average life expectancy 1 year<a href="#cite_note-Donnan2008-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">42.4 million (2015)<a href="#cite_note-GBD2015Pre-11">[11]</a></td></tr><tr><th scope="row" class="infobox-label">Deaths</th><td class="infobox-data">6.3 million (2015)<a href="#cite_note-GBD2015De-12">[12]</a></td></tr></tbody></table> Stroke is a medical condition in which poor <a href="/wiki/Cerebral_circulation" title="Cerebral circulation">blood flow</a> to a part of the <a href="/wiki/Brain" title="Brain">brain</a> causes <a href="/wiki/Cell_death" title="Cell death">cell death</a>.<a href="#cite_note-HLB2014W-5">[5]</a> There are two main types of stroke: <a href="/wiki/Brain_ischemia" title="Brain ischemia">ischemic</a>, due to lack of blood flow, and <a href="/wiki/Intracranial_hemorrhage" title="Intracranial hemorrhage">hemorrhagic</a>, due to <a href="/wiki/Bleeding" title="Bleeding">bleeding</a>.<a href="#cite_note-HLB2014W-5">[5]</a> Both cause parts of the brain to stop functioning properly.<a href="#cite_note-HLB2014W-5">[5]</a> Signs and symptoms of stroke may include an <a href="/wiki/Hemiplegia" class="mw-redirect" title="Hemiplegia">inability to move or feel on one side of the body</a>, <a href="/wiki/Receptive_aphasia" title="Receptive aphasia">problems understanding</a> or <a href="/wiki/Expressive_aphasia" title="Expressive aphasia">speaking</a>, <a href="/wiki/Dizziness" title="Dizziness">dizziness</a>, or <a href="/wiki/Homonymous_hemianopsia" title="Homonymous hemianopsia">loss of vision to one side</a>.<a href="#cite_note-Donnan2008-2">[2]</a><a href="#cite_note-HLB2014S-3">[3]</a> Signs and symptoms often appear soon after the stroke has occurred.<a href="#cite_note-HLB2014S-3">[3]</a> If symptoms last less than 24 hours, the stroke is a <a href="/wiki/Transient_ischemic_attack" title="Transient ischemic attack">transient ischemic attack</a> (TIA), also called a mini-stroke.<a href="#cite_note-HLB2014S-3">[3]</a> <a href="/wiki/Subarachnoid_hemorrhage" title="Subarachnoid hemorrhage">Hemorrhagic stroke</a> may also be associated with a <a href="/wiki/Thunderclap_headache" title="Thunderclap headache">severe headache</a>.<a href="#cite_note-HLB2014S-3">[3]</a> The symptoms of stroke can be permanent.<a href="#cite_note-HLB2014W-5">[5]</a> Long-term complications may include <a href="/wiki/Pneumonia" title="Pneumonia">pneumonia</a> and <a href="/wiki/Urinary_incontinence" title="Urinary incontinence">loss of bladder control</a>.<a href="#cite_note-HLB2014S-3">[3]</a> The biggest <a href="/wiki/Risk_factor" title="Risk factor">risk factor</a> for stroke is <a href="/wiki/Hypertension" title="Hypertension">high blood pressure</a>.<a href="#cite_note-HLB2014C-7">[7]</a> Other risk factors include <a href="/wiki/Hypercholesterolemia" title="Hypercholesterolemia">high blood cholesterol</a>, <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">tobacco smoking</a>, <a href="/wiki/Obesity" title="Obesity">obesity</a>, <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a>, a previous <a href="/wiki/Transient_ischemic_attack" title="Transient ischemic attack">TIA</a>, <a href="/wiki/End-stage_kidney_disease" class="mw-redirect" title="End-stage kidney disease">end-stage kidney disease</a>, and <a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a>.<a href="#cite_note-Donnan2008-2">[2]</a><a href="#cite_note-HLB2014C-7">[7]</a><a href="#cite_note-Hu2018-8">[8]</a> Ischemic stroke is typically caused by blockage of a blood vessel, though there are also less common causes.<a href="#cite_note-HLB2014T-13">[13]</a><a href="#cite_note-14">[14]</a><a href="#cite_note-15">[15]</a> Hemorrhagic stroke is caused by either <a href="/wiki/Intracerebral_hemorrhage" title="Intracerebral hemorrhage">bleeding directly into the brain</a> or <a href="/wiki/Subarachnoid_hemorrhage" title="Subarachnoid hemorrhage">into the space between</a> the <a href="/wiki/Meninges" title="Meninges">brain's membranes</a>.<a href="#cite_note-HLB2014T-13">[13]</a><a href="#cite_note-Feigin05-16">[16]</a> Bleeding may occur due to a ruptured <a href="/wiki/Intracranial_aneurysm" title="Intracranial aneurysm">brain aneurysm</a>.<a href="#cite_note-HLB2014T-13">[13]</a> Diagnosis is typically based on a <a href="/wiki/Physical_exam" class="mw-redirect" title="Physical exam">physical exam</a> and supported by <a href="/wiki/Medical_imaging" title="Medical imaging">medical imaging</a> such as a <a href="/wiki/CT_scan" title="CT scan">CT scan</a> or <a href="/wiki/Magnetic_resonance_imaging" title="Magnetic resonance imaging">MRI scan</a>.<a href="#cite_note-HLB2014D-9">[9]</a> A CT scan can rule out bleeding, but may not necessarily rule out ischemia, which early on typically does not show up on a CT scan.<a href="#cite_note-AFP2009-10">[10]</a> Other tests such as an <a href="/wiki/Electrocardiogram" class="mw-redirect" title="Electrocardiogram">electrocardiogram</a> (ECG) and <a href="/wiki/Blood_test" title="Blood test">blood tests</a> are done to determine risk factors and possible causes.<a href="#cite_note-HLB2014D-9">[9]</a> <a href="/wiki/Low_blood_sugar" class="mw-redirect" title="Low blood sugar">Low blood sugar</a> may cause similar symptoms.<a href="#cite_note-HLB2014D-9">[9]</a> Prevention includes decreasing risk factors, <a href="/wiki/Carotid_endarterectomy" title="Carotid endarterectomy">surgery to open up the arteries to the brain</a> in those with problematic <a href="/wiki/Carotid_stenosis" class="mw-redirect" title="Carotid stenosis">carotid narrowing</a>, and <a href="/wiki/Anticoagulant" title="Anticoagulant">anticoagulant</a> medication in people with <a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a>.<a href="#cite_note-Donnan2008-2">[2]</a> <a href="/wiki/Aspirin" title="Aspirin">Aspirin</a> or <a href="/wiki/Statin" title="Statin">statins</a> may be recommended by physicians for prevention.<a href="#cite_note-Donnan2008-2">[2]</a> Stroke is a medical emergency.<a href="#cite_note-HLB2014W-5">[5]</a> Ischemic strokes, if detected within three to four-and-a-half hours, may be treatable with <a href="/wiki/Thrombolytic_drug" class="mw-redirect" title="Thrombolytic drug">medication</a> that can <a href="/wiki/Thrombolysis" title="Thrombolysis">break down the clot</a>,<a href="#cite_note-Donnan2008-2">[2]</a> while hemorrhagic strokes sometimes benefit from <a href="/wiki/Neurosurgery" title="Neurosurgery">surgery</a>.<a href="#cite_note-Donnan2008-2">[2]</a> Treatment to attempt recovery of lost function is called <a href="/wiki/Stroke_rehabilitation" class="mw-redirect" title="Stroke rehabilitation">stroke rehabilitation</a>, and ideally takes place in a stroke unit; however, these are not available in much of the world.<a href="#cite_note-Donnan2008-2">[2]</a> In 2023, 15 million people worldwide had a stroke.<a href="#cite_note-who24-17">[17]</a> In 2021, stroke was the third biggest cause of death, responsible for approximately 10% of total deaths.<a href="#cite_note-18">[18]</a> In 2015, there were about 42.4 million people who had previously had stroke and were still alive.<a href="#cite_note-GBD2015Pre-11">[11]</a> Between 1990 and 2010 the annual incidence of stroke decreased by approximately 10% in the <a href="/wiki/Developed_world" class="mw-redirect" title="Developed world">developed world</a>, but increased by 10% in the developing world.<a href="#cite_note-Fei2013-19">[19]</a> In 2015, stroke was the second most <a href="/wiki/List_of_causes_of_death_by_rate" title="List of causes of death by rate">frequent cause of death</a> after <a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">coronary artery disease</a>, accounting for 6.3 million deaths (11% of the total).<a href="#cite_note-GBD2015De-12">[12]</a> About 3.0 million deaths resulted from ischemic stroke while 3.3 million deaths resulted from hemorrhagic stroke.<a href="#cite_note-GBD2015De-12">[12]</a> About half of people who have had stroke live less than one year.<a href="#cite_note-Donnan2008-2">[2]</a> Overall, two thirds of cases of stroke occurred in those over 65 years old.<a href="#cite_note-Fei2013-19">[19]</a> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Classification">Classification</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Ischemic_Stroke.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c3/Ischemic_Stroke.svg/220px-Ischemic_Stroke.svg.png" decoding="async" width="220" height="154" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c3/Ischemic_Stroke.svg/330px-Ischemic_Stroke.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c3/Ischemic_Stroke.svg/440px-Ischemic_Stroke.svg.png 2x" data-file-width="512" data-file-height="358" /></a><figcaption>There are two main categories of stroke. Ischemic (top), typically caused by a blood clot in an artery (1a) resulting in brain death to the affected area (2a). Hemorrhagic (bottom), caused by blood leaking into or around the brain from a ruptured blood vessel (1b) allowing blood to pool in the affected area (2b) thus increasing the pressure on the brain.</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:MCA-Stroke-Brain-Human-2.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/36/MCA-Stroke-Brain-Human-2.JPG/220px-MCA-Stroke-Brain-Human-2.JPG" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/36/MCA-Stroke-Brain-Human-2.JPG/330px-MCA-Stroke-Brain-Human-2.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/36/MCA-Stroke-Brain-Human-2.JPG/440px-MCA-Stroke-Brain-Human-2.JPG 2x" data-file-width="720" data-file-height="540" /></a><figcaption>A slice of brain from the autopsy of a person who had an acute <a href="/wiki/Middle_cerebral_artery" title="Middle cerebral artery">middle cerebral artery (MCA)</a> stroke</figcaption></figure> Stroke can be classified into two major categories: <a href="/wiki/Ischemia" title="Ischemia">ischemic</a> and <a href="/wiki/Bleeding" title="Bleeding">hemorrhagic</a>.<a href="#cite_note-20">[20]</a> Ischemic stroke is caused by <a href="/wiki/Perfusion#Malperfusion" title="Perfusion">interruption of the blood supply</a> to the brain, while hemorrhagic stroke results from the rupture of a <a href="/wiki/Blood_vessel" title="Blood vessel">blood vessel</a> or an <a href="/wiki/Cerebral_arteriovenous_malformation" title="Cerebral arteriovenous malformation">abnormal vascular structure</a>. About 87% of stroke is ischemic, with the rest being hemorrhagic. Bleeding can develop inside areas of ischemia, a condition known as "<a href="/wiki/Hemorrhagic_transformation" title="Hemorrhagic transformation">hemorrhagic transformation</a>." It is unknown how many cases of hemorrhagic stroke actually start as ischemic stroke.<a href="#cite_note-Donnan2008-2">[2]</a> <div class="mw-heading mw-heading3"><h3 id="Definition">Definition</h3></div> In the 1970s the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> defined "stroke" as a "neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours",<a href="#cite_note-21">[21]</a> although the word "stroke" is centuries old. This definition was supposed to reflect the reversibility of tissue damage and was devised for the purpose, with the time frame of 24 hours being chosen arbitrarily. The 24-hour limit divides stroke from <a href="/wiki/Transient_ischemic_attack" title="Transient ischemic attack">transient ischemic attack</a>, which is a related syndrome of stroke symptoms that resolve completely within 24 hours.<a href="#cite_note-Donnan2008-2">[2]</a> With the availability of treatments that can reduce stroke severity when given early, many now prefer alternative terminology, such as "brain attack" and "acute ischemic cerebrovascular syndrome" (modeled after <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">heart attack</a> and <a href="/wiki/Acute_coronary_syndrome" title="Acute coronary syndrome">acute coronary syndrome</a>, respectively), to reflect the urgency of stroke symptoms and the need to act swiftly.<a href="#cite_note-22">[22]</a> <div class="mw-heading mw-heading3"><h3 id="Ischemic">Ischemic</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/Cerebral_infarction" title="Cerebral infarction">Cerebral infarction</a> and <a href="/wiki/Brain_ischemia" title="Brain ischemia">Brain ischemia</a></div> During ischemic stroke, blood supply to part of the brain is decreased, leading to dysfunction of the brain tissue in that area. There are four reasons why this might happen: <ol><li><a href="/wiki/Thrombosis" title="Thrombosis">Thrombosis</a> (obstruction of a blood vessel by a blood clot forming locally)</li> <li><a href="/wiki/Embolism" title="Embolism">Embolism</a> (obstruction due to an <a href="/wiki/Embolus" title="Embolus">embolus</a> from elsewhere in the body),<a href="#cite_note-Donnan2008-2">[2]</a></li> <li>Systemic <a href="/wiki/Hypoperfusion" class="mw-redirect" title="Hypoperfusion">hypoperfusion</a> (general decrease in blood supply, e.g., in <a href="/wiki/Shock_(circulatory)" title="Shock (circulatory)">shock</a>)<a href="#cite_note-23">[23]</a></li> <li><a href="/wiki/Cerebral_venous_sinus_thrombosis" title="Cerebral venous sinus thrombosis">Cerebral venous sinus thrombosis</a>.<a href="#cite_note-Stam2005-24">[24]</a></li></ol> Stroke without an obvious explanation is termed cryptogenic stroke (<a href="/wiki/Idiopathic_disease" title="Idiopathic disease">idiopathic</a>); this constitutes 30–40% of all cases of ischemic stroke.<a href="#cite_note-Donnan2008-2">[2]</a><a href="#cite_note-Guercini-25">[25]</a> There are classification systems for acute ischemic stroke. The Oxford Community Stroke Project classification (OCSP, also known as the Bamford or Oxford classification) relies primarily on the initial symptoms; based on the extent of the symptoms, the stroke episode is classified as <a href="/wiki/Total_anterior_circulation_infarct" title="Total anterior circulation infarct">total anterior circulation infarct</a> (TACI), <a href="/wiki/Partial_anterior_circulation_infarct" title="Partial anterior circulation infarct">partial anterior circulation infarct</a> (PACI), <a href="/wiki/Lacunar_infarct" class="mw-redirect" title="Lacunar infarct">lacunar infarct</a> (LACI) or <a href="/wiki/Posterior_circulation_infarct" title="Posterior circulation infarct">posterior circulation infarct</a> (POCI). These four entities predict the extent of the stroke, the area of the brain that is affected, the underlying cause, and the prognosis.<a href="#cite_note-26">[26]</a><a href="#cite_note-27">[27]</a> The TOAST (Trial of <a href="/wiki/Danaparoid" title="Danaparoid">Org 10172</a> in Acute Stroke Treatment) classification is based on clinical symptoms as well as results of further investigations; on this basis, stroke is classified as being due to (1) thrombosis or embolism due to <a href="/wiki/Atherosclerosis" title="Atherosclerosis">atherosclerosis</a> of a large artery, (2) an embolism originating in the <a href="/wiki/Heart" title="Heart">heart</a>, (3) complete blockage of a small blood vessel, (4) other determined cause, (5) undetermined cause (two possible causes, no cause identified, or incomplete investigation).<a href="#cite_note-28">[28]</a> <a href="/wiki/Recreational_drug_use" title="Recreational drug use">Users</a> of <a href="/wiki/Stimulant" title="Stimulant">stimulants</a> such as <a href="/wiki/Cocaine" title="Cocaine">cocaine</a> and <a href="/wiki/Methamphetamine" title="Methamphetamine">methamphetamine</a> are at a high risk for ischemic stroke.<a href="#cite_note-29">[29]</a> <div class="mw-heading mw-heading3"><h3 id="Hemorrhagic">Hemorrhagic</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/Intracerebral_hemorrhage" title="Intracerebral hemorrhage">Intracerebral hemorrhage</a> and <a href="/wiki/Subarachnoid_hemorrhage" title="Subarachnoid hemorrhage">Subarachnoid hemorrhage</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Parachemableedwithedema.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/32/Parachemableedwithedema.png/220px-Parachemableedwithedema.png" decoding="async" width="220" height="259" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/32/Parachemableedwithedema.png/330px-Parachemableedwithedema.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/32/Parachemableedwithedema.png/440px-Parachemableedwithedema.png 2x" data-file-width="831" data-file-height="977" /></a><figcaption><a href="/wiki/CT_scan" title="CT scan">CT scan</a> of an intraparenchymal bleed (bottom arrow) with surrounding edema (top arrow)</figcaption></figure> There are two main types of hemorrhagic stroke:<a href="#cite_note-30">[30]</a><a href="#cite_note-31">[31]</a> <ul><li><a href="/wiki/Intracerebral_hemorrhage" title="Intracerebral hemorrhage">Intracerebral hemorrhage</a>, which is bleeding within the brain itself (when an artery in the brain bursts, flooding the surrounding tissue with blood), due to either <a href="/wiki/Intraparenchymal_hemorrhage" title="Intraparenchymal hemorrhage">intraparenchymal hemorrhage</a> (bleeding within the brain tissue) or <a href="/wiki/Intraventricular_hemorrhage" title="Intraventricular hemorrhage">intraventricular hemorrhage</a> (bleeding within the brain's <a href="/wiki/Ventricular_system" title="Ventricular system">ventricular system</a>).</li> <li><a href="/wiki/Subarachnoid_hemorrhage" title="Subarachnoid hemorrhage">Subarachnoid hemorrhage</a>, which is bleeding that occurs outside of the brain tissue but still within the skull, and precisely between the <a href="/wiki/Arachnoid_mater" title="Arachnoid mater">arachnoid mater</a> and <a href="/wiki/Pia_mater" title="Pia mater">pia mater</a> (the delicate innermost layer of the three layers of the <a href="/wiki/Meninges" title="Meninges">meninges</a> that surround the brain).</li></ul> The above two main types of hemorrhagic stroke are also two different forms of <a href="/wiki/Intracranial_hemorrhage" title="Intracranial hemorrhage">intracranial hemorrhage</a>, which is the accumulation of blood anywhere within the <a href="/wiki/Cranial_vault" title="Cranial vault">cranial vault</a>; but the other forms of intracranial hemorrhage, such as <a href="/wiki/Epidural_hematoma" title="Epidural hematoma">epidural hematoma</a> (bleeding between the skull and the <a href="/wiki/Dura_mater" title="Dura mater">dura mater</a>, which is the thick outermost layer of the meninges that surround the brain) and <a href="/wiki/Subdural_hematoma" title="Subdural hematoma">subdural hematoma</a> (bleeding in the <a href="/wiki/Subdural_space" title="Subdural space">subdural space</a>), are not considered "hemorrhagic stroke".<a href="#cite_note-32">[32]</a> Hemorrhagic stroke may occur on the background of alterations to the blood vessels in the brain, such as <a href="/wiki/Cerebral_amyloid_angiopathy" title="Cerebral amyloid angiopathy">cerebral amyloid angiopathy</a>, <a href="/wiki/Cerebral_arteriovenous_malformation" title="Cerebral arteriovenous malformation">cerebral arteriovenous malformation</a> and an <a href="/wiki/Intracranial_aneurysm" title="Intracranial aneurysm">intracranial aneurysm</a>, which can cause intraparenchymal or subarachnoid hemorrhage.<a href="#cite_note-Articles-33">[33]</a> In addition to neurological impairment, hemorrhagic stroke usually causes specific symptoms (for instance, subarachnoid hemorrhage classically causes a severe <a href="/wiki/Headache" title="Headache">headache</a> known as a <a href="/wiki/Thunderclap_headache" title="Thunderclap headache">thunderclap headache</a>) or reveal evidence of a previous <a href="/wiki/Head_injury" title="Head injury">head injury</a>. <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2></div> Stroke may be preceded by premonitory symptoms, which may indicate a stroke is imminent. These symptoms may include dizziness, <a href="/wiki/Dysarthria" title="Dysarthria">dysarthria</a> (speech disorder), exhaustion, <a href="/wiki/Hemiparesis" title="Hemiparesis">hemiparesis</a> (weakness on one side of the body), <a href="/wiki/Paresthesia" title="Paresthesia">paresthesia</a> (tingling, pricking, chilling, burning, numbness of the skin), pathological laughter, seizure that turns into paralysis, "thunderclap" headache, or vomiting. Premonitory symptoms are not diagnostic of a stroke, and may be a sign of other illness. Assessing onset (gradual or sudden), duration, and the presence of other associated symptoms are important, and premonitory symptoms may not appear at all or may vary depending on the type of stroke.<a href="#cite_note-34">[34]</a> Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases do not progress further. The symptoms depend on the area of the brain affected. The more extensive the area of the brain affected, the more functions that are likely to be lost. Some forms of stroke can cause additional symptoms. For example, in intracranial hemorrhage, the affected area may compress other structures. Most forms of stroke are not associated with a <a href="/wiki/Headache" title="Headache">headache</a>, apart from subarachnoid hemorrhage and cerebral venous thrombosis and occasionally intracerebral hemorrhage.<a href="#cite_note-Articles-33">[33]</a> <div class="mw-heading mw-heading3"><h3 id="Early_recognition">Early recognition</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/FAST_(stroke)" title="FAST (stroke)">FAST (stroke)</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Act_FAST.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fd/Act_FAST.svg/220px-Act_FAST.svg.png" decoding="async" width="220" height="375" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fd/Act_FAST.svg/330px-Act_FAST.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fd/Act_FAST.svg/440px-Act_FAST.svg.png 2x" data-file-width="270" data-file-height="460" /></a><figcaption>A <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> <a href="/wiki/Infographic" title="Infographic">infographic</a> describing the FAST mnemonic for early recognition of stroke</figcaption></figure> Systems have been proposed to increase recognition of stroke. Sudden-onset face weakness, arm drift (i.e., if a person, when asked to raise both arms, involuntarily lets one arm drift downward) and abnormal speech are the findings most likely to lead to the correct identification of a case of stroke, increasing the likelihood by 5.5 when at least one of these is present. Similarly, when all three of these are absent, the likelihood of stroke is decreased (– <a href="/wiki/Likelihood_ratios_in_diagnostic_testing" title="Likelihood ratios in diagnostic testing">likelihood ratio</a> of 0.39).<a href="#cite_note-pmid15900010-35">[35]</a> While these findings are not perfect for diagnosing stroke, the fact that they can be evaluated relatively rapidly and easily make them very valuable in the acute setting. A mnemonic to remember the warning signs of stroke is <a href="/wiki/FAST_(stroke)" title="FAST (stroke)">FAST</a> (facial droop, arm weakness, speech difficulty, and time to call emergency services),<a href="#cite_note-36">[36]</a> as advocated by the <a href="/wiki/Department_of_Health_(United_Kingdom)" class="mw-redirect" title="Department of Health (United Kingdom)">Department of Health (United Kingdom)</a> and the <a href="/wiki/Stroke_Association" title="Stroke Association">Stroke Association</a>, the <a href="/wiki/American_Stroke_Association" class="mw-redirect" title="American Stroke Association">American Stroke Association</a>, and the <a href="/wiki/National_Stroke_Association" title="National Stroke Association">National Stroke Association</a> (US). FAST is less reliable in the recognition of posterior circulation stroke.<a href="#cite_note-37">[37]</a> The revised mnemonic BE FAST, which adds balance (sudden trouble keeping balance while walking or standing) and eyesight (new onset of blurry or double vision or sudden, painless loss of sight) to the assessment, has been proposed to address this shortcoming and improve early detection of stroke even further.<a href="#cite_note-BEFAST-38">[38]</a><a href="#cite_note-39">[39]</a> Other scales for prehospital detection of stroke include the <a href="/wiki/Los_Angeles_Prehospital_Stroke_Screen_(LAPSS)" class="mw-redirect" title="Los Angeles Prehospital Stroke Screen (LAPSS)">Los Angeles Prehospital Stroke Screen (LAPSS)</a><a href="#cite_note-40">[40]</a> and the <a href="/wiki/Cincinnati_Stroke_Scale" class="mw-redirect" title="Cincinnati Stroke Scale">Cincinnati Prehospital Stroke Scale</a> (CPSS),<a href="#cite_note-41">[41]</a> on which the FAST method was based.<a href="#cite_note-42">[42]</a> Use of these scales is recommended by professional guidelines.<a href="#cite_note-NICECG68-43">[43]</a> For people referred to the <a href="/wiki/Emergency_room" class="mw-redirect" title="Emergency room">emergency room</a>, early recognition of stroke is deemed important as this can expedite diagnostic tests and treatments. A scoring system called ROSIER (recognition of stroke in the emergency room) is recommended for this purpose; it is based on features from the medical history and physical examination.<a href="#cite_note-NICECG68-43">[43]</a><a href="#cite_note-44">[44]</a> <div class="mw-heading mw-heading3"><h3 id="Associated_symptoms">Associated symptoms</h3></div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Unreferenced_section plainlinks metadata ambox ambox-content ambox-Unreferenced" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><a href="/wiki/File:Question_book-new.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/50px-Question_book-new.svg.png" decoding="async" width="50" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/75px-Question_book-new.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/100px-Question_book-new.svg.png 2x" data-file-width="512" data-file-height="399" /></a></div></td><td class="mbox-text"><div class="mbox-text-span">This section does not <a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources">cite</a> any <a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">sources</a>. Please help <a href="/wiki/Special:EditPage/Stroke" title="Special:EditPage/Stroke">improve this section</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">adding citations to reliable sources</a>. Unsourced material may be challenged and <a href="/wiki/Wikipedia:Verifiability#Burden_of_evidence" title="Wikipedia:Verifiability">removed</a>. (April 2024) (<a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a>)</div></td></tr></tbody></table> <a href="/wiki/Unconsciousness" title="Unconsciousness">Loss of consciousness</a>, <a href="/wiki/Headache" title="Headache">headache</a>, and <a href="/wiki/Vomiting" title="Vomiting">vomiting</a> usually occur more often in hemorrhagic stroke than in thrombosis because of the increased <a href="/wiki/Intracranial_pressure" title="Intracranial pressure">intracranial pressure</a> from the leaking blood compressing the brain. If symptoms are maximal at onset, the cause is more likely to be a subarachnoid hemorrhage or an embolic stroke. <div class="mw-heading mw-heading3"><h3 id="Subtypes">Subtypes</h3></div> If the area of the brain affected includes one of the three prominent <a href="/wiki/Neural_pathway" title="Neural pathway">central nervous system pathways</a>—the <a href="/wiki/Spinothalamic_tract" title="Spinothalamic tract">spinothalamic tract</a>, <a href="/wiki/Corticospinal_tract" title="Corticospinal tract">corticospinal tract</a>, and the <a href="/wiki/Dorsal_column%E2%80%93medial_lemniscus_pathway" title="Dorsal column–medial lemniscus pathway">dorsal column–medial lemniscus pathway</a>, symptoms may include: <ul><li><a href="/wiki/Hemiplegia" class="mw-redirect" title="Hemiplegia">hemiplegia</a> and <a href="/wiki/Central_facial_palsy" title="Central facial palsy">muscle weakness of the face</a></li> <li><a href="/wiki/Numbness" class="mw-redirect" title="Numbness">numbness</a></li> <li>reduction in sensory or vibratory sensation</li> <li>initial <a href="/wiki/Flaccidity" class="mw-redirect" title="Flaccidity">flaccidity</a> (reduced muscle tone), replaced by <a href="/wiki/Spasticity" title="Spasticity">spasticity</a> (increased muscle tone), <a href="/wiki/Hyperreflexia" title="Hyperreflexia">excessive reflexes</a>, and obligatory synergies.<a href="#cite_note-OSul07_719-45">[45]</a></li></ul> In most cases, the symptoms affect only one side of the body (unilateral). The defect in the brain is usually on the <a href="/wiki/Contralateral" class="mw-redirect" title="Contralateral">opposite side</a> of the body. However, since these pathways also travel in the <a href="/wiki/Spinal_cord" title="Spinal cord">spinal cord</a> and any lesion there can also produce these symptoms, the presence of any one of these symptoms does not necessarily indicate stroke. In addition to the above central nervous system pathways, the <a href="/wiki/Brainstem" title="Brainstem">brainstem</a> gives rise to most of the twelve <a href="/wiki/Cranial_nerves" title="Cranial nerves">cranial nerves</a>. A <a href="/wiki/Brainstem_stroke_syndrome" title="Brainstem stroke syndrome">brainstem stroke</a> affecting the brainstem and brain, therefore, can produce symptoms relating to deficits in these cranial nerves:[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <ul><li>altered smell, taste, hearing, or vision (total or partial)</li> <li>drooping of eyelid (<a href="/wiki/Ptosis_(eyelid)" title="Ptosis (eyelid)">ptosis</a>) and weakness of <a href="/wiki/Extraocular_muscles" title="Extraocular muscles">ocular muscles</a></li> <li>decreased <a href="/wiki/Reflex" title="Reflex">reflexes</a>: gag, swallow, pupil reactivity to light</li> <li>decreased sensation and muscle weakness of the face</li> <li><a href="/wiki/Balance_disorder" title="Balance disorder">balance problems</a> and <a href="/wiki/Nystagmus" title="Nystagmus">nystagmus</a></li> <li>altered breathing and heart rate</li> <li>weakness in <a href="/wiki/Sternocleidomastoid_muscle" title="Sternocleidomastoid muscle">sternocleidomastoid muscle</a> with inability to turn head to one side</li> <li>weakness in tongue (inability to stick out the tongue or move it from side to side)</li></ul> If the <a href="/wiki/Cerebral_cortex" title="Cerebral cortex">cerebral cortex</a> is involved, the central nervous system pathways can again be affected, but can also produce the following symptoms: <ul><li><a href="/wiki/Aphasia" title="Aphasia">aphasia</a> (difficulty with verbal expression, auditory comprehension, <a href="/wiki/Alexia_(condition)" class="mw-redirect" title="Alexia (condition)">reading</a> and <a href="/wiki/Agraphia" title="Agraphia">writing</a>; <a href="/wiki/Broca%27s_area" title="Broca's area">Broca's</a> or <a href="/wiki/Wernicke%27s_area" title="Wernicke's area">Wernicke's area</a> typically involved)</li> <li><a href="/wiki/Dysarthria" title="Dysarthria">dysarthria</a> (<a href="/wiki/Motor_speech_disorders" title="Motor speech disorders">motor speech disorder</a> resulting from neurological injury)</li> <li><a href="/wiki/Apraxia" title="Apraxia">apraxia</a> (altered voluntary movements)</li> <li><a href="/wiki/Visual_field" title="Visual field">visual field</a> defect</li> <li>memory deficits (involvement of <a href="/wiki/Temporal_lobe" title="Temporal lobe">temporal lobe</a>)</li> <li><a href="/wiki/Hemineglect" class="mw-redirect" title="Hemineglect">hemineglect</a> (involvement of <a href="/wiki/Parietal_lobe" title="Parietal lobe">parietal lobe</a>)</li> <li>disorganized thinking, confusion, <a href="/wiki/Hypersexual" class="mw-redirect" title="Hypersexual">hypersexual</a> gestures (with involvement of frontal lobe)</li> <li><a href="/wiki/Anosognosia" title="Anosognosia">lack of insight</a> of his or her, usually stroke-related, disability</li></ul> If the <a href="/wiki/Cerebellum" title="Cerebellum">cerebellum</a> is involved, <a href="/wiki/Ataxia#Cerebellar" title="Ataxia">ataxia</a> might be present and this includes: <ul><li>altered walking <a href="/wiki/Gait_abnormality" title="Gait abnormality">gait</a></li> <li>altered <a href="/wiki/Motor_coordination" title="Motor coordination">movement coordination</a></li> <li><a href="/wiki/Vertigo_(medical)" class="mw-redirect" title="Vertigo (medical)">vertigo</a> and or disequilibrium</li></ul> <div class="mw-heading mw-heading3"><h3 id="Preceding_signs_and_symptoms">Preceding signs and symptoms</h3></div> In the days before a stroke (generally in the previous 7 days, even the previous one), a considerable proportion of patients have a "sentinel headache": a severe and unusual headache that indicates a problem.<a href="#cite_note-46">[46]</a> Its appearance makes it advisable to seek medical review and to consider <a class="mw-selflink-fragment" href="#Prevention">prevention against stroke</a>. <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2></div> <div class="mw-heading mw-heading3"><h3 id="Thrombotic_stroke">Thrombotic stroke</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Blausen_0836_Stroke.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b4/Blausen_0836_Stroke.png/220px-Blausen_0836_Stroke.png" decoding="async" width="220" height="320" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b4/Blausen_0836_Stroke.png/330px-Blausen_0836_Stroke.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b4/Blausen_0836_Stroke.png/440px-Blausen_0836_Stroke.png 2x" data-file-width="550" data-file-height="800" /></a><figcaption>Illustration of an embolic stroke, showing a blockage lodged in a blood vessel</figcaption></figure> In thrombotic stroke, a thrombus<a href="#cite_note-47">[47]</a> (blood clot) usually forms around <a href="/wiki/Atherosclerosis" title="Atherosclerosis">atherosclerotic</a> plaques. Since blockage of the artery is gradual, onset of symptomatic thrombotic stroke is slower than that of hemorrhagic stroke. A thrombus itself (even if it does not completely block the blood vessel) can lead to an embolic stroke (see below) if the thrombus breaks off and travels in the bloodstream, at which point it is called an <a href="/wiki/Embolus" title="Embolus">embolus</a>. Two types of thrombosis can cause stroke: <ul><li>Large vessel disease involves the <a href="/wiki/Common_carotid_artery" title="Common carotid artery">common</a> and <a href="/wiki/Internal_carotid_artery" title="Internal carotid artery">internal carotid arteries</a>, the <a href="/wiki/Vertebral_artery" title="Vertebral artery">vertebral artery</a>, and the <a href="/wiki/Circle_of_Willis" title="Circle of Willis">Circle of Willis</a>.<a href="#cite_note-48">[48]</a> Diseases that may form <a href="/wiki/Thrombi" class="mw-redirect" title="Thrombi">thrombi</a> in the large vessels include (in descending incidence): atherosclerosis, <a href="/wiki/Vasoconstriction" title="Vasoconstriction">vasoconstriction</a> (tightening of the artery), <a href="/wiki/Aortic_dissection" title="Aortic dissection">aortic</a>, <a href="/wiki/Carotid_artery_dissection" title="Carotid artery dissection">carotid</a> or <a href="/wiki/Vertebral_artery_dissection" title="Vertebral artery dissection">vertebral artery dissection</a>, inflammatory diseases of the blood vessel wall (<a href="/wiki/Takayasu_arteritis" class="mw-redirect" title="Takayasu arteritis">Takayasu arteritis</a>, <a href="/wiki/Giant_cell_arteritis" title="Giant cell arteritis">giant cell arteritis</a>, <a href="/wiki/Vasculitis" title="Vasculitis">vasculitis</a>), noninflammatory vasculopathy, <a href="/wiki/Moyamoya_disease" title="Moyamoya disease">Moyamoya disease</a> and <a href="/wiki/Fibromuscular_dysplasia" title="Fibromuscular dysplasia">fibromuscular dysplasia</a>. Strokes caused by artery dissections are in the strictest sense not always caused by a 'defined disease state', such events can occur in very young people and can be caused by physical injury such as hyperextension of the neck area or often by other forms of trauma.<a href="#cite_note-49">[49]</a></li> <li><a href="/wiki/Small_vessel_disease" class="mw-redirect" title="Small vessel disease">Small vessel disease</a> involves the smaller arteries inside the brain: branches of the <a href="/wiki/Circle_of_Willis" title="Circle of Willis">circle of Willis</a>, middle cerebral artery, stem, and arteries arising from the distal vertebral and <a href="/wiki/Basilar_artery" title="Basilar artery">basilar artery</a>.<a href="#cite_note-50">[50]</a> Diseases that may form thrombi in the small vessels include (in descending incidence): <a href="/wiki/Lipohyalinosis" title="Lipohyalinosis">lipohyalinosis</a> (build-up of fatty hyaline matter in the blood vessel as a result of high blood pressure and aging) and <a href="/w/index.php?title=Fibrinoid_degeneration&action=edit&redlink=1" class="new" title="Fibrinoid degeneration (page does not exist)">fibrinoid degeneration</a> (stroke involving these vessels is known as a <a href="/wiki/Lacunar_stroke" title="Lacunar stroke">lacunar stroke</a>) and microatheroma (small atherosclerotic plaques).<a href="#cite_note-51">[51]</a></li></ul> Anemia causes increase blood flow in the blood circulatory system. This causes the endothelial cells of the blood vessels to express adhesion factors which encourages the clotting of blood and formation of thrombus.<a href="#cite_note-pmid34207841-52">[52]</a> <a href="/wiki/Sickle-cell_disease" class="mw-redirect" title="Sickle-cell disease">Sickle-cell anemia</a>, which can cause <a href="/wiki/Blood_cell" title="Blood cell">blood cells</a> to clump up and block blood vessels, can also lead to stroke. Stroke is the second leading cause of death in people under 20 with sickle-cell anemia.<a href="#cite_note-NINDS1999-53">[53]</a> <a href="/wiki/Air_pollution" title="Air pollution">Air pollution</a> may also increase stroke risk.<a href="#cite_note-54">[54]</a> <div class="mw-heading mw-heading3"><h3 id="Embolic_stroke">Embolic stroke</h3></div> An embolic stroke refers to an <a href="/wiki/Arterial_embolism" title="Arterial embolism">arterial embolism</a> (a blockage of an artery) by an <a href="/wiki/Embolus" title="Embolus">embolus</a>, a traveling particle or debris in the arterial bloodstream originating from elsewhere. An embolus is most frequently a thrombus, but it can also be a number of other substances including <a href="/wiki/Fat_embolism" class="mw-redirect" title="Fat embolism">fat</a> (e.g., from <a href="/wiki/Bone_marrow" title="Bone marrow">bone marrow</a> in a <a href="/wiki/Bone_fracture" title="Bone fracture">broken bone</a>), air, <a href="/wiki/Cancer" title="Cancer">cancer</a> cells or clumps of <a href="/wiki/Bacteria" title="Bacteria">bacteria</a> (usually from infectious <a href="/wiki/Endocarditis" title="Endocarditis">endocarditis</a>).<a href="#cite_note-Robbins-55">[55]</a> Because an embolus arises from elsewhere, local therapy solves the problem only temporarily. Thus, the source of the embolus must be identified. Because the embolic blockage is sudden in onset, symptoms are usually maximal at the start. Also, symptoms may be transient as the embolus is partially resorbed and moves to a different location or dissipates altogether. Emboli most commonly arise from the <a href="/wiki/Heart" title="Heart">heart</a> (especially in <a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a>) but may originate from elsewhere in the arterial tree. In <a href="/wiki/Paradoxical_embolism" title="Paradoxical embolism">paradoxical embolism</a>, a <a href="/wiki/Deep_vein_thrombosis" title="Deep vein thrombosis">deep vein thrombosis</a> embolizes through an <a href="/wiki/Atrial_septal_defect" title="Atrial septal defect">atrial</a> or <a href="/wiki/Ventricular_septal_defect" title="Ventricular septal defect">ventricular septal defect</a> in the heart into the brain.<a href="#cite_note-Robbins-55">[55]</a> Causes of stroke related to the heart can be distinguished between high- and low-risk:<a href="#cite_note-ay-56">[56]</a> <ul><li>High risk: atrial fibrillation and <a href="/wiki/Paroxysmal_atrial_fibrillation" class="mw-redirect" title="Paroxysmal atrial fibrillation">paroxysmal atrial fibrillation</a>, <a href="/wiki/Rheumatic_fever" title="Rheumatic fever">rheumatic disease</a> of the <a href="/wiki/Mitral_valve" title="Mitral valve">mitral</a> or <a href="/wiki/Aortic_valve" title="Aortic valve">aortic valve</a> disease, <a href="/wiki/Artificial_heart_valve" title="Artificial heart valve">artificial heart valves</a>, known cardiac thrombus of the atrium or ventricle, <a href="/wiki/Sick_sinus_syndrome" class="mw-redirect" title="Sick sinus syndrome">sick sinus syndrome</a>, sustained <a href="/wiki/Atrial_flutter" title="Atrial flutter">atrial flutter</a>, recent myocardial infarction, chronic myocardial infarction together with <a href="/wiki/Ejection_fraction" title="Ejection fraction">ejection fraction</a> <28 percent, symptomatic <a href="/wiki/Congestive_heart_failure" class="mw-redirect" title="Congestive heart failure">congestive heart failure</a> with ejection fraction <30 percent, <a href="/wiki/Dilated_cardiomyopathy" title="Dilated cardiomyopathy">dilated cardiomyopathy</a>, <a href="/wiki/Libman-Sacks_endocarditis" class="mw-redirect" title="Libman-Sacks endocarditis">Libman-Sacks endocarditis</a>, <a href="/wiki/Marantic_endocarditis" class="mw-redirect" title="Marantic endocarditis">Marantic endocarditis</a>, <a href="/wiki/Infective_endocarditis" title="Infective endocarditis">infective endocarditis</a>, <a href="/wiki/Papillary_fibroelastoma" title="Papillary fibroelastoma">papillary fibroelastoma</a>, <a href="/wiki/Atrial_myxoma" class="mw-redirect" title="Atrial myxoma">left atrial myxoma</a>, and <a href="/wiki/Coronary_artery_bypass_graft" class="mw-redirect" title="Coronary artery bypass graft">coronary artery bypass graft</a> (CABG) surgery.</li> <li>Low risk/potential: calcification of the annulus (ring) of the mitral valve, patent foramen ovale (PFO), atrial septal aneurysm, atrial septal aneurysm with patent foramen ovale, left ventricular aneurysm without thrombus, isolated left atrial "smoke" on <a href="/wiki/Echocardiography" title="Echocardiography">echocardiography</a> (no <a href="/wiki/Mitral_stenosis" title="Mitral stenosis">mitral stenosis</a> or atrial fibrillation), and complex atheroma in the <a href="/wiki/Ascending_aorta" title="Ascending aorta">ascending aorta</a> or proximal arch</li></ul> Among those who have a complete blockage of one of the carotid arteries, the risk of stroke on that side is about one percent per year.<a href="#cite_note-57">[57]</a> A special form of embolic stroke is the <a href="/wiki/Embolic_stroke_of_undetermined_source" title="Embolic stroke of undetermined source">embolic stroke of undetermined source</a> (ESUS). This subset of cryptogenic stroke is defined as a non-lacunar brain infarct without proximal arterial stenosis or cardioembolic sources. About one out of six cases of ischemic stroke could be classified as ESUS.<a href="#cite_note-58">[58]</a> <div class="mw-heading mw-heading3"><h3 id="Cerebral_hypoperfusion">Cerebral hypoperfusion</h3></div> <a href="/wiki/Shock_(circulatory)" title="Shock (circulatory)">Cerebral hypoperfusion</a> is the reduction of blood flow to all parts of the brain. The reduction could be to a particular part of the brain depending on the cause. It is most commonly due to <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a> from <a href="/wiki/Cardiac_arrest" title="Cardiac arrest">cardiac arrest</a> or <a href="/wiki/Arrhythmia" title="Arrhythmia">arrhythmias</a>, or from reduced <a href="/wiki/Cardiac_output" title="Cardiac output">cardiac output</a> as a result of <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">myocardial infarction</a>, <a href="/wiki/Pulmonary_embolism" title="Pulmonary embolism">pulmonary embolism</a>, <a href="/wiki/Pericardial_effusion" title="Pericardial effusion">pericardial effusion</a>, or bleeding.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <a href="/wiki/Hypoxia_(medical)" class="mw-redirect" title="Hypoxia (medical)">Hypoxemia</a> (low blood oxygen content) may precipitate the hypoperfusion. Because the reduction in blood flow is global, all parts of the brain may be affected, especially vulnerable "watershed" areas—border zone regions supplied by the major cerebral arteries. A <a href="/wiki/Watershed_stroke" title="Watershed stroke">watershed stroke</a> refers to the condition when the blood supply to these areas is compromised. Blood flow to these areas does not necessarily stop, but instead it may lessen to the point where brain damage can occur. <div class="mw-heading mw-heading3"><h3 id="Venous_thrombosis">Venous thrombosis</h3></div> <a href="/wiki/Cerebral_venous_sinus_thrombosis" title="Cerebral venous sinus thrombosis">Cerebral venous sinus thrombosis</a> leads to stroke due to locally increased venous pressure, which exceeds the pressure generated by the arteries. Infarcts are more likely to undergo hemorrhagic transformation (leaking of blood into the damaged area) than other types of ischemic stroke.<a href="#cite_note-Stam2005-24">[24]</a> <div class="mw-heading mw-heading3"><h3 id="Intracerebral_hemorrhage">Intracerebral hemorrhage</h3></div> It generally occurs in small arteries or arterioles and is commonly due to hypertension,<a href="#cite_note-59">[59]</a> intracranial vascular malformations (including <a href="/wiki/Cavernous_angioma" class="mw-redirect" title="Cavernous angioma">cavernous angiomas</a> or <a href="/wiki/Arteriovenous_malformation" title="Arteriovenous malformation">arteriovenous malformations</a>), cerebral <a href="/wiki/Amyloid_angiopathy" class="mw-redirect" title="Amyloid angiopathy">amyloid angiopathy</a>, or infarcts into which secondary hemorrhage has occurred.<a href="#cite_note-Donnan2008-2">[2]</a> Other potential causes are trauma, <a href="/wiki/Hemophilia" class="mw-redirect" title="Hemophilia">bleeding disorders</a>, <a href="/wiki/Amyloid_angiopathy" class="mw-redirect" title="Amyloid angiopathy">amyloid angiopathy</a>, <a href="/wiki/Recreational_drug_use" title="Recreational drug use">illicit drug use</a> (e.g., amphetamines or <a href="/wiki/Cocaine" title="Cocaine">cocaine</a>). The hematoma enlarges until pressure from surrounding tissue limits its growth, or until it decompresses by emptying into the <a href="/wiki/Ventricular_system" title="Ventricular system">ventricular system</a>, <a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">CSF</a> or the pial surface. A third of intracerebral bleed is into the brain's ventricles. ICH has a <a href="/wiki/Mortality_rate" title="Mortality rate">mortality rate</a> of 44 percent after 30 days, higher than ischemic stroke or <a href="/wiki/Subarachnoid_hemorrhage" title="Subarachnoid hemorrhage">subarachnoid hemorrhage</a> (which technically may also be classified as a type of stroke<a href="#cite_note-Donnan2008-2">[2]</a>). <div class="mw-heading mw-heading3"><h3 id="Other">Other</h3></div> Other causes may include spasm of an artery. This may occur due to <a href="/wiki/Cocaine" title="Cocaine">cocaine</a>.<a href="#cite_note-60">[60]</a> <a href="/wiki/Cancer" title="Cancer">Cancer</a> is also another well recognized potential cause of stroke. Although, malignancy in general can increase the risk of stroke, certain types of cancer such as pancreatic, lung and gastric are typically associated with a higher thromboembolism risk. The mechanism with which cancer increases stroke risk is thought to be secondary to an acquired <a href="/wiki/Thrombophilia" title="Thrombophilia">hypercoagulability</a>.<a href="#cite_note-61">[61]</a> <div class="mw-heading mw-heading3"><h3 id="Silent_stroke">Silent stroke</h3></div> <a href="/wiki/Silent_stroke" title="Silent stroke">Silent stroke</a> is stroke that does not have any outward symptoms, and people are typically unaware they had experienced stroke. Despite not causing identifiable symptoms, silent stroke still damages the brain and places the person at increased risk for both <a href="/wiki/Transient_ischemic_attack" title="Transient ischemic attack">transient ischemic attack</a> and major stroke in the future. Conversely, those who have had major stroke are also at risk of having silent stroke.<a href="#cite_note-62">[62]</a> In a broad study in 1998, more than 11 million people were estimated to have experienced stroke in the United States. Approximately 770,000 of these were symptomatic and 11 million were first-ever silent MRI infarcts or <a href="/wiki/Hemorrhage" class="mw-redirect" title="Hemorrhage">hemorrhages</a>. Silent stroke typically causes <a href="/wiki/Lesion" title="Lesion">lesions</a> which are detected via the use of neuroimaging such as <a href="/wiki/MRI" class="mw-redirect" title="MRI">MRI</a>. Silent stroke is estimated to occur at five times the rate of symptomatic stroke.<a href="#cite_note-Dutch_TIA92-63">[63]</a><a href="#cite_note-64">[64]</a> The risk of silent stroke increases with age, but they may also affect younger adults and children, especially those with acute <a href="/wiki/Anemia" title="Anemia">anemia</a>.<a href="#cite_note-Dutch_TIA92-63">[63]</a><a href="#cite_note-65">[65]</a> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2></div> <div class="mw-heading mw-heading3"><h3 id="Ischemic_2">Ischemic</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Histopathology_of_thalamus_infarction_at_approximately_24_hours,_high_magnification,_annotated.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1e/Histopathology_of_thalamus_infarction_at_approximately_24_hours%2C_high_magnification%2C_annotated.jpg/220px-Histopathology_of_thalamus_infarction_at_approximately_24_hours%2C_high_magnification%2C_annotated.jpg" decoding="async" width="220" height="122" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/1e/Histopathology_of_thalamus_infarction_at_approximately_24_hours%2C_high_magnification%2C_annotated.jpg/330px-Histopathology_of_thalamus_infarction_at_approximately_24_hours%2C_high_magnification%2C_annotated.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/1e/Histopathology_of_thalamus_infarction_at_approximately_24_hours%2C_high_magnification%2C_annotated.jpg/440px-Histopathology_of_thalamus_infarction_at_approximately_24_hours%2C_high_magnification%2C_annotated.jpg 2x" data-file-width="1226" data-file-height="679" /></a><figcaption>Histopathology at high magnification of a normal neuron, and ischemic stroke at approximately 24 hours on <a href="/wiki/H%26E_stain" title="H&E stain">H&E stain</a>: The neurons become hypereosinophilic and there is an infiltrate of <a href="/wiki/Neutrophil" title="Neutrophil">neutrophils</a>. There is slight edema and loss of normal architecture in the surrounding <a href="/wiki/Neuropil" title="Neuropil">neuropil</a>.</figcaption></figure> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1251242444"><table class="box-Medical_citations_needed plainlinks metadata ambox ambox-content" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/b/b4/Ambox_important.svg/40px-Ambox_important.svg.png" decoding="async" width="40" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/b/b4/Ambox_important.svg/60px-Ambox_important.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/b/b4/Ambox_important.svg/80px-Ambox_important.svg.png 2x" data-file-width="40" data-file-height="40" /></div></td><td class="mbox-text"><div class="mbox-text-span">This section needs more <a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)">reliable medical references</a> for <a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">verification</a> or relies too heavily on <a href="/wiki/Wikipedia:Primary_sources" class="mw-redirect" title="Wikipedia:Primary sources">primary sources</a>. Please review the contents of the section and <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Stroke&action=edit">add the appropriate references</a> if you can. Unsourced or poorly sourced material may be challenged and <a href="/wiki/Wikipedia:Verifiability#Burden_of_evidence" title="Wikipedia:Verifiability">removed</a>. Find sources: <a rel="nofollow" class="external text" href="https://www.google.com/search?as_eq=wikipedia&q=%22Stroke%22">"Stroke"</a> – <a rel="nofollow" class="external text" href="https://www.google.com/search?tbm=nws&q=%22Stroke%22+-wikipedia&tbs=ar:1">news</a> · <a rel="nofollow" class="external text" href="https://www.google.com/search?&q=%22Stroke%22&tbs=bkt:s&tbm=bks">newspapers</a> · <a rel="nofollow" class="external text" href="https://www.google.com/search?tbs=bks:1&q=%22Stroke%22+-wikipedia">books</a> · <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar?q=%22Stroke%22">scholar</a> · <a rel="nofollow" class="external text" href="https://www.jstor.org/action/doBasicSearch?Query=%22Stroke%22&acc=on&wc=on">JSTOR</a> (June 2022)</div></td><td class="mbox-imageright"><div class="mbox-image-div"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/52px-Star_of_life.svg.png" decoding="async" width="52" height="50" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/77px-Star_of_life.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/103px-Star_of_life.svg.png 2x" data-file-width="198" data-file-height="192" /></div></td></tr></tbody></table> Ischemic stroke occurs because of a loss of blood supply to part of the brain, initiating the <a href="/wiki/Ischemic_cascade" title="Ischemic cascade">ischemic cascade</a>.<a href="#cite_note-Deb-66">[66]</a> Atherosclerosis may disrupt the blood supply by narrowing the lumen of blood vessels leading to a reduction of blood flow by causing the formation of blood clots within the vessel or by releasing showers of small <a href="/wiki/Emboli" class="mw-redirect" title="Emboli">emboli</a> through the disintegration of atherosclerotic plaques.<a href="#cite_note-67">[67]</a> Embolic infarction occurs when emboli formed elsewhere in the circulatory system, typically in the heart as a consequence of atrial fibrillation, or in the carotid arteries, break off, enter the cerebral circulation, then lodge in and block brain blood vessels. Since blood vessels in the brain are now blocked, the brain becomes low in energy, and thus it resorts to using <a href="/wiki/Anaerobic_metabolism" class="mw-redirect" title="Anaerobic metabolism">anaerobic metabolism</a> within the region of brain tissue affected by ischemia. Anaerobic metabolism produces less <a href="/wiki/Adenosine_triphosphate" title="Adenosine triphosphate">adenosine triphosphate</a> (ATP) but releases a by-product called <a href="/wiki/Lactic_acid" title="Lactic acid">lactic acid</a>. Lactic acid is an irritant which could potentially destroy cells since it is an acid and disrupts the normal acid-base balance in the brain. The ischemia area is referred to as the "ischemic <a href="/wiki/Penumbra_(medicine)" title="Penumbra (medicine)">penumbra</a>".<a href="#cite_note-68">[68]</a> After the initial ischemic event the penumbra transitions from a <a href="/wiki/Tissue_remodeling" title="Tissue remodeling">tissue remodeling</a> characterized by damage to a remodeling characterized by repair.<a href="#cite_note-pmid18463660-69">[69]</a> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Molecular_pathways_outlining_the_role_of_glutamate_in_excitoxicity_following_stroke.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/79/Molecular_pathways_outlining_the_role_of_glutamate_in_excitoxicity_following_stroke.png/300px-Molecular_pathways_outlining_the_role_of_glutamate_in_excitoxicity_following_stroke.png" decoding="async" width="300" height="196" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/79/Molecular_pathways_outlining_the_role_of_glutamate_in_excitoxicity_following_stroke.png/450px-Molecular_pathways_outlining_the_role_of_glutamate_in_excitoxicity_following_stroke.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/79/Molecular_pathways_outlining_the_role_of_glutamate_in_excitoxicity_following_stroke.png/600px-Molecular_pathways_outlining_the_role_of_glutamate_in_excitoxicity_following_stroke.png 2x" data-file-width="1628" data-file-height="1062" /></a><figcaption>Molecular pathways outlining the role of glutamate excitoxicity following stroke</figcaption></figure> As oxygen or glucose becomes depleted in ischemic brain tissue, the production of <a href="/wiki/High_energy_phosphate" class="mw-redirect" title="High energy phosphate">high energy phosphate</a> compounds such as adenosine triphosphate (ATP) fails, leading to failure of energy-dependent processes (such as ion pumping) necessary for tissue cell survival. This sets off a series of interrelated events that result in cellular injury and death. A major cause of neuronal injury is the release of the excitatory neurotransmitter glutamate. The concentration of glutamate outside the cells of the nervous system is normally kept low by so-called uptake carriers, which are powered by the concentration gradients of ions (mainly Na+) across the cell membrane. However, stroke cuts off the supply of oxygen and glucose which powers the ion pumps maintaining these gradients. As a result, the transmembrane ion gradients run down, and glutamate transporters reverse their direction, releasing glutamate into the extracellular space. Glutamate acts on receptors in nerve cells (especially NMDA receptors), producing an influx of calcium which activates enzymes that digest the cells' proteins, lipids, and nuclear material. Calcium influx can also lead to the failure of <a href="/wiki/Mitochondria" class="mw-redirect" title="Mitochondria">mitochondria</a>, which can lead further toward energy depletion and may trigger cell death due to <a href="/wiki/Apoptosis" title="Apoptosis">programmed cell death</a>.<a href="#cite_note-PMID8761323-70">[70]</a> Ischemia also induces production of <a href="/wiki/Radical_(chemistry)" title="Radical (chemistry)">oxygen free radicals</a> and other <a href="/wiki/Reactive_oxygen_species" title="Reactive oxygen species">reactive oxygen species</a>. These react with and damage a number of cellular and extracellular elements. Damage to the blood vessel lining or endothelium may occur. These processes are the same for any type of ischemic tissue and are referred to collectively as the ischemic cascade. However, brain tissue is especially vulnerable to ischemia since it has little respiratory reserve and is completely dependent on <a href="/wiki/Aerobic_metabolism" class="mw-redirect" title="Aerobic metabolism">aerobic metabolism</a>, unlike most other organs. <div class="mw-heading mw-heading4"><h4 id="Collateral_flow">Collateral flow</h4></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Impact_of_collateral_flow_on_clot_lysis_and_reperfusion._(a)_Schematic_drawing_of_the_collateral_network_showing_anastomoses_between_the_middle_cerebral_artery_(MCA)_and_anterior_cerebral_artery.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/57/Impact_of_collateral_flow_on_clot_lysis_and_reperfusion._%28a%29_Schematic_drawing_of_the_collateral_network_showing_anastomoses_between_the_middle_cerebral_artery_%28MCA%29_and_anterior_cerebral_artery.png/220px-thumbnail.png" decoding="async" width="220" height="112" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/57/Impact_of_collateral_flow_on_clot_lysis_and_reperfusion._%28a%29_Schematic_drawing_of_the_collateral_network_showing_anastomoses_between_the_middle_cerebral_artery_%28MCA%29_and_anterior_cerebral_artery.png/330px-thumbnail.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/57/Impact_of_collateral_flow_on_clot_lysis_and_reperfusion._%28a%29_Schematic_drawing_of_the_collateral_network_showing_anastomoses_between_the_middle_cerebral_artery_%28MCA%29_and_anterior_cerebral_artery.png/440px-thumbnail.png 2x" data-file-width="850" data-file-height="434" /></a><figcaption>Impact of collateral flow on <a href="/wiki/Clot_lysis" class="mw-redirect" title="Clot lysis">clot lysis</a> and <a href="/wiki/Reperfusion_therapy" title="Reperfusion therapy">reperfusion</a></figcaption></figure> The brain can compensate inadequate blood flow in a single artery by the collateral system. This system relies on the efficient connection between the carotid and <a href="/wiki/Vertebral_arteries" class="mw-redirect" title="Vertebral arteries">vertebral arteries</a> through the <a href="/wiki/Circle_of_Willis" title="Circle of Willis">circle of Willis</a> and, to a lesser extent, the major arteries supplying the <a href="/wiki/Cerebral_hemisphere" title="Cerebral hemisphere">cerebral hemispheres</a>. However, variations in the circle of Willis, caliber of collateral vessels, and acquired <a href="/wiki/Atheroma" title="Atheroma">arterial lesions</a> such as atherosclerosis can disrupt this compensatory mechanism, increasing the risk of brain ischemia resulting from artery blockage.<a href="#cite_note-MSD-2023-71">[71]</a> The extent of damage depends on the duration and severity of the ischemia. If ischemia persists for more than 5 minutes with <a href="/wiki/Perfusion" title="Perfusion">perfusion</a> below 5% of normal, some neurons will die. However, if ischemia is mild, the damage will occur slowly and may take up to 6 hours to completely destroy the brain tissue. In case of severe ischemia lasting more than 15 to 30 minutes, all of the affected tissue will die, leading to infarction. The rate of damage is affected by temperature, with <a href="/wiki/Hyperthermia" title="Hyperthermia">hyperthermia</a> accelerating damage and <a href="/wiki/Hypothermia" title="Hypothermia">hypothermia</a> slowing it down and other factors. Prompt restoration of blood flow to ischemic tissues can reduce or reverse injury, especially if the tissues are not yet irreversibly damaged. This is particularly important for the moderately ischemic areas (penumbras) surrounding areas of severe ischemia, which may still be salvageable due to collateral flow.<a href="#cite_note-MSD-2023-71">[71]</a><a href="#cite_note-72">[72]</a><a href="#cite_note-73">[73]</a> <div class="mw-heading mw-heading3"><h3 id="Hemorrhagic_2">Hemorrhagic</h3></div> Hemorrhagic stroke is classified based on their underlying pathology. Some causes of hemorrhagic stroke are <a href="/wiki/Hypertensive" class="mw-redirect" title="Hypertensive">hypertensive hemorrhage</a>, ruptured <a href="/wiki/Aneurysm" title="Aneurysm">aneurysm</a>, ruptured <a href="/wiki/AV_fistula" class="mw-redirect" title="AV fistula">AV fistula</a>, transformation of prior ischemic infarction, and drug-induced <a href="/wiki/Bleeding" title="Bleeding">bleeding</a>.<a href="#cite_note-Harrison's-74">[74]</a> They result in tissue injury by causing compression of tissue from an expanding <a href="/wiki/Hematoma" title="Hematoma">hematoma</a> or hematomas. In addition, the pressure may lead to a loss of blood supply to affected tissue with resulting <a href="/wiki/Infarction" title="Infarction">infarction</a>, and the blood released by brain hemorrhage appears to have direct toxic effects on brain tissue and <a href="/wiki/Vasculature" class="mw-redirect" title="Vasculature">vasculature</a>.<a href="#cite_note-NINDS1999-53">[53]</a><a href="#cite_note-Wang_2010-75">[75]</a> <a href="/wiki/Inflammation" title="Inflammation">Inflammation</a> contributes to the <a href="/wiki/Secondary_brain_injury" class="mw-redirect" title="Secondary brain injury">secondary brain injury</a> after hemorrhage.<a href="#cite_note-Wang_2010-75">[75]</a> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:StrokeMCA_overlay.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/92/StrokeMCA_overlay.png/220px-StrokeMCA_overlay.png" decoding="async" width="220" height="257" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/92/StrokeMCA_overlay.png/330px-StrokeMCA_overlay.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/92/StrokeMCA_overlay.png/440px-StrokeMCA_overlay.png 2x" data-file-width="820" data-file-height="958" /></a><figcaption>A CT showing early signs of a middle cerebral artery stroke with loss of definition of the gyri and grey white boundary</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Dens_media_sign_mit_Mediainfarkt_-_CCT_001.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/03/Dens_media_sign_mit_Mediainfarkt_-_CCT_001.jpg/220px-Dens_media_sign_mit_Mediainfarkt_-_CCT_001.jpg" decoding="async" width="220" height="140" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/03/Dens_media_sign_mit_Mediainfarkt_-_CCT_001.jpg/330px-Dens_media_sign_mit_Mediainfarkt_-_CCT_001.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/03/Dens_media_sign_mit_Mediainfarkt_-_CCT_001.jpg/440px-Dens_media_sign_mit_Mediainfarkt_-_CCT_001.jpg 2x" data-file-width="1750" data-file-height="1116" /></a><figcaption>Dense artery sign in a patient with <a href="/wiki/Middle_cerebral_artery" title="Middle cerebral artery">middle cerebral artery</a> infarction shown on the left. Right image after 7 hours.</figcaption></figure> Stroke is diagnosed through several techniques: a neurological examination (such as the <a href="/wiki/NIHSS" class="mw-redirect" title="NIHSS">NIHSS</a>), CT scans (most often without contrast enhancements) or <a href="/wiki/MRI_scan" class="mw-redirect" title="MRI scan">MRI scans</a>, <a href="/wiki/Doppler_ultrasound" class="mw-redirect" title="Doppler ultrasound">Doppler ultrasound</a>, and <a href="/wiki/Arteriography" class="mw-redirect" title="Arteriography">arteriography</a>. The diagnosis of stroke itself is clinical, with assistance from the imaging techniques. Imaging techniques also assist in determining the subtypes and cause of stroke. There is yet no commonly used <a href="/wiki/Blood_test" title="Blood test">blood test</a> for the stroke diagnosis itself, though blood tests may be of help in finding out the likely cause of stroke.<a href="#cite_note-hill2005-76">[76]</a> In deceased people, an <a href="/wiki/Autopsy_of_stroke" class="mw-redirect" title="Autopsy of stroke">autopsy of stroke</a> may help establishing the time between stroke onset and death. <div class="mw-heading mw-heading3"><h3 id="Physical_examination">Physical examination</h3></div> A <a href="/wiki/Physical_examination" title="Physical examination">physical examination</a>, including taking a <a href="/wiki/Medical_history" title="Medical history">medical history</a> of the symptoms and a neurological status, helps giving an evaluation of the location and severity of stroke. It can give a standard score on e.g., the <a href="/wiki/NIH_stroke_scale" class="mw-redirect" title="NIH stroke scale">NIH stroke scale</a>. <div class="mw-heading mw-heading3"><h3 id="Imaging">Imaging</h3></div> For diagnosing ischemic (blockage) stroke in the emergency setting:<a href="#cite_note-pmid17258669-77">[77]</a> <ul><li>CT scans (without contrast enhancements) <ul><li><a href="/wiki/Sensitivity_(tests)" class="mw-redirect" title="Sensitivity (tests)">sensitivity</a>= 16% (less than 10% within first 3 hours of symptom onset)</li> <li><a href="/wiki/Specificity_(tests)" class="mw-redirect" title="Specificity (tests)">specificity</a>= 96%</li></ul></li> <li>MRI scan <ul><li>sensitivity= 83%</li> <li>specificity= 98%</li></ul></li></ul> For diagnosing hemorrhagic stroke in the emergency setting: <ul><li>CT scans (without contrast enhancements) <ul><li>sensitivity= 89%</li> <li>specificity= 100%</li></ul></li> <li>MRI scan <ul><li>sensitivity= 81%</li> <li>specificity= 100%</li></ul></li></ul> For detecting chronic hemorrhages, an MRI scan is more sensitive.<a href="#cite_note-pmid15494579-78">[78]</a> For the assessment of stable stroke, nuclear medicine scans such as <a href="/wiki/Single-photon_emission_computed_tomography" title="Single-photon emission computed tomography">single-photon emission computed tomography</a> (SPECT) and <a href="/wiki/Positron_emission_tomography%E2%80%93computed_tomography" class="mw-redirect" title="Positron emission tomography–computed tomography">positron emission tomography–computed tomography</a> (PET/CT) may be helpful. SPECT documents cerebral blood flow, whereas PET with an FDG isotope shows cerebral glucose metabolism. CT scans may not detect ischemic stroke, especially if it is small, of recent onset,<a href="#cite_note-AFP2009-10">[10]</a> or in the brainstem or cerebellum areas (<a href="/wiki/Posterior_circulation_infarct" title="Posterior circulation infarct">posterior circulation infarct</a>). MRI is better at detecting a posterior circulation infarct with <a href="/wiki/Diffusion_MRI" class="mw-redirect" title="Diffusion MRI">diffusion-weighted imaging</a>.<a href="#cite_note-pmid24778625-79">[79]</a> A CT scan is used more to rule out certain stroke mimics and detect bleeding.<a href="#cite_note-AFP2009-10">[10]</a> The presence of <a href="/wiki/Leptomeningeal_collateral_circulation" title="Leptomeningeal collateral circulation">leptomeningeal collateral circulation</a> in the brain is associated with better clinical outcomes after recanalization treatment.<a href="#cite_note-pmid28864854-80">[80]</a> Cerebrovascular reserve capacity is another factor that affects stroke outcome – it is the amount of increase in cerebral blood flow after a purposeful stimulation of blood flow by the physician, such as by giving inhaled carbon dioxide or <a href="/wiki/Intravenous" class="mw-redirect" title="Intravenous">intravenous</a> <a href="/wiki/Acetazolamide" title="Acetazolamide">acetazolamide</a>. The increase in blood flow can be measured by PET scan or transcranial doppler sonography.<a href="#cite_note-pmid12242957-81">[81]</a> However, in people with obstruction of the <a href="/wiki/Internal_carotid_artery" title="Internal carotid artery">internal carotid artery</a> of one side, the presence of leptomeningeal collateral circulation is associated with reduced cerebral reserve capacity.<a href="#cite_note-pmid34112002-82">[82]</a> <div class="mw-heading mw-heading3"><h3 id="Underlying_cause">Underlying cause</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Left_MCA_Stroke.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/71/Left_MCA_Stroke.png/220px-Left_MCA_Stroke.png" decoding="async" width="220" height="133" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/71/Left_MCA_Stroke.png/330px-Left_MCA_Stroke.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/71/Left_MCA_Stroke.png/440px-Left_MCA_Stroke.png 2x" data-file-width="765" data-file-height="462" /></a><figcaption>12-lead ECG of a patient with stroke, showing large deeply inverted <a href="/wiki/T_wave" title="T wave">T-waves</a>. ECG changes may occur in people with stroke and other brain disorders.</figcaption></figure> When stroke has been diagnosed, other studies may be performed to determine the underlying cause. With the treatment and diagnosis options available, it is of particular importance to determine whether there is a peripheral source of emboli. Test selection may vary since the cause of stroke varies with age, <a href="/wiki/Comorbidity" title="Comorbidity">comorbidity</a> and the clinical presentation. The following are commonly used techniques: <ul><li>an <a href="/wiki/Medical_ultrasonography" class="mw-redirect" title="Medical ultrasonography">ultrasound/doppler study</a> of the <a href="/wiki/Carotid_artery" title="Carotid artery">carotid arteries</a> (to detect <a href="/wiki/Carotid_stenosis" class="mw-redirect" title="Carotid stenosis">carotid stenosis</a>) or dissection of the precerebral arteries;</li> <li>an <a href="/wiki/Electrocardiogram" class="mw-redirect" title="Electrocardiogram">electrocardiogram</a> (ECG) and <a href="/wiki/Echocardiogram" class="mw-redirect" title="Echocardiogram">echocardiogram</a> (to identify <a href="/wiki/Cardiac_arrhythmia" class="mw-redirect" title="Cardiac arrhythmia">arrhythmias</a> and resultant clots in the heart which may spread to the brain vessels through the bloodstream);</li> <li>a <a href="/wiki/Holter_monitor" title="Holter monitor">Holter monitor</a> study to identify intermittent <a href="/wiki/Heart_arrhythmia" class="mw-redirect" title="Heart arrhythmia">abnormal heart rhythms</a>;</li> <li>an <a href="/wiki/Angiogram" class="mw-redirect" title="Angiogram">angiogram</a> of the cerebral vasculature (if a bleed is thought to have originated from an <a href="/wiki/Aneurysm" title="Aneurysm">aneurysm</a> or <a href="/wiki/Arteriovenous_malformation" title="Arteriovenous malformation">arteriovenous malformation</a>);</li> <li>blood tests to determine if <a href="/wiki/Hypercholesterolemia" title="Hypercholesterolemia">blood cholesterol is high</a>, if there is an abnormal <a href="/wiki/Bleeding_diathesis" title="Bleeding diathesis">tendency to bleed</a>, and if some rarer processes such as <a href="/wiki/Homocysteinuria" class="mw-redirect" title="Homocysteinuria">homocystinuria</a> might be involved.</li></ul> For hemorrhagic stroke, a <a href="/wiki/Computed_tomography_angiography" title="Computed tomography angiography">CT</a> or <a href="/wiki/Magnetic_resonance_angiography" title="Magnetic resonance angiography">MRI scan with intravascular contrast</a> may be able to identify abnormalities in the brain arteries (such as aneurysms) or other sources of bleeding, and structural MRI if this shows no cause. If this too does not identify an underlying reason for the bleeding, invasive <a href="/wiki/Cerebral_angiography" title="Cerebral angiography">cerebral angiography</a> could be performed but this requires access to the bloodstream with an intravascular catheter and can cause further stroke as well as complications at the insertion site and this investigation is therefore reserved for specific situations.<a href="#cite_note-Wilson2015-83">[83]</a> If there are symptoms suggesting that the hemorrhage might have occurred as a result of <a href="/wiki/Cerebral_venous_sinus_thrombosis" title="Cerebral venous sinus thrombosis">venous thrombosis</a>, CT or MRI venography can be used to examine the cerebral veins.<a href="#cite_note-Wilson2015-83">[83]</a> <div class="mw-heading mw-heading3"><h3 id="Misdiagnosis">Misdiagnosis</h3></div> Among people with ischemic stroke, misdiagnosis occurs 2 to 26% of the time.<a href="#cite_note-Bak2018-84">[84]</a> A "stroke chameleon" (SC) is stroke which is diagnosed as something else.<a href="#cite_note-Bak2018-84">[84]</a><a href="#cite_note-Stroke_chameleons,_Dupre_et._al,_2013-85">[85]</a> People not having stroke may also be misdiagnosed with the condition. Giving thrombolytics (clot-busting) in such cases causes intracerebral bleeding 1 to 2% of the time, which is less than that of people with stroke. This unnecessary treatment adds to health care costs. Even so, the AHA/ASA guidelines state that starting intravenous tPA in possible mimics is preferred to delaying treatment for additional testing.<a href="#cite_note-Bak2018-84">[84]</a> Women, African-Americans, Hispanic-Americans, Asian and Pacific Islanders are more often misdiagnosed for a condition other than stroke when in fact having stroke. In addition, adults under 44 years of age are seven times more likely to have stroke missed than are adults over 75 years of age. This is especially the case for younger people with posterior circulation infarcts.<a href="#cite_note-Bak2018-84">[84]</a> Some medical centers have used hyperacute MRI in experimental studies for people initially thought to have a low likelihood of stroke, and in some of these people, stroke has been found which were then treated with thrombolytic medication.<a href="#cite_note-Bak2018-84">[84]</a> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2></div> Given the disease burden of stroke, <a href="/wiki/Prevention_(medical)" class="mw-redirect" title="Prevention (medical)">prevention</a> is an important <a href="/wiki/Public_health" title="Public health">public health</a> concern.<a href="#cite_note-pmid12234233-86">[86]</a> <a href="/wiki/Primary_prevention" class="mw-redirect" title="Primary prevention">Primary prevention</a> is less effective than secondary prevention (as judged by the <a href="/wiki/Number_needed_to_treat" title="Number needed to treat">number needed to treat</a> to prevent one stroke per year).<a href="#cite_note-pmid12234233-86">[86]</a> Recent guidelines detail the evidence for primary prevention in stroke.<a href="#cite_note-PreventionGuidelines-87">[87]</a> About the use of aspirin as a preventive medication for stroke, in healthy people aspirin does not appear beneficial and thus is not recommended,<a href="#cite_note-88">[88]</a> but in people with high cardiovascular risk, or those who have had a myocardial infarction, it provides some protection against a first stroke.<a href="#cite_note-AP01-89">[89]</a><a href="#cite_note-BMJ2002-90">[90]</a> In those who have previously had stroke, treatment with medications such as <a href="/wiki/Aspirin" title="Aspirin">aspirin</a>, <a href="/wiki/Clopidogrel" title="Clopidogrel">clopidogrel</a>, and <a href="/wiki/Dipyridamole" title="Dipyridamole">dipyridamole</a> may be beneficial.<a href="#cite_note-AP01-89">[89]</a> The <a href="/wiki/U.S._Preventive_Services_Task_Force" class="mw-redirect" title="U.S. Preventive Services Task Force">U.S. Preventive Services Task Force</a> (USPSTF) recommends against <a href="/wiki/Screening_(medicine)" title="Screening (medicine)">screening</a> for <a href="/wiki/Carotid_artery_stenosis" title="Carotid artery stenosis">carotid artery stenosis</a> in those without symptoms.<a href="#cite_note-91">[91]</a> <div class="mw-heading mw-heading3"><h3 id="Risk_factors">Risk factors</h3></div> The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation, although the size of the effect is small; 833 people have to be treated for 1 year to prevent one stroke.<a href="#cite_note-92">[92]</a><a href="#cite_note-93">[93]</a> Other modifiable risk factors include high blood cholesterol levels, <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a>, <a href="/wiki/End-stage_kidney_disease" class="mw-redirect" title="End-stage kidney disease">end-stage kidney disease</a>,<a href="#cite_note-Hu2018-8">[8]</a> cigarette smoking<a href="#cite_note-94">[94]</a><a href="#cite_note-pmid7596004-95">[95]</a> (active and passive), heavy <a href="/wiki/Alcohol_consumption_and_health" class="mw-redirect" title="Alcohol consumption and health">alcohol</a> use,<a href="#cite_note-pmid12578491-96">[96]</a> drug use,<a href="#cite_note-pmid1891081-97">[97]</a> lack of <a href="/wiki/Physical_activity" title="Physical activity">physical activity</a>, <a href="/wiki/Obesity" title="Obesity">obesity</a>, processed <a href="/wiki/Red_meat" title="Red meat">red meat</a> consumption,<a href="#cite_note-98">[98]</a> and unhealthy diet.<a href="#cite_note-American_heart_risk-99">[99]</a> Smoking just one cigarette per day increases the risk more than 30%.<a href="#cite_note-100">[100]</a> Alcohol use could predispose to ischemic stroke, as well as intracerebral and subarachnoid hemorrhage via multiple mechanisms (for example, via hypertension, atrial fibrillation, rebound <a href="/wiki/Thrombocytosis" class="mw-redirect" title="Thrombocytosis">thrombocytosis</a> and <a href="/wiki/Platelet_aggregation" class="mw-redirect" title="Platelet aggregation">platelet aggregation</a> and <a href="/wiki/Clotting" class="mw-redirect" title="Clotting">clotting</a> disturbances).<a href="#cite_note-pmid3810763-101">[101]</a> Drugs, most commonly amphetamines and cocaine, can induce stroke through damage to the blood vessels in the brain and acute hypertension.<a href="#cite_note-Harrison's-74">[74]</a><a href="#cite_note-pmid17404126-102">[102]</a>[<a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability"><span title="Quotation needed from source to verify. amphetamines do not normally cause any of this (hypertension or stroke) without pre-existing abnormalities, see DOI 10.1056/NEJMoa1110212 and related adult study, esp hazard ratio supplements (November 2024)">need quotation to verify</a>] <a href="/wiki/Migraine" title="Migraine">Migraine</a> with <a href="/wiki/Aura_(symptom)" title="Aura (symptom)">aura</a> doubles a person's risk for ischemic stroke.<a href="#cite_note-Stroke2009-103">[103]</a><a href="#cite_note-104">[104]</a> Untreated, <a href="/wiki/Celiac_disease" class="mw-redirect" title="Celiac disease">celiac disease</a> regardless of the presence of symptoms can be an underlying cause of stroke, both in children and adults.<a href="#cite_note-CiaccioLewis2017-105">[105]</a> According to a 2021 WHO study, working 55+ hours a week raises the risk of stroke by 35% and the risk of dying from heart conditions by 17%, when compared to a 35-40-hour week.<a href="#cite_note-106">[106]</a> High levels of physical activity reduce the risk of stroke by about 26%.<a href="#cite_note-BMJ2016-107">[107]</a> There is a lack of high quality studies looking at promotional efforts to improve lifestyle factors.<a href="#cite_note-pmid14705756-108">[108]</a> Nonetheless, given the large body of circumstantial evidence, best medical management for stroke includes advice on diet, exercise, smoking and alcohol use.<a href="#cite_note-endart-review-109">[109]</a> Medication is the most common method of stroke prevention; <a href="/wiki/Carotid_endarterectomy" title="Carotid endarterectomy">carotid endarterectomy</a> can be a useful surgical method of preventing stroke. <div class="mw-heading mw-heading4"><h4 id="Blood_pressure">Blood pressure</h4></div> <a href="/wiki/Hypertension" title="Hypertension">High blood pressure</a> accounts for 35–50% of stroke risk.<a href="#cite_note-pmid8614485-110">[110]</a> Blood pressure reduction of 10 mmHg systolic or 5 mmHg diastolic reduces the risk of stroke by ~40%.<a href="#cite_note-111">[111]</a> Lowering blood pressure has been conclusively shown to prevent both ischemic and hemorrhagic stroke.<a href="#cite_note-Psaty2003-112">[112]</a><a href="#cite_note-pmid8551820-113">[113]</a> It is equally important in secondary prevention.<a href="#cite_note-pmid9412649-114">[114]</a> Even people older than 80 years and those with <a href="/wiki/Isolated_systolic_hypertension" class="mw-redirect" title="Isolated systolic hypertension">isolated systolic hypertension</a> benefit from antihypertensive therapy.<a href="#cite_note-INDANAsub-115">[115]</a><a href="#cite_note-Staessen2000-116">[116]</a><a href="#cite_note-HYVET-NEJM2008-117">[117]</a> The available evidence does not show large differences in stroke prevention between antihypertensive drugs—therefore, other factors such as protection against other forms of cardiovascular disease and cost should be considered.<a href="#cite_note-BPLT-118">[118]</a><a href="#cite_note-pmid12479763-119">[119]</a> The routine use of <a href="/wiki/Beta-blocker" class="mw-redirect" title="Beta-blocker">beta-blockers</a> following stroke or TIA has not been shown to result in benefits.<a href="#cite_note-120">[120]</a> <div class="mw-heading mw-heading4"><h4 id="Blood_lipids">Blood lipids</h4></div> High cholesterol levels have been inconsistently associated with (ischemic) stroke.<a href="#cite_note-pmid8551820-113">[113]</a><a href="#cite_note-NEJM1989-121">[121]</a> <a href="/wiki/Statins" class="mw-redirect" title="Statins">Statins</a> have been shown to reduce the risk of stroke by about 15%.<a href="#cite_note-Statins2008-122">[122]</a> Since earlier meta-analyses of other <a href="/wiki/Lipid-lowering_drugs" class="mw-redirect" title="Lipid-lowering drugs">lipid-lowering drugs</a> did not show a decreased risk,<a href="#cite_note-pmid7802520-123">[123]</a> statins might exert their effect through mechanisms other than their lipid-lowering effects.<a href="#cite_note-Statins2008-122">[122]</a> <div class="mw-heading mw-heading4"><h4 id="Diabetes_mellitus">Diabetes mellitus</h4></div> <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">Diabetes mellitus</a> increases the risk of stroke by 2 to 3 times.[<a href="/wiki/Wikipedia:Please_clarify" title="Wikipedia:Please clarify">clarification needed</a>][<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] While intensive blood sugar control has been shown to reduce small blood vessel complications such as <a href="/wiki/Diabetic_nephropathy" title="Diabetic nephropathy">kidney damage</a> and <a href="/wiki/Diabetic_retinopathy" title="Diabetic retinopathy">damage to the retina of the eye</a> it has not been shown to reduce large blood vessel complications such as stroke.<a href="#cite_note-UKPDS-124">[124]</a><a href="#cite_note-ProACTIVE-125">[125]</a> <div class="mw-heading mw-heading4"><h4 id="Anticoagulant_drugs">Anticoagulant drugs</h4></div> Oral anticoagulants such as <a href="/wiki/Warfarin" title="Warfarin">warfarin</a> have been the mainstay of stroke prevention for over 50 years. However, several studies have shown that aspirin and other <a href="/wiki/Antiplatelet_drug" title="Antiplatelet drug">antiplatelets</a> are highly effective in <a href="/wiki/Secondary_prevention" class="mw-redirect" title="Secondary prevention">secondary prevention</a> after stroke or transient ischemic attack.<a href="#cite_note-AP01-89">[89]</a> Low doses of aspirin (for example 75–150 mg) are as effective as high doses but have fewer side effects; the lowest effective dose remains unknown.<a href="#cite_note-pmid10371234-126">[126]</a> <a href="/wiki/Thienopyridine" title="Thienopyridine">Thienopyridines</a> (<a href="/wiki/Clopidogrel" title="Clopidogrel">clopidogrel</a>, <a href="/wiki/Ticlopidine" title="Ticlopidine">ticlopidine</a>) might be slightly more effective than aspirin and have a decreased risk of <a href="/wiki/Gastrointestinal_bleeding" title="Gastrointestinal bleeding">gastrointestinal bleeding</a> but are more expensive.<a href="#cite_note-CochraneThienopyridines-127">[127]</a> Both aspirin and clopidogrel may be useful in the first few weeks after a minor stroke or high-risk TIA.<a href="#cite_note-128">[128]</a> Clopidogrel has less side effects than ticlopidine.<a href="#cite_note-CochraneThienopyridines-127">[127]</a> <a href="/wiki/Dipyridamole" title="Dipyridamole">Dipyridamole</a> can be added to aspirin therapy to provide a small additional benefit, even though headache is a common side effect.<a href="#cite_note-ESPRIT-129">[129]</a> Low-dose aspirin is also effective for stroke prevention after having a myocardial infarction.<a href="#cite_note-BMJ2002-90">[90]</a> Those with <a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a> have a 5% a year risk of stroke, and those with valvular atrial fibrillation have an even higher risk.<a href="#cite_note-AFIB-130">[130]</a> Depending on the stroke risk, anticoagulation with medications such as <a href="/wiki/Warfarin" title="Warfarin">warfarin</a> or aspirin is useful for prevention with various levels of <a href="/wiki/Comparative_effectiveness_research" title="Comparative effectiveness research">comparative effectiveness</a> depending on the type of treatment used.<a href="#cite_note-AFib-guidelines-131">[131]</a><a href="#cite_note-:1-132">[132]</a> <a href="/wiki/Oral_anticoagulants" class="mw-redirect" title="Oral anticoagulants">Oral anticoagulants</a>, especially Xa (<a href="/wiki/Apixaban" title="Apixaban">apixaban</a>) and thrombin (<a href="/wiki/Dabigatran" title="Dabigatran">dabigatran</a>) inhibitors, have been shown to be superior to warfarin in stroke reduction and have a lower or similar bleeding risk in patients with atrial fibrillation.<a href="#cite_note-:1-132">[132]</a> Except in people with atrial fibrillation, <a href="/wiki/Oral_anticoagulants" class="mw-redirect" title="Oral anticoagulants">oral anticoagulants</a> are not advised for stroke prevention—any benefit is offset by bleeding risk.<a href="#cite_note-pmid17239798-133">[133]</a> In primary prevention, however, antiplatelet drugs did not reduce the risk of ischemic stroke but increased the risk of major bleeding.<a href="#cite_note-aspirin-134">[134]</a><a href="#cite_note-aspirin-meta-135">[135]</a> Further studies are needed to investigate a possible protective effect of aspirin against ischemic stroke in women.<a href="#cite_note-aspirin-women-136">[136]</a><a href="#cite_note-gender-137">[137]</a> <div class="mw-heading mw-heading4"><h4 id="Surgery">Surgery</h4></div> <a href="/wiki/Carotid_endarterectomy" title="Carotid endarterectomy">Carotid endarterectomy</a> or carotid <a href="/wiki/Angioplasty" title="Angioplasty">angioplasty</a> can be used to remove atherosclerotic narrowing of the <a href="/wiki/Carotid_artery" title="Carotid artery">carotid artery</a>. There is evidence supporting this procedure in selected cases.<a href="#cite_note-endart-review-109">[109]</a> Endarterectomy for a significant stenosis has been shown to be useful in preventing further stroke in those who have already had the condition.<a href="#cite_note-pmid12531577-138">[138]</a> Carotid artery stenting has not been shown to be equally useful.<a href="#cite_note-endarterectomy-meta-139">[139]</a><a href="#cite_note-140">[140]</a> People are selected for surgery based on age, gender, degree of stenosis, time since symptoms and the person's preferences.<a href="#cite_note-endart-review-109">[109]</a> Surgery is most efficient when not delayed too long—the risk of recurrent stroke in a person who has a 50% or greater stenosis is up to 20% after 5 years, but endarterectomy reduces this risk to around 5%. The number of procedures needed to cure one person was 5 for early surgery (within two weeks after the initial stroke), but 125 if delayed longer than 12 weeks.<a href="#cite_note-pmid15043958-141">[141]</a><a href="#cite_note-pmid16087900-142">[142]</a> <a href="/wiki/Screening_(medicine)" title="Screening (medicine)">Screening</a> for carotid artery narrowing has not been shown to be a useful test in the general population.<a href="#cite_note-USPSTF-carotidUS-143">[143]</a> Studies of surgical intervention for carotid artery stenosis without symptoms have shown only a small decrease in the risk of stroke.<a href="#cite_note-pmid15135594-144">[144]</a><a href="#cite_note-pmid16235289-145">[145]</a> To be beneficial, the complication rate of the surgery should be kept below 4%. Even then, for 100 surgeries, 5 people will benefit by avoiding stroke, 3 will develop stroke despite surgery, 3 will develop stroke or die due to the surgery itself, and 89 will remain stroke-free but would also have done so without intervention.<a href="#cite_note-endart-review-109">[109]</a> <div class="mw-heading mw-heading4"><h4 id="Diet">Diet</h4></div> Nutrition, specifically the <a href="/wiki/Mediterranean_diet" title="Mediterranean diet">Mediterranean-style diet</a>, has the potential to decrease the risk of having a stroke by more than half.<a href="#cite_note-strokenutrition-146">[146]</a> It does not appear that lowering levels of <a href="/wiki/Homocysteine" title="Homocysteine">homocysteine</a> with <a href="/wiki/Folic_acid" class="mw-redirect" title="Folic acid">folic acid</a> affects the risk of stroke.<a href="#cite_note-147">[147]</a><a href="#cite_note-148">[148]</a> <figure class="mw-default-size" typeof="mw:File/Thumb"><video id="mwe_player_0" poster="//upload.wikimedia.org/wikipedia/commons/thumb/f/f7/CDC_video_about_stroke_2.ogv/220px--CDC_video_about_stroke_2.ogv.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="220" height="124" data-durationhint="24" data-mwtitle="CDC_video_about_stroke_2.ogv" data-mwprovider="wikimediacommons" resource="/wiki/File:CDC_video_about_stroke_2.ogv"><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/f/f7/CDC_video_about_stroke_2.ogv/CDC_video_about_stroke_2.ogv.480p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="480p.vp9.webm" data-width="854" data-height="480" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/f/f7/CDC_video_about_stroke_2.ogv/CDC_video_about_stroke_2.ogv.720p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="720p.vp9.webm" data-width="1280" data-height="720" /><source src="//upload.wikimedia.org/wikipedia/commons/f/f7/CDC_video_about_stroke_2.ogv" type="video/ogg; codecs="theora"" data-width="1280" data-height="720" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/f/f7/CDC_video_about_stroke_2.ogv/CDC_video_about_stroke_2.ogv.144p.mjpeg.mov" type="video/quicktime" data-transcodekey="144p.mjpeg.mov" data-width="256" data-height="144" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/f/f7/CDC_video_about_stroke_2.ogv/CDC_video_about_stroke_2.ogv.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="426" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/f/f7/CDC_video_about_stroke_2.ogv/CDC_video_about_stroke_2.ogv.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="640" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/f/f7/CDC_video_about_stroke_2.ogv/CDC_video_about_stroke_2.ogv.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="640" data-height="360" /></video><figcaption>A <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> public service announcement about a woman who had stroke after pregnancy</figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Women">Women</h3></div> A number of specific recommendations have been made for women including taking aspirin after the 11th week of pregnancy if there is a history of previous chronic high blood pressure and taking blood pressure medications during pregnancy if the blood pressure is greater than 150 mmHg systolic or greater than 100 mmHg diastolic. In those who have previously had <a href="/wiki/Preeclampsia" class="mw-redirect" title="Preeclampsia">preeclampsia</a>, other risk factors should be treated more aggressively.<a href="#cite_note-Bush2014-149">[149]</a> <div class="mw-heading mw-heading3"><h3 id="Previous_stroke_or_TIA">Previous stroke or TIA</h3></div> Keeping blood pressure below 140/90 mmHg is recommended.<a href="#cite_note-AHA2014-150">[150]</a> Anticoagulation can prevent recurrent ischemic stroke. Among people with nonvalvular atrial fibrillation, anticoagulation can reduce stroke by 60% while antiplatelet agents can reduce stroke by 20%.<a href="#cite_note-pmid17577005-151">[151]</a> However, a recent meta-analysis suggests harm from anticoagulation started early after an embolic stroke.<a href="#cite_note-pmid17204681-152">[152]</a><a href="#cite_note-153">[153]</a> Stroke prevention treatment for atrial fibrillation is determined according to the <a href="/wiki/CHA2DS2%E2%80%93VASc_score" title="CHA2DS2–VASc score">CHA2DS2–VASc score</a>. The most widely used anticoagulant to prevent thromboembolic stroke in people with nonvalvular atrial fibrillation is the oral agent <a href="/wiki/Warfarin" title="Warfarin">warfarin</a> while a number of newer agents including <a href="/wiki/Dabigatran" title="Dabigatran">dabigatran</a> are alternatives which do not require <a href="/wiki/Prothrombin_time" title="Prothrombin time">prothrombin time</a> monitoring.<a href="#cite_note-AHA2014-150">[150]</a> Anticoagulants, when used following stroke, should not be stopped for dental procedures.<a href="#cite_note-154">[154]</a> If studies show carotid artery stenosis, and the person has a degree of residual function on the affected side, carotid endarterectomy (surgical removal of the stenosis) may decrease the risk of recurrence if performed rapidly after stroke. <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2></div> Stroke, whether ischemic or hemorrhagic, is an emergency that warrants immediate medical attention.<a href="#cite_note-HLB2014W-5">[5]</a><a href="#cite_note-HLB2023T-155">[155]</a> The specific treatment will depend on the type of stroke, the time elapsed since the onset of symptoms, and the underlying cause or presence of <a href="/wiki/Comorbidity" title="Comorbidity">comorbidities</a>.<a href="#cite_note-HLB2023T-155">[155]</a> <div class="mw-heading mw-heading3"><h3 id="Ischemic_stroke">Ischemic stroke</h3></div> <a href="/wiki/Aspirin" title="Aspirin">Aspirin</a> reduces the overall risk of recurrence by 13% with greater benefit early on.<a href="#cite_note-156">[156]</a> Definitive therapy within the first few hours is aimed at removing the blockage by breaking the clot down (<a href="/wiki/Thrombolysis" title="Thrombolysis">thrombolysis</a>), or by removing it mechanically (<a href="/wiki/Thrombectomy" title="Thrombectomy">thrombectomy</a>). The philosophical premise underlying the importance of rapid stroke intervention was summed up as Time is Brain! in the early 1990s.<a href="#cite_note-157">[157]</a> Years later, that same idea, that rapid cerebral blood flow restoration results in fewer brain cells dying, has been proved and quantified.<a href="#cite_note-158">[158]</a> Tight blood sugar control in the first few hours does not improve outcomes and may cause harm.<a href="#cite_note-159">[159]</a> High blood pressure is also not typically lowered as this has not been found to be helpful.<a href="#cite_note-160">[160]</a><a href="#cite_note-161">[161]</a> <a href="/wiki/Cerebrolysin" title="Cerebrolysin">Cerebrolysin</a>, a mixture of pig brain-derived <a href="/wiki/Neurotrophic_factors" title="Neurotrophic factors">neurotrophic factors</a> used widely to treat acute ischemic stroke in China, Eastern Europe, Russia, post-Soviet countries, and other Asian countries, does not improve outcomes or prevent death and may increase the risk of severe adverse events.<a href="#cite_note-:0-162">[162]</a> There is also no evidence that cerebrolysin‐like peptide mixtures which are extracted from cattle brain is helpful in treating acute ischemic stroke.<a href="#cite_note-:0-162">[162]</a> <div class="mw-heading mw-heading4"><h4 id="Thrombolysis">Thrombolysis</h4></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><video id="mwe_player_1" poster="//upload.wikimedia.org/wikipedia/commons/thumb/7/7d/CDC_video_about_stroke_emergency_treatment.ogv/220px--CDC_video_about_stroke_emergency_treatment.ogv.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="220" height="116" data-durationhint="32" data-mwtitle="CDC_video_about_stroke_emergency_treatment.ogv" data-mwprovider="wikimediacommons" resource="/wiki/File:CDC_video_about_stroke_emergency_treatment.ogv"><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/7/7d/CDC_video_about_stroke_emergency_treatment.ogv/CDC_video_about_stroke_emergency_treatment.ogv.480p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="480p.vp9.webm" data-width="854" data-height="448" /><source src="//upload.wikimedia.org/wikipedia/commons/7/7d/CDC_video_about_stroke_emergency_treatment.ogv" type="video/ogg; codecs="theora"" data-width="1200" data-height="630" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/7/7d/CDC_video_about_stroke_emergency_treatment.ogv/CDC_video_about_stroke_emergency_treatment.ogv.144p.mjpeg.mov" type="video/quicktime" data-transcodekey="144p.mjpeg.mov" data-width="256" data-height="134" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/7/7d/CDC_video_about_stroke_emergency_treatment.ogv/CDC_video_about_stroke_emergency_treatment.ogv.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="426" data-height="224" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/7/7d/CDC_video_about_stroke_emergency_treatment.ogv/CDC_video_about_stroke_emergency_treatment.ogv.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="640" data-height="336" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/7/7d/CDC_video_about_stroke_emergency_treatment.ogv/CDC_video_about_stroke_emergency_treatment.ogv.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="640" data-height="336" /></video><figcaption>A <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> public service announcement on emergency medical treatment after or during stroke from 2021</figcaption></figure> <a href="/wiki/Thrombolysis" title="Thrombolysis">Thrombolysis</a>, such as with <a href="/wiki/Recombinant_tissue_plasminogen_activator" class="mw-redirect" title="Recombinant tissue plasminogen activator">recombinant tissue plasminogen activator</a> (rtPA), in acute ischemic stroke, when given within three hours of symptom onset, results in an overall benefit of 10% with respect to living without disability.<a href="#cite_note-Ward2014-163">[163]</a><a href="#cite_note-Lancet2014-164">[164]</a> It does not, however, improve chances of survival.<a href="#cite_note-Ward2014-163">[163]</a> Benefit is greater the earlier it is used.<a href="#cite_note-Ward2014-163">[163]</a> Between three and four and a half hours the effects are less clear.<a href="#cite_note-Dyna2014-165">[165]</a><a href="#cite_note-166">[166]</a><a href="#cite_note-167">[167]</a> The AHA/ASA recommend it for certain people in this time frame.<a href="#cite_note-168">[168]</a> A 2014 review found a 5% increase in the number of people living without disability at three to six months; however, there was a 2% increased risk of death in the short term.<a href="#cite_note-Lancet2014-164">[164]</a> After four and a half hours thrombolysis worsens outcomes.<a href="#cite_note-Dyna2014-165">[165]</a> These benefits or lack of benefits occurred regardless of the age of the person treated.<a href="#cite_note-Lancet2012-169">[169]</a> There is no reliable way to determine who will have an intracranial bleed post-treatment versus who will not.<a href="#cite_note-170">[170]</a> In those with findings of savable tissue on medical imaging between 4.5 hours and 9 hours or who wake up with stroke, <a href="/wiki/Alteplase" title="Alteplase">alteplase</a> results in some benefit.<a href="#cite_note-171">[171]</a> Its use is endorsed by the <a href="/wiki/American_Heart_Association" title="American Heart Association">American Heart Association</a>, the <a href="/wiki/American_College_of_Emergency_Physicians" title="American College of Emergency Physicians">American College of Emergency Physicians</a> and the <a href="/wiki/American_Academy_of_Neurology" title="American Academy of Neurology">American Academy of Neurology</a> as the recommended treatment for acute stroke within three hours of onset of symptoms as long as there are no other contraindications (such as abnormal lab values, high blood pressure, or recent surgery). This position for tPA is based upon the findings of two studies by one group of investigators<a href="#cite_note-172">[172]</a> which showed that tPA improves the chances for a good neurological outcome. When administered within the first three hours thrombolysis improves functional outcome without affecting mortality.<a href="#cite_note-173">[173]</a> 6.4% of people with large stroke developed substantial brain bleeding as a complication from being given tPA thus part of the reason for increased short term mortality.<a href="#cite_note-Dubinsky06-174">[174]</a> The <a href="/wiki/American_Academy_of_Emergency_Medicine" title="American Academy of Emergency Medicine">American Academy of Emergency Medicine</a> had previously stated that objective evidence regarding the applicability of tPA for acute ischemic stroke was insufficient.<a href="#cite_note-175">[175]</a> In 2013 the American College of Emergency Medicine refuted this position,<a href="#cite_note-176">[176]</a> acknowledging the body of evidence for the use of tPA in ischemic stroke;<a href="#cite_note-177">[177]</a> but debate continues.<a href="#cite_note-178">[178]</a><a href="#cite_note-179">[179]</a> <a href="/wiki/Intra-arterial_fibrinolysis" class="mw-redirect" title="Intra-arterial fibrinolysis">Intra-arterial fibrinolysis</a>, where a catheter is passed up an artery into the brain and the medication is injected at the site of thrombosis, has been found to improve outcomes in people with acute ischemic stroke.<a href="#cite_note-180">[180]</a> <div class="mw-heading mw-heading4"><h4 id="Endovascular_treatment">Endovascular treatment</h4></div> Mechanical removal of the blood clot causing the ischemic stroke, called <a href="/wiki/Thrombectomy" title="Thrombectomy">mechanical thrombectomy</a>, is a potential treatment for occlusion of a large artery, such as the <a href="/wiki/Middle_cerebral_artery" title="Middle cerebral artery">middle cerebral artery</a>. In 2015, one review demonstrated the safety and efficacy of this procedure if performed within 12 hours of the onset of symptoms.<a href="#cite_note-181">[181]</a><a href="#cite_note-182">[182]</a> It did not change the risk of death but did reduce disability compared to the use of intravenous thrombolysis, which is generally used in people evaluated for mechanical thrombectomy.<a href="#cite_note-183">[183]</a><a href="#cite_note-184">[184]</a> Certain cases may benefit from thrombectomy up to 24 hours after the onset of symptoms.<a href="#cite_note-185">[185]</a> <div class="mw-heading mw-heading4"><h4 id="Craniectomy">Craniectomy</h4></div> Stroke affecting large portions of the brain can cause significant brain swelling with secondary brain injury in surrounding tissue. This phenomenon is mainly encountered in stroke affecting brain tissue dependent upon the middle cerebral artery for blood supply and is also called "malignant cerebral infarction" because it carries a dismal prognosis. Relief of the pressure may be attempted with medication, but some require <a href="/wiki/Hemicraniectomy" class="mw-redirect" title="Hemicraniectomy">hemicraniectomy</a>, the temporary surgical removal of the skull on one side of the head. This decreases the risk of death, although some people – who would otherwise have died – survive with disability.<a href="#cite_note-pmid21190097-186">[186]</a><a href="#cite_note-187">[187]</a> <div class="mw-heading mw-heading3"><h3 id="Hemorrhagic_stroke">Hemorrhagic stroke</h3></div> People with <a href="/wiki/Intracerebral_hemorrhage" title="Intracerebral hemorrhage">intracerebral hemorrhage</a> require supportive care, including blood pressure control if required. People are monitored for changes in the level of consciousness, and their blood sugar and oxygenation are kept at optimum levels. Anticoagulants and antithrombotics can make bleeding worse and are generally discontinued (and reversed if possible).[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] A proportion may benefit from <a href="/wiki/Neurosurgery" title="Neurosurgery">neurosurgical</a> intervention to remove the blood and treat the underlying cause, but this depends on the location and the size of the hemorrhage as well as patient-related factors, and ongoing research is being conducted into the question as to which people with intracerebral hemorrhage may benefit.<a href="#cite_note-188">[188]</a> In <a href="/wiki/Subarachnoid_hemorrhage" title="Subarachnoid hemorrhage">subarachnoid hemorrhage</a>, early treatment for underlying cerebral aneurysms may reduce the risk of further hemorrhages. Depending on the site of the aneurysm this may be by <a href="/wiki/Craniotomy" title="Craniotomy">surgery that involves opening the skull</a> or <a href="/wiki/Interventional_neuroradiology" title="Interventional neuroradiology">endovascularly</a> (through the blood vessels).<a href="#cite_note-189">[189]</a> <div class="mw-heading mw-heading3"><h3 id="Stroke_unit">Stroke unit</h3></div> Ideally, people who have had stroke are admitted to a "stroke unit", a ward or dedicated area in a hospital staffed by nurses and therapists with experience in stroke treatment. It has been shown that people admitted to stroke units have a higher chance of surviving than those admitted elsewhere in hospital, even if they are being cared for by doctors without experience in stroke.<a href="#cite_note-Donnan2008-2">[2]</a><a href="#cite_note-190">[190]</a> <a href="/wiki/Nursing_care" class="mw-redirect" title="Nursing care">Nursing care</a> is fundamental in maintaining <a href="/wiki/Skin" title="Skin">skin care</a>, feeding, hydration, positioning, and monitoring <a href="/wiki/Vital_signs" title="Vital signs">vital signs</a> such as temperature, pulse, and blood pressure.<a href="#cite_note-191">[191]</a> <div class="mw-heading mw-heading2"><h2 id="Rehabilitation">Rehabilitation</h2></div> <a href="/wiki/Stroke_rehabilitation" class="mw-redirect" title="Stroke rehabilitation">Stroke rehabilitation</a> is the process by which those with disabling stroke undergo treatment to help them return to normal life as much as possible by regaining and relearning the skills of everyday living. It also aims to help the survivor understand and adapt to difficulties, prevent secondary complications, and educate family members to play a supporting role. Stroke rehabilitation should begin almost immediately with a multidisciplinary approach. The rehabilitation team may involve physicians trained in rehabilitation medicine, <a href="/wiki/Neurologist" class="mw-redirect" title="Neurologist">neurologists</a>, <a href="/wiki/Clinical_pharmacist" class="mw-redirect" title="Clinical pharmacist">clinical pharmacists</a>, nursing staff, <a href="/wiki/Physiotherapist" class="mw-redirect" title="Physiotherapist">physiotherapists</a>, <a href="/wiki/Occupational_therapist" title="Occupational therapist">occupational therapists</a>, <a href="/wiki/Speech-language_pathology" class="mw-redirect" title="Speech-language pathology">speech-language pathologists</a>, and <a href="/wiki/Orthotist" title="Orthotist">orthotists</a>. Some teams may also include <a href="/wiki/Psychologists" class="mw-redirect" title="Psychologists">psychologists</a> and <a href="/wiki/Social_work" title="Social work">social workers</a>, since at least one-third of affected people manifests <a href="/wiki/Post_stroke_depression" class="mw-redirect" title="Post stroke depression">post stroke depression</a>. Validated instruments such as the <a href="/wiki/Barthel_scale" title="Barthel scale">Barthel scale</a> may be used to assess the likelihood of a person who has had stroke being able to manage at home with or without support subsequent to discharge from a hospital.<a href="#cite_note-192">[192]</a> <a href="/wiki/Stroke_rehabilitation" class="mw-redirect" title="Stroke rehabilitation">Stroke rehabilitation</a> should be started as quickly as possible and can last anywhere from a few days to over a year. Most return of function is seen in the first few months, and then improvement falls off with the "window" considered officially by <a href="/wiki/U.S._state" title="U.S. state">U.S. state</a> rehabilitation units and others to be closed after six months, with little chance of further improvement.[<a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)">medical citation needed</a>] However, some people have reported that they continue to improve for years, regaining and strengthening abilities like writing, walking, running, and talking.[<a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)">medical citation needed</a>] Daily rehabilitation exercises should continue to be part of the daily routine for people who have had stroke. Complete recovery is unusual but not impossible and most people will improve to some extent: proper diet and exercise are known to help the brain to recover. <div class="mw-heading mw-heading3"><h3 id="Spatial_neglect">Spatial neglect</h3></div> The body of evidence is uncertain on the efficacy of cognitive rehabilitation for reducing the disabling effects of neglect and increasing independence remains unproven.<a href="#cite_note-Longley_Hazelton_Heal_et_al_2021-193">[193]</a> However, there is limited evidence that cognitive rehabilitation may have an immediate beneficial effect on tests of neglect.<a href="#cite_note-Longley_Hazelton_Heal_et_al_2021-193">[193]</a> Overall, no rehabilitation approach can be supported by evidence for spatial neglect. <div class="mw-heading mw-heading3"><h3 id="Automobile_driving">Automobile driving</h3></div> The body of evidence is uncertain whether the use of rehabilitation can improve on-road driving skills following stroke.<a href="#cite_note-George-2014-194">[194]</a> There is limited evidence that training on a driving simulator will improve performance on recognizing road signs after training.<a href="#cite_note-George-2014-194">[194]</a> The findings are based on low-quality evidence as further research is needed involving large numbers of participants. <div class="mw-heading mw-heading3"><h3 id="Yoga">Yoga</h3></div> Based on low quality evidence, it is uncertain whether yoga has a significant benefit for stroke rehabilitation on measures of quality of life, balance, strength, endurance, pain, and disability scores.<a href="#cite_note-Lawrence-2017-195">[195]</a> Yoga may reduce anxiety and could be included as part of patient-centred stroke rehabilitation.<a href="#cite_note-Lawrence-2017-195">[195]</a> Further research is needed assessing the benefits and safety of yoga in stroke rehabilitation. <div class="mw-heading mw-heading3"><h3 id="Action_observation_physical_therapy_for_upper_limbs">Action observation physical therapy for upper limbs</h3></div> Low-quality evidence suggests that action observation (a type of physiotherapy that is meant to improve neural plasticity through the mirror-neuronal system) may be of some benefit and has no significant adverse effects, however this benefit may not be clinically significant and further research is suggested.<a href="#cite_note-196">[196]</a> <div class="mw-heading mw-heading3"><h3 id="Cognitive_rehabilitation_for_attention_deficits">Cognitive rehabilitation for attention deficits</h3></div> The body of scientific evidence is uncertain on the effectiveness of cognitive rehabilitation for attention deficits in patients following stroke.<a href="#cite_note-Loetscher-2019-197">[197]</a> While there may be an immediate effect after treatment on attention, the findings are based on low to moderate quality and small number of studies.<a href="#cite_note-Loetscher-2019-197">[197]</a> Further research is needed to assess whether the effect can be sustained in day-to-day tasks requiring attention. <div class="mw-heading mw-heading3"><h3 id="Motor_imagery_for_gait_rehabilitation">Motor imagery for gait rehabilitation</h3></div> The latest evidence supports the short-term benefits of motor imagery (MI) on walking speed in individuals who have had stroke, in comparison to other therapies.<a href="#cite_note-Silva-2020-198">[198]</a> MI does not improve motor function after stroke and does not seem to cause significant adverse events.<a href="#cite_note-Silva-2020-198">[198]</a> The findings are based on low-quality evidence as further research is needed to estimate the effect of MI on walking endurance and the dependence on personal assistance. <div class="mw-heading mw-heading3"><h3 id="Physical_and_occupational_therapy">Physical and occupational therapy</h3></div> Physical and occupational therapy have overlapping areas of expertise; however, physical therapy focuses on joint range of motion and strength by performing exercises and relearning functional tasks such as bed mobility, transferring, walking and other gross motor functions. Physiotherapists can also work with people who have had stroke to improve awareness and use of the <a href="/wiki/Hemiplegic" class="mw-redirect" title="Hemiplegic">hemiplegic</a> side. Rehabilitation involves working on the ability to produce strong movements or the ability to perform tasks using normal patterns. Emphasis is often concentrated on functional tasks and people's goals. One example physiotherapists employ to promote <a href="/wiki/Motor_learning" title="Motor learning">motor learning</a> involves <a href="/wiki/Constraint-induced_movement_therapy" title="Constraint-induced movement therapy">constraint-induced movement therapy</a>. Through continuous practice the person relearns to use and adapt the hemiplegic limb during functional activities to create lasting permanent changes.<a href="#cite_note-199">[199]</a> Physical therapy is effective for recovery of function and mobility after stroke.<a href="#cite_note-CD001920-200">[200]</a> Occupational therapy is involved in training to help relearn everyday activities known as the <a href="/wiki/Activities_of_daily_living" title="Activities of daily living">activities of daily living</a> (ADLs) such as eating, drinking, dressing, bathing, cooking, <a href="/wiki/Alexia_(condition)" class="mw-redirect" title="Alexia (condition)">reading</a> and <a href="/wiki/Agraphia" title="Agraphia">writing</a>, and toileting. Approaches to helping people with urinary incontinence include physical therapy, cognitive therapy, and specialized interventions with experienced medical professionals, however, it is not clear how effective these approaches are at improving urinary incontinence following stroke.<a href="#cite_note-Thomas-2019-201">[201]</a> Treatment of spasticity related to stroke often involves early mobilizations, commonly performed by a physiotherapist, combined with elongation of spastic muscles and sustained stretching through different positions.<a href="#cite_note-OSul07_719-45">[45]</a> Gaining initial improvement in range of motion is often achieved through rhythmic rotational patterns associated with the affected limb.<a href="#cite_note-OSul07_719-45">[45]</a> After full range has been achieved by the therapist, the limb should be positioned in the lengthened positions to prevent against further contractures, skin breakdown, and disuse of the limb with the use of splints or other tools to stabilize the joint.<a href="#cite_note-OSul07_719-45">[45]</a> Cold ice wraps or ice packs may briefly relieve spasticity by temporarily reducing neural firing rates.<a href="#cite_note-OSul07_719-45">[45]</a> <a href="/wiki/Sensory_stimulation_therapy#Coactivation" title="Sensory stimulation therapy">Electrical stimulation</a> to the antagonist muscles or vibrations has also been used with some success.<a href="#cite_note-OSul07_719-45">[45]</a> Physical therapy is sometimes suggested for people who experience sexual dysfunction following stroke.<a href="#cite_note-Stratton-2020-202">[202]</a> <div class="mw-heading mw-heading4"><h4 id="Interventions_for_age-related_visual_problems_in_patients_with_stroke">Interventions for age-related visual problems in patients with stroke</h4></div> With the prevalence of vision problems increasing with age in stroke patients, the overall effect of interventions for age-related visual problems is uncertain. It is also not sure whether people with stroke respond differently from the general population when treating eye problems.<a href="#cite_note-203">[203]</a> Further research in this area is needed as the body of evidence is very low quality. <div class="mw-heading mw-heading3"><h3 id="Speech_and_language_therapy">Speech and language therapy</h3></div> <a href="/wiki/Speech_and_language_therapy" class="mw-redirect" title="Speech and language therapy">Speech and language therapy</a> is appropriate for people with the speech production disorders: <a href="/wiki/Dysarthria" title="Dysarthria">dysarthria</a><a href="#cite_note-Mackenzie_2011-204">[204]</a> and <a href="/wiki/Apraxia_of_speech" title="Apraxia of speech">apraxia of speech</a>,<a href="#cite_note-West_2005-205">[205]</a> <a href="/wiki/Aphasia" title="Aphasia">aphasia</a>,<a href="#cite_note-Brady2016-206">[206]</a> cognitive-communication impairments, and <a href="/wiki/Dysphagia" title="Dysphagia">problems with swallowing</a>. Speech and language therapy for aphasia following stroke improves functional communication, reading, writing and expressive language. Speech and language therapy that is higher intensity, higher dose or provided over a long duration of time leads to significantly better functional communication but people might be more likely to drop out of high intensity treatment (up to 15 hours per week).<a href="#cite_note-Brady2016-206">[206]</a> A total of 20–50 hours of speech and language therapy is necessary for the best recovery. The most improvement happens when 2–5 hours of therapy is provided each week over 4–5 days. Recovery is further improved when besides the therapy people practice tasks at home.<a href="#cite_note-Brady-2022a-207">[207]</a><a href="#cite_note-NIHR-2023a-208">[208]</a> Speech and language therapy is also effective if it is <a href="/wiki/Telerehabilitation" title="Telerehabilitation">delivered online through video</a> or by a family member who has been trained by a professional therapist.<a href="#cite_note-Brady-2022a-207">[207]</a><a href="#cite_note-NIHR-2023a-208">[208]</a> Recovery with therapy for aphasia is also dependent on the recency of stroke and the age of the person. Receiving therapy within a month after the stroke leads to the greatest improvements. 3 or 6 months after the stroke more therapy will be needed but symptoms can still be improved. People with aphasia who are younger than 55 years are the most likely to improve but people older than 75 years can still get better with therapy.<a href="#cite_note-Brady-2022a-207">[207]</a><a href="#cite_note-NIHR-2023a-208">[208]</a> People who have had stroke may have particular problems, such as <a href="/wiki/Dysphagia" title="Dysphagia">dysphagia</a>, which can cause swallowed material to pass into the lungs and cause <a href="/wiki/Aspiration_pneumonia" title="Aspiration pneumonia">aspiration pneumonia</a>. The condition may improve with time, but in the interim, a <a href="/wiki/Nasogastric_intubation" class="mw-redirect" title="Nasogastric intubation">nasogastric tube</a> may be inserted, enabling liquid food to be given directly into the stomach. If swallowing is still deemed unsafe, then a <a href="/wiki/Percutaneous_endoscopic_gastrostomy" title="Percutaneous endoscopic gastrostomy">percutaneous endoscopic gastrostomy</a> (PEG) tube is passed and this can remain indefinitely. Swallowing therapy has mixed results as of 2018.<a href="#cite_note-209">[209]</a> <div class="mw-heading mw-heading3"><h3 id="Devices">Devices</h3></div> Often, <a href="/wiki/Assistive_technology" title="Assistive technology">assistive technology</a> such as <a href="/wiki/Wheelchairs" class="mw-redirect" title="Wheelchairs">wheelchairs</a>, walkers and canes may be beneficial. Many mobility problems can be improved by the use of <a href="/wiki/Orthotics" title="Orthotics">ankle foot orthoses</a>.<a href="#cite_note-210">[210]</a> <div class="mw-heading mw-heading3"><h3 id="Physical_fitness">Physical fitness</h3></div> Stroke can also reduce people's general fitness.<a href="#cite_note-Saunders-2020-211">[211]</a> Reduced fitness can reduce capacity for rehabilitation as well as general health.<a href="#cite_note-IQWiG-Fitness-212">[212]</a> Physical exercises as part of a rehabilitation program following stroke appear safe.<a href="#cite_note-Saunders-2020-211">[211]</a> Cardiorespiratory fitness training that involves walking in rehabilitation can improve speed, tolerance and independence during walking, and may improve balance.<a href="#cite_note-Saunders-2020-211">[211]</a> There are inadequate long-term data about the effects of exercise and training on death, dependence and disability after stroke.<a href="#cite_note-Saunders-2020-211">[211]</a> The future areas of research may concentrate on the optimal exercise prescription and long-term health benefits of exercise. The effect of physical training on cognition also may be studied further. The ability to walk independently in their community, indoors or outdoors, is important following stroke. Although no negative effects have been reported, it is unclear if outcomes can improve with these walking programs when compared to usual treatment.<a href="#cite_note-213">[213]</a> <div class="mw-heading mw-heading3"><h3 id="Other_therapy_methods">Other therapy methods</h3></div> Some current and future therapy methods include the use of <a href="/wiki/Virtual_reality" title="Virtual reality">virtual reality</a> and video games for rehabilitation. These forms of rehabilitation offer potential for motivating people to perform specific therapy tasks that many other forms do not.<a href="#cite_note-Lange-214">[214]</a> While virtual reality and interactive video gaming are not more effective than conventional therapy for improving upper limb function, when used in conjunction with usual care these approaches may improve upper limb function and ADL function.<a href="#cite_note-Laver-2017-215">[215]</a> There are inadequate data on the effect of virtual reality and interactive video gaming on gait speed, balance, participation and quality of life.<a href="#cite_note-Laver-2017-215">[215]</a> Many clinics and hospitals are adopting the use of these off-the-shelf devices for exercise, social interaction, and rehabilitation because they are affordable, accessible and can be used within the clinic and home.<a href="#cite_note-Lange-214">[214]</a> <a href="/wiki/Mirror_therapy" title="Mirror therapy">Mirror therapy</a> is associated with improved motor function of the upper extremity in people who have had stroke.<a href="#cite_note-216">[216]</a> Other non-invasive rehabilitation methods used to augment physical therapy of motor function in people recovering from stroke include <a href="/wiki/Transcranial_magnetic_stimulation" title="Transcranial magnetic stimulation">transcranial magnetic stimulation</a> and <a href="/wiki/Transcranial_direct-current_stimulation" title="Transcranial direct-current stimulation">transcranial direct-current stimulation</a>.<a href="#cite_note-217">[217]</a> and <a href="/wiki/Rehabilitation_robotics" title="Rehabilitation robotics">robotic therapies</a>.<a href="#cite_note-218">[218]</a> Constraint‐induced movement therapy (CIMT), mental practice, mirror therapy, interventions for sensory impairment, virtual reality and a relatively high dose of repetitive task practice may be effective in improving upper limb function. However, further primary research, specifically of CIMT, mental practice, mirror therapy and virtual reality is needed.<a href="#cite_note-219">[219]</a> <div class="mw-heading mw-heading3"><h3 id="Orthotics">Orthotics</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Gehen_mit_Orthese_nach_Schlaganfall_220.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/4/4c/Gehen_mit_Orthese_nach_Schlaganfall_220.jpg" decoding="async" width="220" height="459" class="mw-file-element" data-file-width="220" data-file-height="459" /></a><figcaption>Walking with an <a href="/wiki/Orthotics#Stroke" title="Orthotics">orthosis after stroke</a></figcaption></figure> Clinical studies confirm the importance of <a href="/wiki/Orthotics" title="Orthotics">orthoses</a> in stroke rehabilitation.<a href="#cite_note-220">[220]</a><a href="#cite_note-221">[221]</a><a href="#cite_note-222">[222]</a> The orthosis supports the therapeutic applications and also helps to mobilize the patient at an early stage. With the help of an orthosis, physiological standing and walking can be learned again, and late health consequences caused by a wrong gait pattern can be prevented. A treatment with an orthosis can therefore be used to support the therapy. <div class="mw-heading mw-heading3"><h3 id="Self-management">Self-management</h3></div> Stroke can affect the ability to live independently and with quality. Self-management programs are a special training that educates stroke survivors about stroke and its consequences, helps them acquire skills to cope with their challenges, and helps them set and meet their own goals during their recovery process. These programs are tailored to the target audience, and led by someone trained and expert in stroke and its consequences (most commonly professionals, but also stroke survivors and peers). A 2016 review reported that these programs improve the quality of life after stroke, without negative effects. People with stroke felt more empowered, happy and satisfied with life after participating in this training.<a href="#cite_note-Fryer-2016-223">[223]</a> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2></div> Disability affects 75% of stroke survivors enough to decrease their ability to work.<a href="#cite_note-Coffey2000-224">[224]</a> Stroke can affect people physically, mentally, emotionally, or a combination of the three. The results of stroke vary widely depending on size and location of the lesion.<a href="#cite_note-Stanford2005-225">[225]</a> <div class="mw-heading mw-heading3"><h3 id="Physical_effects">Physical effects</h3></div> Some of the physical disabilities that can result from stroke include muscle weakness, numbness, <a href="/wiki/Pressure_sore" class="mw-redirect" title="Pressure sore">pressure sores</a>, <a href="/wiki/Pneumonia" title="Pneumonia">pneumonia</a>, <a href="/wiki/Urinary_incontinence" title="Urinary incontinence">incontinence</a>, <a href="/wiki/Apraxia" title="Apraxia">apraxia</a> (inability to perform learned movements), difficulties carrying out <a href="/wiki/Activities_of_daily_living" title="Activities of daily living">daily activities</a>, appetite loss, <a href="/wiki/Aphasia" title="Aphasia">speech loss</a>, <a href="/wiki/Vision_loss" class="mw-redirect" title="Vision loss">vision loss</a> and <a href="/wiki/Pain" title="Pain">pain</a>. If the stroke is severe enough, or in a certain location such as parts of the brainstem, <a href="/wiki/Coma" title="Coma">coma</a> or death can result. Up to 10% of people following stroke develop <a href="/wiki/Seizure" title="Seizure">seizures</a>, most commonly in the week subsequent to the event; the severity of the stroke increases the likelihood of a seizure.<a href="#cite_note-Reith1997-226">[226]</a><a href="#cite_note-Burn1997-227">[227]</a> An estimated 15% of people experience urinary incontinence for more than a year following stroke.<a href="#cite_note-Thomas-2019-201">[201]</a> 50% of people have a decline in sexual function (<a href="/wiki/Sexual_dysfunction" title="Sexual dysfunction">sexual dysfunction</a>) following stroke.<a href="#cite_note-Stratton-2020-202">[202]</a> <div class="mw-heading mw-heading3"><h3 id="Emotional_and_mental_effects">Emotional and mental effects</h3></div> Emotional and mental dysfunctions correspond to areas in the brain that have been damaged. Emotional problems following stroke can be due to direct damage to emotional centers in the brain or from frustration and difficulty adapting to new limitations. Post-stroke emotional difficulties include <a href="/wiki/Anxiety" title="Anxiety">anxiety</a>, <a href="/wiki/Panic_attack" title="Panic attack">panic attacks</a>, <a href="/wiki/Flat_affect" class="mw-redirect" title="Flat affect">flat affect</a> (failure to express emotions), <a href="/wiki/Mania" title="Mania">mania</a>, <a href="/wiki/Apathy" title="Apathy">apathy</a> and <a href="/wiki/Psychosis" title="Psychosis">psychosis</a>. Other difficulties may include a decreased ability to communicate emotions through facial expression, body language and voice.<a href="#cite_note-228">[228]</a> Disruption in self-identity, relationships with others, and emotional well-being can lead to social consequences after stroke due to the lack of ability to communicate. Many people who experience communication impairments after stroke find it more difficult to cope with the social issues rather than physical impairments. Broader aspects of care must address the emotional impact speech impairment has on those who experience difficulties with speech after stroke.<a href="#cite_note-Mackenzie_2011-204">[204]</a> Those who experience a stroke are at risk of <a href="/wiki/Paralysis" title="Paralysis">paralysis</a>, which could result in a self-disturbed body image, which may also lead to other social issues.<a href="#cite_note-229">[229]</a> 30 to 50% of stroke survivors develop <a href="/wiki/Post-stroke_depression" title="Post-stroke depression">post-stroke depression</a>, which is characterized by lethargy, irritability, <a href="/wiki/Sleep_disorder" title="Sleep disorder">sleep disturbances</a>, lowered <a href="/wiki/Self-esteem" title="Self-esteem">self-esteem</a> and withdrawal.<a href="#cite_note-Senelick1994-230">[230]</a> It is most common in those with a stroke affecting the anterior parts of the brain or the <a href="/wiki/Basal_ganglia" title="Basal ganglia">basal ganglia</a>, particularly on the left side.<a href="#cite_note-231">[231]</a> <a href="/wiki/Clinical_depression" class="mw-redirect" title="Clinical depression">Depression</a> can reduce motivation and worsen outcome, but can be treated with social and family support, <a href="/wiki/Psychotherapy" title="Psychotherapy">psychotherapy</a> and, in severe cases, <a href="/wiki/Antidepressant" title="Antidepressant">antidepressants</a>. Psychotherapy sessions may have a small effect on improving mood and preventing depression after stroke.<a href="#cite_note-:2-232">[232]</a> Antidepressant medications may be useful for treating depression after stroke but are associated with central nervous system and gastrointestinal adverse events.<a href="#cite_note-:2-232">[232]</a> <a href="/wiki/Emotional_lability" title="Emotional lability">Emotional lability</a>, another consequence of stroke, causes the person to switch quickly between emotional highs and lows and to express emotions inappropriately, for instance with an excess of laughing or crying with little or no provocation. While these expressions of emotion usually correspond to the person's actual emotions, a more severe form of emotional lability causes the affected person to laugh and cry pathologically, without regard to context or emotion.<a href="#cite_note-Coffey2000-224">[224]</a> Some people show the opposite of what they feel, for example crying when they are happy.<a href="#cite_note-Villarosa1993-233">[233]</a> Emotional lability occurs in about 20% of those who have had stroke. Those with a right hemisphere stroke are more likely to have empathy problems which can make communication harder.<a href="#cite_note-234">[234]</a> Cognitive deficits resulting from stroke include perceptual disorders, <a href="/wiki/Aphasia" title="Aphasia">aphasia</a>,<a href="#cite_note-Hamilton_2011-235">[235]</a> <a href="/wiki/Dementia" title="Dementia">dementia</a>,<a href="#cite_note-Leys_2005-236">[236]</a><a href="#cite_note-237">[237]</a> and problems with attention<a href="#cite_note-Coulthard_2006-238">[238]</a> and memory.<a href="#cite_note-Lim_2009-239">[239]</a> Stroke survivors may be unaware of their own disabilities, a condition called <a href="/wiki/Anosognosia" title="Anosognosia">anosognosia</a>. In a condition called <a href="/wiki/Hemispatial_neglect" title="Hemispatial neglect">hemispatial neglect</a>, the affected person is unable to attend to anything on the side of space opposite to the damaged hemisphere. Cognitive and psychological outcome after stroke can be affected by the age at which the stroke happened, pre-stroke baseline intellectual functioning, psychiatric history and whether there is pre-existing brain pathology.<a href="#cite_note-240">[240]</a> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Stroke_world_map-Deaths_per_million_persons-WHO2012.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4e/Stroke_world_map-Deaths_per_million_persons-WHO2012.svg/220px-Stroke_world_map-Deaths_per_million_persons-WHO2012.svg.png" decoding="async" width="220" height="97" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4e/Stroke_world_map-Deaths_per_million_persons-WHO2012.svg/330px-Stroke_world_map-Deaths_per_million_persons-WHO2012.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4e/Stroke_world_map-Deaths_per_million_persons-WHO2012.svg/440px-Stroke_world_map-Deaths_per_million_persons-WHO2012.svg.png 2x" data-file-width="940" data-file-height="415" /></a><figcaption>Stroke deaths per million persons in 2012: <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col div-col-small" style="column-width: 10em;"><style data-mw-deduplicate="TemplateStyles:r981673959">.mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{}</style><div class="legend">  58–316</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  317–417</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  418–466</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  467–518</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  519–575</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  576–640</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  641–771</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  772–974</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  975-1,683</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1,684–3,477</div></div></figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Cerebrovascular_disease_world_map_-_DALY_-_WHO2004.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f7/Cerebrovascular_disease_world_map_-_DALY_-_WHO2004.svg/220px-Cerebrovascular_disease_world_map_-_DALY_-_WHO2004.svg.png" decoding="async" width="220" height="97" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f7/Cerebrovascular_disease_world_map_-_DALY_-_WHO2004.svg/330px-Cerebrovascular_disease_world_map_-_DALY_-_WHO2004.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f7/Cerebrovascular_disease_world_map_-_DALY_-_WHO2004.svg/440px-Cerebrovascular_disease_world_map_-_DALY_-_WHO2004.svg.png 2x" data-file-width="940" data-file-height="415" /></a><figcaption><a href="/wiki/Disability-adjusted_life_year" title="Disability-adjusted life year">Disability-adjusted life year</a> for cerebral vascular disease per 100,000 inhabitants in 2004:<a href="#cite_note-241">[241]</a> <style data-mw-deduplicate="TemplateStyles:r1216972533">.mw-parser-output .col-begin{border-collapse:collapse;padding:0;color:inherit;width:100%;border:0;margin:0}.mw-parser-output .col-begin-small{font-size:90%}.mw-parser-output .col-break{vertical-align:top;text-align:left}.mw-parser-output .col-break-2{width:50%}.mw-parser-output .col-break-3{width:33.3%}.mw-parser-output .col-break-4{width:25%}.mw-parser-output .col-break-5{width:20%}@media(max-width:720px){.mw-parser-output .col-begin,.mw-parser-output .col-begin>tbody,.mw-parser-output .col-begin>tbody>tr,.mw-parser-output .col-begin>tbody>tr>td{display:block!important;width:100%!important}.mw-parser-output .col-break{padding-left:0!important}}</style><div> <table class="col-begin" role="presentation"> <tbody><tr> <td class="col-break"> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  no data</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  <250</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  250–425</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  425–600</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  600–775</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  775–950</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  950–1125</div> </td> <td class="col-break"> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1125–1300</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1300–1475</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1475–1650</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1650–1825</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1825–2000</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  >2000</div> </td></tr></tbody></table></div></figcaption></figure> Stroke was the second most frequent cause of death worldwide in 2011, accounting for 6.2 million deaths (~11% of the total).<a href="#cite_note-The_top_10_causes_of_death-242">[242]</a> Approximately 17 million people had stroke in 2010 and 33 million people have previously had stroke and were still alive.<a href="#cite_note-Fei2013-19">[19]</a> Between 1990 and 2010 the incidence of stroke decreased by approximately 10% in the developed world and increased by 10% in the developing world.<a href="#cite_note-Fei2013-19">[19]</a> Overall, two-thirds of stroke occurred in those over 65 years old.<a href="#cite_note-Fei2013-19">[19]</a> South Asians are at particularly high risk of stroke, accounting for 40% of global stroke deaths.<a href="#cite_note-Indian_Stroke_Association-243">[243]</a> Incidence of ischemic stroke is ten times more frequent than haemorrhagic stroke.<a href="#cite_note-244">[244]</a> It is ranked after heart disease and before cancer.<a href="#cite_note-Donnan2008-2">[2]</a> In the United States stroke is a leading cause of disability, and recently declined from the third leading to the fourth leading cause of death.<a href="#cite_note-pmid21778445-245">[245]</a> Geographic disparities in stroke incidence have been observed, including the existence of a "<a href="/wiki/Stroke_belt" class="mw-redirect" title="Stroke belt">stroke belt</a>" in the <a href="/wiki/Southeastern_United_States" title="Southeastern United States">southeastern United States</a>, but causes of these disparities have not been explained. The risk of stroke <a href="/wiki/Exponential_growth" title="Exponential growth">increases exponentially</a> from 30 years of age, and the cause varies by age.<a href="#cite_note-ellekjaer1997-246">[246]</a> Advanced age is one of the most significant stroke risk factors. 95% of stroke occurs in people age 45 and older, and two-thirds of stroke occurs in those over the age of 65.<a href="#cite_note-NINDS1999-53">[53]</a><a href="#cite_note-Senelick1994-230">[230]</a> A person's risk of dying if he or she does have stroke also increases with age. However, stroke can occur at any age, including in childhood.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] Family members may have a genetic tendency for stroke or share a lifestyle that contributes to stroke. Higher levels of <a href="/wiki/Von_Willebrand_factor" title="Von Willebrand factor">Von Willebrand factor</a> are more common amongst people who have had ischemic stroke for the first time.<a href="#cite_note-247">[247]</a> The results of this study found that the only significant genetic factor was the person's <a href="/wiki/Blood_type" title="Blood type">blood type</a>. Having stroke in the past greatly increases one's risk of future stroke. Men are 25% more likely to develop stroke than women,<a href="#cite_note-NINDS1999-53">[53]</a> yet 60% of deaths from stroke occur in women.<a href="#cite_note-Villarosa1993-233">[233]</a> Since women live longer, they are older on average when they have stroke and thus more often killed.<a href="#cite_note-NINDS1999-53">[53]</a> Some risk factors for stroke apply only to women. Primary among these are pregnancy, childbirth, <a href="/wiki/Menopause" title="Menopause">menopause</a>, and the treatment thereof (<a href="/wiki/Hormone_replacement_therapy_(menopause)" class="mw-redirect" title="Hormone replacement therapy (menopause)">HRT</a>). <div class="mw-heading mw-heading2"><h2 id="History">History</h2></div> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:Hippocrates.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Hippocrates.jpg/170px-Hippocrates.jpg" decoding="async" width="170" height="250" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Hippocrates.jpg/255px-Hippocrates.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Hippocrates.jpg/340px-Hippocrates.jpg 2x" data-file-width="483" data-file-height="710" /></a><figcaption><a href="/wiki/Hippocrates" title="Hippocrates">Hippocrates</a> first described the sudden paralysis that is often associated with stroke.</figcaption></figure> Episodes of stroke and familial stroke have been reported from the 2nd millennium BC onward in ancient Mesopotamia and Persia.<a href="#cite_note-248">[248]</a> <a href="/wiki/Hippocrates" title="Hippocrates">Hippocrates</a> (460 to 370 BC) was first to describe the phenomenon of sudden <a href="/wiki/Paralysis" title="Paralysis">paralysis</a> that is often associated with <a href="/wiki/Ischemia" title="Ischemia">ischemia</a>. <a href="/wiki/Apoplexy" title="Apoplexy">Apoplexy</a>, from the <a href="/wiki/Greek_language" title="Greek language">Greek</a> word meaning "struck down with violence", first appeared in Hippocratic writings to describe this phenomenon.<a href="#cite_note-Stroke1996-Thompson-249">[249]</a><a href="#cite_note-Merginet2001-Kopito-250">[250]</a> The word stroke was used as a synonym for apoplectic <a href="/wiki/Seizure" title="Seizure">seizure</a> as early as 1599,<a href="#cite_note-251">[251]</a> and is a fairly literal translation of the Greek term. The term apoplectic stroke is an archaic, nonspecific term, for a cerebrovascular accident accompanied by haemorrhage or haemorrhagic stroke.<a href="#cite_note-252">[252]</a> <a href="/wiki/Martin_Luther" title="Martin Luther">Martin Luther</a> was described as having an apoplectic stroke that deprived him of his speech shortly before his death in 1546.<a href="#cite_note-253">[253]</a> In 1658, in his Apoplexia, <a href="/wiki/Johann_Jakob_Wepfer" title="Johann Jakob Wepfer">Johann Jacob Wepfer</a> (1620–1695) identified the cause of <a href="/wiki/Hemorrhagic" class="mw-redirect" title="Hemorrhagic">hemorrhagic</a> stroke when he suggested that people who had <a href="/wiki/Died" class="mw-redirect" title="Died">died</a> of apoplexy had bleeding in their brains.<a href="#cite_note-NINDS1999-53">[53]</a><a href="#cite_note-Stroke1996-Thompson-249">[249]</a> Wepfer also identified the main <a href="/wiki/Arteries" class="mw-redirect" title="Arteries">arteries</a> supplying the brain, the <a href="/wiki/Vertebral" class="mw-redirect" title="Vertebral">vertebral</a> and <a href="/wiki/Carotid" class="mw-redirect" title="Carotid">carotid</a> arteries, and identified the cause of a type of <a href="/wiki/Ischemic" class="mw-redirect" title="Ischemic">ischemic</a> stroke known as a <a href="/wiki/Cerebral_infarction" title="Cerebral infarction">cerebral infarction</a> when he suggested that <a href="/wiki/Apoplexy" title="Apoplexy">apoplexy</a> might be caused by a blockage to those vessels.<a href="#cite_note-NINDS1999-53">[53]</a> <a href="/wiki/Rudolf_Virchow" title="Rudolf Virchow">Rudolf Virchow</a> first described the mechanism of <a href="/wiki/Thromboembolism" title="Thromboembolism">thromboembolism</a> as a major factor.<a href="#cite_note-pmid4914683-254">[254]</a> The term cerebrovascular accident was introduced in 1927, reflecting a "growing awareness and acceptance of vascular theories and (...) recognition of the consequences of a sudden disruption in the vascular supply of the brain".<a href="#cite_note-FingerBoller2010-255">[255]</a> Its use is now discouraged by a number of neurology textbooks, reasoning that the connotation of fortuitousness carried by the word accident insufficiently highlights the modifiability of the underlying risk factors.<a href="#cite_note-Scadding2011-256">[256]</a><a href="#cite_note-SirvenMalamut2008-257">[257]</a><a href="#cite_note-KaufmanMilstein2012-258">[258]</a> Cerebrovascular insult may be used interchangeably.<a href="#cite_note-Mosby-259">[259]</a> The term brain attack was introduced for use to underline the acute nature of stroke according to the <a href="/wiki/American_Stroke_Association" class="mw-redirect" title="American Stroke Association">American Stroke Association</a>,<a href="#cite_note-Mosby-259">[259]</a> which has used the term since 1990,<a href="#cite_note-NSA_Brain_Attack-260">[260]</a> and is used colloquially to refer to both ischemic as well as hemorrhagic stroke.<a href="#cite_note-261">[261]</a> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2></div> As of 2017, <a href="/wiki/Angioplasty" title="Angioplasty">angioplasty</a> and <a href="/wiki/Stent" title="Stent">stents</a> were under preliminary <a href="/wiki/Clinical_research" title="Clinical research">clinical research</a> to determine the possible therapeutic advantages of these procedures in comparison to therapy with <a href="/wiki/Statin" title="Statin">statins</a>, <a href="/wiki/Antithrombotic" title="Antithrombotic">antithrombotics</a>, or <a href="/wiki/Antihypertensive_drug" class="mw-redirect" title="Antihypertensive drug">antihypertensive drugs</a>.<a href="#cite_note-Morris-262">[262]</a> <div style="clear:left;" class=""></div> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1184024115"><div class="div-col" style="column-width: 30em;"> <ul><li><a href="/wiki/Anoxic_depolarization_in_the_brain" title="Anoxic depolarization in the brain">Anoxic depolarization in the brain</a></li> <li><a href="/wiki/Cerebrovascular_disease" title="Cerebrovascular disease">Cerebrovascular disease</a></li> <li><a href="/wiki/Cerebral_palsy" title="Cerebral palsy">Cerebral palsy</a></li> <li><a href="/wiki/Dejerine%E2%80%93Roussy_syndrome" title="Dejerine–Roussy syndrome">Dejerine–Roussy syndrome</a></li> <li><a href="/wiki/Functional_Independence_Measure" title="Functional Independence Measure">Functional Independence Measure</a></li> <li><a href="/wiki/Lipoprotein(a)" title="Lipoprotein(a)">Lipoprotein(a)</a></li> <li><a href="/wiki/Mobile_Stroke_Unit" class="mw-redirect" title="Mobile Stroke Unit">Mobile Stroke Unit</a></li> <li><a href="/wiki/Ultrasound-enhanced_systemic_thrombolysis" title="Ultrasound-enhanced systemic thrombolysis">Ultrasound-enhanced systemic thrombolysis</a></li> <li><a href="/wiki/Weber%27s_syndrome" title="Weber's syndrome">Weber's syndrome</a></li> <li><a href="/wiki/World_Stroke_Day" title="World Stroke Day">World Stroke Day</a></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><a href="#cite_ref-1">^</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output 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Stroke. 34 (12): 2995–8. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1161%2F01.STR.0000098902.69855.A9">10.1161/01.STR.0000098902.69855.A9</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14605325">14605325</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:16083887">16083887</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Stroke&rft.atitle=Acute+ischemic+cerebrovascular+syndrome%3A+diagnostic+criteria&rft.volume=34&rft.issue=12&rft.pages=2995-8&rft.date=2003-12&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A16083887%23id-name%3DS2CID&rft_id=info%3Apmid%2F14605325&rft_id=info%3Adoi%2F10.1161%2F01.STR.0000098902.69855.A9&rft.aulast=Kidwell&rft.aufirst=CS&rft.au=Warach%2C+S&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-23"><a href="#cite_ref-23">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFShuaibHachinski1991" class="citation journal cs1">Shuaib A, Hachinski VC (September 1991). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1335826">"Mechanisms and management of stroke in the elderly"</a>. CMAJ. 145 (5): 433–43. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1335826">1335826</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/1878825">1878825</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=CMAJ&rft.atitle=Mechanisms+and+management+of+stroke+in+the+elderly&rft.volume=145&rft.issue=5&rft.pages=433-43&rft.date=1991-09&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1335826%23id-name%3DPMC&rft_id=info%3Apmid%2F1878825&rft.aulast=Shuaib&rft.aufirst=A&rft.au=Hachinski%2C+VC&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1335826&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-Stam2005-24">^ <a href="#cite_ref-Stam2005_24-0">a</a> <a href="#cite_ref-Stam2005_24-1">b</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFStam2005" class="citation journal cs1">Stam J (April 2005). <a rel="nofollow" class="external text" href="https://pure.uva.nl/ws/files/3830901/45867_208116y.pdf">"Thrombosis of the cerebral veins and sinuses"</a> (PDF). The New England Journal of Medicine. 352 (17): 1791–8. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMra042354">10.1056/NEJMra042354</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15858188">15858188</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:42126852">42126852</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+New+England+Journal+of+Medicine&rft.atitle=Thrombosis+of+the+cerebral+veins+and+sinuses&rft.volume=352&rft.issue=17&rft.pages=1791-8&rft.date=2005-04&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A42126852%23id-name%3DS2CID&rft_id=info%3Apmid%2F15858188&rft_id=info%3Adoi%2F10.1056%2FNEJMra042354&rft.aulast=Stam&rft.aufirst=J&rft_id=https%3A%2F%2Fpure.uva.nl%2Fws%2Ffiles%2F3830901%2F45867_208116y.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-Guercini-25"><a href="#cite_ref-Guercini_25-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGuerciniAcciarresiAgnelliPaciaroni2008" class="citation journal cs1">Guercini F, Acciarresi M, Agnelli G, Paciaroni M (April 2008). "Cryptogenic stroke: time to determine aetiology". Journal of Thrombosis and Haemostasis. 6 (4): 549–54. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1538-7836.2008.02903.x">10.1111/j.1538-7836.2008.02903.x</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18208534">18208534</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:20211745">20211745</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Thrombosis+and+Haemostasis&rft.atitle=Cryptogenic+stroke%3A+time+to+determine+aetiology&rft.volume=6&rft.issue=4&rft.pages=549-54&rft.date=2008-04&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A20211745%23id-name%3DS2CID&rft_id=info%3Apmid%2F18208534&rft_id=info%3Adoi%2F10.1111%2Fj.1538-7836.2008.02903.x&rft.aulast=Guercini&rft.aufirst=F&rft.au=Acciarresi%2C+M&rft.au=Agnelli%2C+G&rft.au=Paciaroni%2C+M&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-26"><a href="#cite_ref-26">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBamfordSandercockDennisBurn1991" class="citation journal cs1">Bamford J, Sandercock P, Dennis M, Burn J, Warlow C (June 1991). "Classification and natural history of clinically identifiable subtypes of cerebral infarction". Lancet. 337 (8756): 1521–6. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2F0140-6736%2891%2993206-O">10.1016/0140-6736(91)93206-O</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/1675378">1675378</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:21784682">21784682</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Lancet&rft.atitle=Classification+and+natural+history+of+clinically+identifiable+subtypes+of+cerebral+infarction&rft.volume=337&rft.issue=8756&rft.pages=1521-6&rft.date=1991-06&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A21784682%23id-name%3DS2CID&rft_id=info%3Apmid%2F1675378&rft_id=info%3Adoi%2F10.1016%2F0140-6736%2891%2993206-O&rft.aulast=Bamford&rft.aufirst=J&rft.au=Sandercock%2C+P&rft.au=Dennis%2C+M&rft.au=Burn%2C+J&rft.au=Warlow%2C+C&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> Later publications distinguish between "syndrome" and "infarct", based on evidence from imaging. "Syndrome" may be replaced by "hemorrhage" if imaging demonstrates a bleed. See <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFInternet_Stroke_Center" class="citation web cs1">Internet Stroke Center. <a rel="nofollow" class="external text" href="http://www.strokecenter.org/trials/scales/oxford.html">"Oxford Stroke Scale"</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20081025134133/http://www.strokecenter.org/trials/scales/oxford.html">Archived</a> from the original on 2008-10-25. Retrieved 2008-11-14.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Oxford+Stroke+Scale&rft.au=Internet+Stroke+Center&rft_id=http%3A%2F%2Fwww.strokecenter.org%2Ftrials%2Fscales%2Foxford.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-27"><a href="#cite_ref-27">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBamford2000" class="citation journal cs1">Bamford JM (2000). "The role of the clinical examination in the subclassification of stroke". Cerebrovascular Diseases. 10 (4): 2–4. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000047582">10.1159/000047582</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11070389">11070389</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:29493084">29493084</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cerebrovascular+Diseases&rft.atitle=The+role+of+the+clinical+examination+in+the+subclassification+of+stroke&rft.volume=10&rft.issue=4&rft.pages=2-4&rft.date=2000&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A29493084%23id-name%3DS2CID&rft_id=info%3Apmid%2F11070389&rft_id=info%3Adoi%2F10.1159%2F000047582&rft.aulast=Bamford&rft.aufirst=JM&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-28"><a href="#cite_ref-28">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAdamsBendixenKappelleBiller1993" class="citation journal cs1">Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. (January 1993). <a rel="nofollow" class="external text" href="https://doi.org/10.1161%2F01.STR.24.1.35">"Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment"</a>. Stroke. 24 (1): 35–41. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1161%2F01.STR.24.1.35">10.1161/01.STR.24.1.35</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/7678184">7678184</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Stroke&rft.atitle=Classification+of+subtype+of+acute+ischemic+stroke.+Definitions+for+use+in+a+multicenter+clinical+trial.+TOAST.+Trial+of+Org+10172+in+Acute+Stroke+Treatment&rft.volume=24&rft.issue=1&rft.pages=35-41&rft.date=1993-01&rft_id=info%3Adoi%2F10.1161%2F01.STR.24.1.35&rft_id=info%3Apmid%2F7678184&rft.aulast=Adams&rft.aufirst=HP&rft.au=Bendixen%2C+BH&rft.au=Kappelle%2C+LJ&rft.au=Biller%2C+J&rft.au=Love%2C+BB&rft.au=Gordon%2C+DL&rft.au=Marsh%2C+EE&rft_id=https%3A%2F%2Fdoi.org%2F10.1161%252F01.STR.24.1.35&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-29"><a href="#cite_ref-29">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFOsterweil2006" class="citation news cs1">Osterweil N (26 December 2006). <a rel="nofollow" class="external text" href="https://www.medpagetoday.com/neurology/strokes/4761">"Methamphetamine May Trigger Ischemic Stroke"</a>. Medpage Today.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Medpage+Today&rft.atitle=Methamphetamine+May+Trigger+Ischemic+Stroke&rft.date=2006-12-26&rft.aulast=Osterweil&rft.aufirst=N&rft_id=https%3A%2F%2Fwww.medpagetoday.com%2Fneurology%2Fstrokes%2F4761&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-30"><a href="#cite_ref-30">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAnonymous2014" class="citation web cs1">Anonymous (2014-07-29). <a rel="nofollow" class="external text" href="http://www.stroke.org/understand-stroke/what-stroke/hemorrhagic-stroke">"Hemorrhagic stroke"</a>. National Stroke Association. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160627175524/http://www.stroke.org/understand-stroke/what-stroke/hemorrhagic-stroke">Archived</a> from the original on 27 June 2016. Retrieved 30 June 2016.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Hemorrhagic+stroke&rft.pub=National+Stroke+Association&rft.date=2014-07-29&rft.au=Anonymous&rft_id=http%3A%2F%2Fwww.stroke.org%2Funderstand-stroke%2Fwhat-stroke%2Fhemorrhagic-stroke&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-31"><a href="#cite_ref-31">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAnonymous2013" class="citation web cs1">Anonymous (6 December 2013). <a rel="nofollow" class="external text" href="https://www.cdc.gov/stroke/types_of_stroke.htm">"Types of Stroke"</a>. www.cdc.gov. Centers of Disease Control and Prevention. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160627061518/http://www.cdc.gov/stroke/types_of_stroke.htm">Archived</a> from the original on 27 June 2016. Retrieved 30 June 2016.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=www.cdc.gov&rft.atitle=Types+of+Stroke&rft.date=2013-12-06&rft.au=Anonymous&rft_id=https%3A%2F%2Fwww.cdc.gov%2Fstroke%2Ftypes_of_stroke.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-32"><a href="#cite_ref-32">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAl-Shahi_SalmanLabovitzStapf2009" class="citation journal cs1">Al-Shahi Salman R, Labovitz DL, Stapf C (July 2009). "Spontaneous intracerebral haemorrhage". BMJ. 339 (jul24 1): b2586. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fbmj.b2586">10.1136/bmj.b2586</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19633038">19633038</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:206891608">206891608</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=BMJ&rft.atitle=Spontaneous+intracerebral+haemorrhage&rft.volume=339&rft.issue=jul24+1&rft.pages=b2586&rft.date=2009-07&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A206891608%23id-name%3DS2CID&rft_id=info%3Apmid%2F19633038&rft_id=info%3Adoi%2F10.1136%2Fbmj.b2586&rft.aulast=Al-Shahi+Salman&rft.aufirst=R&rft.au=Labovitz%2C+DL&rft.au=Stapf%2C+C&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-Articles-33">^ <a href="#cite_ref-Articles_33-0">a</a> <a href="#cite_ref-Articles_33-1">b</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20200530132825/https://www.cedars-sinai.org/health-library/articles.html">"Articles"</a>. Cedars-Sinai. Archived from <a rel="nofollow" class="external text" href="https://www.cedars-sinai.org/health-library/articles.html">the original</a> on 2020-05-30. Retrieved 2022-04-26.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Cedars-Sinai&rft.atitle=Articles&rft_id=https%3A%2F%2Fwww.cedars-sinai.org%2Fhealth-library%2Farticles.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-34"><a href="#cite_ref-34">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFOdierMichel2014" class="citation book cs1">Odier C, Michel P (2014). "Common Stroke Syndromes". In Brainin M, Heiss WD, Tabernig S (eds.). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=wU5CBAAAQBAJ">Textbook of Stroke Medicine</a>. 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The Cochrane Database of Systematic Reviews. 2023 (7): CD003437. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD003437.pub5">10.1002/14651858.CD003437.pub5</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10327406">10327406</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/37417452">37417452</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Cochrane+Database+of+Systematic+Reviews&rft.atitle=Pharmacological%2C+non-invasive+brain+stimulation+and+psychological+interventions%2C+and+their+combination%2C+for+treating+depression+after+stroke&rft.volume=2023&rft.issue=7&rft.pages=CD003437&rft.date=2023-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC10327406%23id-name%3DPMC&rft_id=info%3Apmid%2F37417452&rft_id=info%3Adoi%2F10.1002%2F14651858.CD003437.pub5&rft.aulast=Allida&rft.aufirst=SM&rft.au=Hsieh%2C+CF&rft.au=Cox%2C+KL&rft.au=Patel%2C+K&rft.au=Rouncefield-Swales%2C+A&rft.au=Lightbody%2C+CE&rft.au=House%2C+A&rft.au=Hackett%2C+ML&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC10327406&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-Villarosa1993-233">^ <a href="#cite_ref-Villarosa1993_233-0">a</a> <a href="#cite_ref-Villarosa1993_233-1">b</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFVillarosaSingletonJohnson1993" class="citation book cs1">Villarosa L, Singleton L, Johnson KA (1993). <a rel="nofollow" class="external text" href="https://archive.org/details/blackhealthlibra00sing">The Black health library guide to stroke</a>. 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Lippincott Williams & Wilkins. p. 243. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-7817-6947-1" title="Special:BookSources/978-0-7817-6947-1"><bdi>978-0-7817-6947-1</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20131012213727/http://books.google.com/books?id=c1tL8C9ryMQC&pg=PA243">Archived</a> from the original on 12 October 2013. Retrieved 1 October 2013.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Clinical+Neurology+of+the+Older+Adult&rft.pages=243&rft.pub=Lippincott+Williams+%26+Wilkins&rft.date=2008&rft.isbn=978-0-7817-6947-1&rft.aulast=Sirven&rft.aufirst=JI&rft.au=Malamut%2C+BL&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3Dc1tL8C9ryMQC%26pg%3DPA243&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-KaufmanMilstein2012-258"><a href="#cite_ref-KaufmanMilstein2012_258-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKaufmanMilstein2012" class="citation book cs1">Kaufman DM, Milstein MJ (5 December 2012). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=7fXzaAT_pwkC&pg=PT892">Kaufman's Clinical Neurology for Psychiatrists</a>. Elsevier Health Sciences. p. 892. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4557-4004-8" title="Special:BookSources/978-1-4557-4004-8"><bdi>978-1-4557-4004-8</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20131012220403/http://books.google.com/books?id=7fXzaAT_pwkC&pg=PT892">Archived</a> from the original on 12 October 2013. Retrieved 1 October 2013.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Kaufman%27s+Clinical+Neurology+for+Psychiatrists&rft.pages=892&rft.pub=Elsevier+Health+Sciences&rft.date=2012-12-05&rft.isbn=978-1-4557-4004-8&rft.aulast=Kaufman&rft.aufirst=DM&rft.au=Milstein%2C+MJ&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D7fXzaAT_pwkC%26pg%3DPT892&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-Mosby-259">^ <a href="#cite_ref-Mosby_259-0">a</a> <a href="#cite_ref-Mosby_259-1">b</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1">Mosby's Medical Dictionary, 8th edition. Elsevier. 2009.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Mosby%27s+Medical+Dictionary%2C+8th+edition&rft.pub=Elsevier&rft.date=2009&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-NSA_Brain_Attack-260"><a href="#cite_ref-NSA_Brain_Attack_260-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20131019161334/http://www.stroke.org/site/DocServer/NSA_complete_guide.pdf">"What is a Stroke/Brain Attack?"</a> (PDF). National Stroke Association. Archived from <a rel="nofollow" class="external text" href="http://www.stroke.org/site/DocServer/NSA_complete_guide.pdf">the original</a> (PDF) on 19 October 2013. Retrieved 27 February 2014.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=National+Stroke+Association&rft.atitle=What+is+a+Stroke%2FBrain+Attack%3F&rft_id=http%3A%2F%2Fwww.stroke.org%2Fsite%2FDocServer%2FNSA_complete_guide.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-261"><a href="#cite_ref-261">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1">Segen's Medical Dictionary. Farlex, Inc. 2010.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Segen%27s+Medical+Dictionary.&rft.pub=Farlex%2C+Inc&rft.date=2010&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> <li id="cite_note-Morris-262"><a href="#cite_ref-Morris_262-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMorrisAyabeInoueSakai2017" class="citation journal cs1">Morris DR, Ayabe K, Inoue T, Sakai N, Bulbulia R, Halliday A, et al. (April 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392474">"Evidence-Based Carotid Interventions for Stroke Prevention: State-of-the-art Review"</a>. Journal of Atherosclerosis and Thrombosis. 24 (4): 373–387. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5551%2Fjat.38745">10.5551/jat.38745</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392474">5392474</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28260723">28260723</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Atherosclerosis+and+Thrombosis&rft.atitle=Evidence-Based+Carotid+Interventions+for+Stroke+Prevention%3A+State-of-the-art+Review&rft.volume=24&rft.issue=4&rft.pages=373-387&rft.date=2017-04&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5392474%23id-name%3DPMC&rft_id=info%3Apmid%2F28260723&rft_id=info%3Adoi%2F10.5551%2Fjat.38745&rft.aulast=Morris&rft.aufirst=DR&rft.au=Ayabe%2C+K&rft.au=Inoue%2C+T&rft.au=Sakai%2C+N&rft.au=Bulbulia%2C+R&rft.au=Halliday%2C+A&rft.au=Goto%2C+S&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5392474&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2></div> <style data-mw-deduplicate="TemplateStyles:r1239549316">.mw-parser-output .refbegin{margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}@media screen{.mw-parser-output .refbegin{font-size:90%}}</style><div class="refbegin" style=""> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBushnellKernanSharriefChaturvedi2024" class="citation journal cs1">Bushnell C, Kernan WN, Sharrief AZ, Chaturvedi S, Cole JW, Cornwell WK, et al. (21 October 2024). "2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association". Stroke. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1161%2FSTR.0000000000000475">10.1161/STR.0000000000000475</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Stroke&rft.atitle=2024+Guideline+for+the+Primary+Prevention+of+Stroke%3A+A+Guideline+From+the+American+Heart+Association%2FAmerican+Stroke+Association&rft.date=2024-10-21&rft_id=info%3Adoi%2F10.1161%2FSTR.0000000000000475&rft.aulast=Bushnell&rft.aufirst=Cheryl&rft.au=Kernan%2C+Walter+N.&rft.au=Sharrief%2C+Anjail+Z.&rft.au=Chaturvedi%2C+Seemant&rft.au=Cole%2C+John+W.&rft.au=Cornwell%2C+William+K.&rft.au=Cosby-Gaither%2C+Christine&rft.au=Doyle%2C+Sarah&rft.au=Goldstein%2C+Larry+B.&rft.au=Lennon%2C+Olive&rft.au=Levine%2C+Deborah+A.&rft.au=Love%2C+Mary&rft.au=Miller%2C+Eliza&rft.au=Nguyen-Huynh%2C+Mai&rft.au=Rasmussen-Winkler%2C+Jennifer&rft.au=Rexrode%2C+Kathryn+M.&rft.au=Rosendale%2C+Nicole&rft.au=Sarma%2C+Satyam&rft.au=Shimbo%2C+Daichi&rft.au=Simpkins%2C+Alexis+N.&rft.au=Spatz%2C+Erica+S.&rft.au=Sun%2C+Lisa+R.&rft.au=Tangpricha%2C+Vin&rft.au=Turnage%2C+Dawn&rft.au=Velazquez%2C+Gabriela&rft.au=Whelton%2C+Paul&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"><code class="cs1-code">{{<a href="/wiki/Template:Cite_journal" title="Template:Cite journal">cite journal</a>}}</code>: CS1 maint: overridden setting (<a href="/wiki/Category:CS1_maint:_overridden_setting" title="Category:CS1 maint: overridden setting">link</a>)</li> <li>Gijn, Jan van (2023). Stroke: A History of Ideas. Cambridge University Press. ISBN 978-1-108-83254-0.</li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMohrChoiGrottaWolf2004" class="citation book cs1">Mohr JP, Choi D, Grotta J, Wolf P (2004). Stroke: Pathophysiology, Diagnosis, and Management. New York: Churchill Livingstone. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-443-06600-9" title="Special:BookSources/978-0-443-06600-9"><bdi>978-0-443-06600-9</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/50477349">50477349</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Stroke%3A+Pathophysiology%2C+Diagnosis%2C+and+Management&rft.place=New+York&rft.pub=Churchill+Livingstone&rft.date=2004&rft_id=info%3Aoclcnum%2F50477349&rft.isbn=978-0-443-06600-9&rft.aulast=Mohr&rft.aufirst=JP&rft.au=Choi%2C+D&rft.au=Grotta%2C+J&rft.au=Wolf%2C+P&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWarlowvan_GijnDennisWardlaw2008" class="citation book cs1">Warlow CP, van Gijn J, Dennis MS, Wardlaw JM, Bamford JM, Hankey GJ, et al. (2008). Stroke: Practical Management (3rd ed.). Wiley-Blackwell. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4051-2766-0" title="Special:BookSources/978-1-4051-2766-0"><bdi>978-1-4051-2766-0</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Stroke%3A+Practical+Management&rft.edition=3rd&rft.pub=Wiley-Blackwell&rft.date=2008&rft.isbn=978-1-4051-2766-0&rft.aulast=Warlow&rft.aufirst=CP&rft.au=van+Gijn%2C+J&rft.au=Dennis%2C+MS&rft.au=Wardlaw%2C+JM&rft.au=Bamford%2C+JM&rft.au=Hankey%2C+GJ&rft.au=Sandercock%2C+PA&rft.au=Rinkel%2C+G&rft.au=Langhorne%2C+P&rft.au=Sudlow%2C+C&rft.au=Rothwell%2C+P&rfr_id=info%3Asid%2Fen.wikipedia.org%3AStroke" class="Z3988"></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}</style><style data-mw-deduplicate="TemplateStyles:r1237033735">@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}</style><div class="side-box side-box-right plainlinks sistersitebox"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-flex"> <div class="side-box-image"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png" decoding="async" width="30" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/45px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/59px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <a href="https://commons.wikimedia.org/wiki/Category:Stroke" class="extiw" title="commons:Category:Stroke">Stroke</a>.</div></div> </div> <ul><li><a rel="nofollow" class="external text" href="http://www.mdcalc.com/dragon-score-post-tpa-stroke-outcome/">DRAGON Score for Post-Thrombolysis</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20201027101249/https://www.mdcalc.com/dragon-score-post-tpa-stroke-outcome">Archived</a> 2020-10-27 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li> <li><a rel="nofollow" class="external text" href="http://www.mdcalc.com/thrive-score-for-stroke-outcome/">THRIVE score for stroke outcome</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160913041433/http://www.mdcalc.com/thrive-score-for-stroke-outcome/">Archived</a> 2016-09-13 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li> <li><a rel="nofollow" class="external text" href="https://www.ninds.nih.gov/Disorders/all-disorders">National Institute of Neurological Disorders and Stroke</a></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output .navbox-group{white-space:nowrap;text-align:right}.mw-parser-output .navbox,.mw-parser-output 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dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q12202" class="extiw" title="d:Q12202">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/I61">I61</a>-<a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/I64">I64</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=434.91">434.91</a></li><li><a href="/wiki/Online_Mendelian_Inheritance_in_Man" title="Online Mendelian Inheritance in Man">OMIM</a>: <a rel="nofollow" class="external text" href="https://omim.org/entry/601367">601367</a></li><li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D020521">D020521</a></li><li><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb2247.htm">2247</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000726.htm">000726</a></li><li><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/neuro/9-overview">neuro/9</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/emerg/topic558.htm#">emerg/558</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/emerg/topic557.htm#">emerg/557</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/pmr/topic187.htm#">pmr/187</a></li><li><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/cerebrovascular-events">Stroke</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Cerebrovascular_diseases_including_stroke" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Cerebrovascular_diseases" title="Template:Cerebrovascular diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Cerebrovascular_diseases" title="Template talk:Cerebrovascular diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Cerebrovascular_diseases" title="Special:EditPage/Template:Cerebrovascular diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Cerebrovascular_diseases_including_stroke" style="font-size:114%;margin:0 4em"><a href="/wiki/Cerebrovascular_disease" title="Cerebrovascular disease">Cerebrovascular diseases</a> including <a class="mw-selflink selflink">stroke</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Ischaemic_stroke" class="mw-redirect" title="Ischaemic stroke">Ischaemic stroke</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Brain" title="Brain">Brain</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anterior_cerebral_artery_syndrome" title="Anterior cerebral artery syndrome">Anterior cerebral artery syndrome</a></li> <li><a href="/wiki/Middle_cerebral_artery_syndrome" title="Middle cerebral artery syndrome">Middle cerebral artery syndrome</a></li> <li><a href="/wiki/Posterior_cerebral_artery_syndrome" title="Posterior cerebral artery syndrome">Posterior cerebral artery syndrome</a></li> <li><a href="/wiki/Amaurosis_fugax" title="Amaurosis fugax">Amaurosis fugax</a></li> <li><a href="/wiki/Moyamoya_disease" title="Moyamoya disease">Moyamoya disease</a></li> <li><a href="/wiki/Dejerine%E2%80%93Roussy_syndrome" title="Dejerine–Roussy syndrome">Dejerine–Roussy syndrome</a></li> <li><a href="/wiki/Watershed_stroke" title="Watershed stroke">Watershed stroke</a></li> <li><a href="/wiki/Lacunar_stroke" title="Lacunar stroke">Lacunar stroke</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Brain_stem" class="mw-redirect" title="Brain stem">Brain stem</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brainstem_stroke_syndrome" title="Brainstem stroke syndrome">Brainstem stroke syndrome</a></li> <li><a href="/wiki/Medulla_oblongata" title="Medulla oblongata">Medulla</a> <ul><li><a href="/wiki/Medial_medullary_syndrome" title="Medial medullary syndrome">Medial medullary syndrome</a></li> <li><a href="/wiki/Lateral_medullary_syndrome" title="Lateral medullary syndrome">Lateral medullary syndrome</a></li></ul></li> <li><a href="/wiki/Pons" title="Pons">Pons</a> <ul><li><a href="/wiki/Medial_pontine_syndrome" title="Medial pontine syndrome">Medial pontine syndrome</a> / <a href="/wiki/Foville%27s_syndrome" title="Foville's syndrome">Foville's</a></li> <li><a href="/wiki/Lateral_pontine_syndrome" title="Lateral pontine syndrome">Lateral pontine syndrome</a> / <a href="/wiki/Millard%E2%80%93Gubler_syndrome" title="Millard–Gubler syndrome">Millard-Gubler</a></li></ul></li> <li><a href="/wiki/Midbrain" title="Midbrain">Midbrain</a> <ul><li><a href="/wiki/Weber%27s_syndrome" title="Weber's syndrome">Weber's syndrome</a></li> <li><a href="/wiki/Benedikt_syndrome" title="Benedikt syndrome">Benedikt syndrome</a></li> <li><a href="/wiki/Claude%27s_syndrome" title="Claude's syndrome">Claude's syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cerebellum" title="Cerebellum">Cerebellum</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cerebellar_stroke_syndrome" title="Cerebellar stroke syndrome">Cerebellar stroke syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Extracranial arteries</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Carotid_artery_stenosis" title="Carotid artery stenosis">Carotid artery stenosis</a></li> <li><a href="/wiki/Precerebral_artery" title="Precerebral artery">precerebral</a></li> <li><a href="/wiki/Anterior_spinal_artery_syndrome" title="Anterior spinal artery syndrome">Anterior spinal artery syndrome</a></li> <li><a href="/wiki/Vertebrobasilar_insufficiency" title="Vertebrobasilar insufficiency">Vertebrobasilar insufficiency</a> <ul><li><a href="/wiki/Subclavian_steal_syndrome" title="Subclavian steal syndrome">Subclavian steal syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brain_ischemia" title="Brain ischemia">Brain ischemia</a></li> <li><a href="/wiki/Cerebral_infarction" title="Cerebral infarction">Cerebral infarction</a></li> <li><a class="mw-selflink-fragment" href="#Classification">Classification</a> <ul><li><a href="/wiki/Transient_ischemic_attack" title="Transient ischemic attack">Transient ischemic attack</a></li> <li><a href="/wiki/Total_anterior_circulation_infarct" title="Total anterior circulation infarct">Total anterior circulation infarct</a></li> <li><a href="/wiki/Partial_anterior_circulation_infarct" title="Partial anterior circulation infarct">Partial anterior circulation infarct</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/CADASIL" title="CADASIL">CADASIL</a></li> <li><a href="/wiki/Binswanger%27s_disease" title="Binswanger's disease">Binswanger's disease</a></li> <li><a href="/wiki/Transient_global_amnesia" title="Transient global amnesia">Transient global amnesia</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Haemorrhagic_stroke" class="mw-redirect" title="Haemorrhagic stroke">Haemorrhagic stroke</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Extra-axial</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Epidural_hematoma" title="Epidural hematoma">Epidural</a></li> <li><a href="/wiki/Subdural_hematoma" title="Subdural hematoma">Subdural</a></li> <li><a href="/wiki/Subarachnoid_hemorrhage" title="Subarachnoid hemorrhage">Subarachnoid</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Intracerebral_hemorrhage" title="Intracerebral hemorrhage">Cerebral/Intra-axial</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intraventricular_hemorrhage" title="Intraventricular hemorrhage">Intraventricular</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Brainstem" title="Brainstem">Brainstem</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Duret_haemorrhages" title="Duret haemorrhages">Duret haemorrhages</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">General</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intracranial_hemorrhage" title="Intracranial hemorrhage">Intracranial hemorrhage</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Aneurysm" title="Aneurysm">Aneurysm</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intracranial_aneurysm" title="Intracranial aneurysm">Intracranial aneurysm</a> <ul><li><a href="/wiki/Charcot%E2%80%93Bouchard_aneurysm" title="Charcot–Bouchard aneurysm">Charcot–Bouchard aneurysm</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cerebral_vasculitis" title="Cerebral vasculitis">Cerebral vasculitis</a></li> <li><a href="/wiki/Cerebral_venous_sinus_thrombosis" title="Cerebral venous sinus thrombosis">Cerebral venous sinus thrombosis</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_the_nervous_system,_primarily_CNS" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Central_nervous_system_disease" title="Template:Central nervous system disease"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Central_nervous_system_disease" title="Template talk:Central nervous system disease"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Central_nervous_system_disease" title="Special:EditPage/Template:Central nervous system disease"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_the_nervous_system,_primarily_CNS" style="font-size:114%;margin:0 4em">Diseases of the <a href="/wiki/Nervous_system" title="Nervous system">nervous system</a>, primarily <a href="/wiki/Central_nervous_system_disease" title="Central nervous system disease">CNS</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Inflammation" title="Inflammation">Inflammation</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Brain" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_brain" title="Human brain">Brain</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Encephalitis" title="Encephalitis">Encephalitis</a> <ul><li><a href="/wiki/Viral_encephalitis" title="Viral encephalitis">Viral encephalitis</a></li> <li><a href="/wiki/Herpesviral_encephalitis" class="mw-redirect" title="Herpesviral encephalitis">Herpesviral encephalitis</a></li> <li><a href="/wiki/Limbic_encephalitis" title="Limbic encephalitis">Limbic encephalitis</a></li> <li><a href="/wiki/Encephalitis_lethargica" title="Encephalitis lethargica">Encephalitis lethargica</a></li></ul></li> <li><a href="/wiki/Cavernous_sinus_thrombosis" title="Cavernous sinus thrombosis">Cavernous sinus thrombosis</a></li> <li><a href="/wiki/Brain_abscess" title="Brain abscess">Brain abscess</a> <ul><li><a href="/wiki/Amoebic_brain_abscess" title="Amoebic brain abscess">Amoebic</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Brain and <a href="/wiki/Spinal_cord" title="Spinal cord">spinal cord</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Encephalomyelitis" title="Encephalomyelitis">Encephalomyelitis</a> <ul><li><a href="/wiki/Acute_disseminated_encephalomyelitis" title="Acute disseminated encephalomyelitis">Acute disseminated</a></li></ul></li> <li><a href="/wiki/Meningitis" title="Meningitis">Meningitis</a></li> <li><a href="/wiki/Meningoencephalitis" title="Meningoencephalitis">Meningoencephalitis</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_brain" title="Human brain">Brain</a>/ <a href="/wiki/Encephalopathy" title="Encephalopathy">encephalopathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neurodegenerative_disease" title="Neurodegenerative disease">Degenerative</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Extrapyramidal_system" title="Extrapyramidal system">Extrapyramidal</a> and <a href="/wiki/Movement_disorders" class="mw-redirect" title="Movement disorders">movement disorders</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Basal_ganglia_disease" title="Basal ganglia disease">Basal ganglia disease</a> <ul><li><a href="/wiki/Parkinsonism" title="Parkinsonism">Parkinsonism</a> <ul><li><a href="/wiki/Parkinson%27s_disease" title="Parkinson's disease">PD</a></li> <li><a href="/wiki/Postencephalitic_parkinsonism" class="mw-redirect" title="Postencephalitic parkinsonism">Postencephalitic</a></li> <li><a href="/wiki/Neuroleptic_malignant_syndrome" title="Neuroleptic malignant syndrome">NMS</a></li></ul></li> <li><a href="/wiki/Neurodegeneration_with_brain_iron_accumulation" title="Neurodegeneration with brain iron accumulation">NBIA</a> <ul><li><a href="/wiki/Pantothenate_kinase-associated_neurodegeneration" title="Pantothenate kinase-associated neurodegeneration">PKAN</a></li></ul></li> <li><a href="/wiki/Tauopathy" title="Tauopathy">Tauopathy</a> <ul><li><a href="/wiki/Progressive_supranuclear_palsy" title="Progressive supranuclear palsy">PSP</a></li></ul></li> <li><a href="/wiki/Multiple_system_atrophy" title="Multiple system atrophy">Striatonigral degeneration</a></li> <li><a href="/wiki/Hemiballismus" title="Hemiballismus">Hemiballismus</a></li> <li><a href="/wiki/Huntington%27s_disease" title="Huntington's disease">HD</a></li> <li><a href="/wiki/Olivopontocerebellar_atrophy" class="mw-redirect" title="Olivopontocerebellar atrophy">OA</a></li></ul></li></ul> <ul><li><a href="/wiki/Dyskinesia" title="Dyskinesia">Dyskinesia</a> <ul><li><a href="/wiki/Dystonia" title="Dystonia">Dystonia</a> <ul><li><a href="/wiki/Status_dystonicus" title="Status dystonicus">Status dystonicus</a></li> <li><a href="/wiki/Spasmodic_torticollis" title="Spasmodic torticollis">Spasmodic torticollis</a></li> <li><a href="/wiki/Meige%27s_syndrome" title="Meige's syndrome">Meige's</a></li> <li><a href="/wiki/Blepharospasm" title="Blepharospasm">Blepharospasm</a></li></ul></li> <li><a href="/wiki/Athetosis" title="Athetosis">Athetosis</a></li> <li><a href="/wiki/Chorea" title="Chorea">Chorea</a> <ul><li><a href="/wiki/Choreoathetosis" title="Choreoathetosis">Choreoathetosis</a></li></ul></li> <li><a href="/wiki/Myoclonus" title="Myoclonus">Myoclonus</a> <ul><li><a href="/wiki/Myoclonic_epilepsy" title="Myoclonic epilepsy">Myoclonic epilepsy</a></li></ul></li> <li><a href="/wiki/Akathisia" title="Akathisia">Akathisia</a></li></ul></li></ul> <ul><li><a href="/wiki/Tremor" title="Tremor">Tremor</a> <ul><li><a href="/wiki/Essential_tremor" title="Essential tremor">Essential tremor</a></li> <li><a href="/wiki/Intention_tremor" title="Intention tremor">Intention tremor</a></li></ul></li> <li><a href="/wiki/Restless_legs_syndrome" title="Restless legs syndrome">Restless legs</a></li> <li><a href="/wiki/Stiff-person_syndrome" title="Stiff-person syndrome">Stiff-person</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dementia" title="Dementia">Dementia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tauopathy" title="Tauopathy">Tauopathy</a> <ul><li><a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's</a> <ul><li><a href="/wiki/Early-onset_Alzheimer%27s_disease" title="Early-onset Alzheimer's disease">Early-onset</a></li></ul></li> <li><a href="/wiki/Primary_progressive_aphasia" title="Primary progressive aphasia">Primary progressive aphasia</a></li></ul></li> <li><a href="/wiki/Frontotemporal_dementia" title="Frontotemporal dementia">Frontotemporal dementia</a>/<a href="/wiki/Frontotemporal_lobar_degeneration" title="Frontotemporal lobar degeneration">Frontotemporal lobar degeneration</a> <ul><li><a href="/wiki/Pick%27s_disease" class="mw-redirect" title="Pick's disease">Pick's</a></li></ul></li> <li><a href="/wiki/Lewy_bodies_dementia" class="mw-redirect" title="Lewy bodies dementia">Lewy bodies dementia</a></li> <li><a href="/wiki/Posterior_cortical_atrophy" title="Posterior cortical atrophy">Posterior cortical atrophy</a></li></ul> <a href="/wiki/Creutzfeldt%E2%80%93Jakob_disease" title="Creutzfeldt–Jakob disease">Creutzfeldt–Jakob disease</a> <ul><li><a href="/wiki/Vascular_dementia" title="Vascular dementia">Vascular dementia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mitochondrial_disease" title="Mitochondrial disease">Mitochondrial disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Leigh_syndrome" title="Leigh syndrome">Leigh syndrome</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Demyelinating_disease" title="Demyelinating disease">Demyelinating</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/CNS_demyelinating_autoimmune_diseases" title="CNS demyelinating autoimmune diseases">Autoimmune</a></li> <li><a href="/wiki/Inflammatory_demyelinating_diseases_of_the_central_nervous_system" title="Inflammatory demyelinating diseases of the central nervous system">Inflammatory</a></li> <li><a href="/wiki/Multiple_sclerosis" title="Multiple sclerosis">Multiple sclerosis</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Demyelinating_diseases_of_CNS" title="Template:Demyelinating diseases of CNS">Template:Demyelinating diseases of CNS</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Episodic/ <a href="/wiki/Paroxysmal_attack" title="Paroxysmal attack">paroxysmal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Epileptic_seizure" class="mw-redirect" title="Epileptic seizure">Seizures</a> and <a href="/wiki/Epilepsy" title="Epilepsy">epilepsy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Focal_seizure" title="Focal seizure">Focal</a></li> <li><a href="/wiki/Generalized_epilepsy" title="Generalized epilepsy">Generalised</a></li> <li><a href="/wiki/Status_epilepticus" title="Status epilepticus">Status epilepticus</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Epilepsy" class="mw-redirect" title="Template:Epilepsy">Template:Epilepsy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Headache" title="Headache">Headache</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Migraine" title="Migraine">Migraine</a></li> <li><a href="/wiki/Cluster_headache" title="Cluster headache">Cluster</a></li> <li><a href="/wiki/Tension_headache" title="Tension headache">Tension</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Headache" title="Template:Headache">Template:Headache</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cerebrovascular_disease" title="Cerebrovascular disease">Cerebrovascular</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Transient_ischemic_attack" title="Transient ischemic attack">TIA</a></li> <li><a class="mw-selflink selflink">Stroke</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Cerebrovascular_diseases" title="Template:Cerebrovascular diseases">Template:Cerebrovascular diseases</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sleep_disorders" class="mw-redirect" title="Sleep disorders">Sleep disorders</a> <ul><li>For more detailed coverage, see <a href="/wiki/Template:Sleep" title="Template:Sleep">Template:Sleep</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">CSF</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intracranial_pressure" title="Intracranial pressure">Intracranial hypertension</a> <ul><li><a href="/wiki/Hydrocephalus" title="Hydrocephalus">Hydrocephalus</a></li> <li><a href="/wiki/Normal_pressure_hydrocephalus" title="Normal pressure hydrocephalus">Normal pressure hydrocephalus</a></li> <li><a href="/wiki/Choroid_plexus_papilloma" title="Choroid plexus papilloma">Choroid plexus papilloma</a></li> <li><a href="/wiki/Idiopathic_intracranial_hypertension" title="Idiopathic intracranial hypertension">Idiopathic intracranial hypertension</a></li></ul></li> <li><a href="/wiki/Cerebral_edema" title="Cerebral edema">Cerebral edema</a></li> <li><a href="/wiki/Spontaneous_cerebrospinal_fluid_leak" class="mw-redirect" title="Spontaneous cerebrospinal fluid leak">Intracranial hypotension</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brain_herniation" title="Brain herniation">Brain herniation</a></li> <li><a href="/wiki/Reye_syndrome" title="Reye syndrome">Reye syndrome</a></li> <li><a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">Hepatic encephalopathy</a></li> <li><a href="/wiki/Toxic_encephalopathy" title="Toxic encephalopathy">Toxic encephalopathy</a></li> <li><a href="/wiki/Hashimoto%27s_encephalopathy" title="Hashimoto's encephalopathy">Hashimoto's encephalopathy</a></li> <li><a href="/wiki/Fetal_alcohol_spectrum_disorder" title="Fetal alcohol spectrum disorder">Static encephalopathy</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Both/either</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Degenerative" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neurodegenerative_disease" title="Neurodegenerative disease">Degenerative</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Spinocerebellar_ataxia" title="Spinocerebellar ataxia">SA</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Friedreich%27s_ataxia" title="Friedreich's ataxia">Friedreich's ataxia</a></li> <li><a href="/wiki/Ataxia%E2%80%93telangiectasia" title="Ataxia–telangiectasia">Ataxia–telangiectasia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Motor_neuron_diseases" title="Motor neuron diseases">MND</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Upper_motor_neuron" title="Upper motor neuron">UMN</a> only: <ul><li><a href="/wiki/Primary_lateral_sclerosis" title="Primary lateral sclerosis">Primary lateral sclerosis</a></li> <li><a href="/wiki/Pseudobulbar_palsy" title="Pseudobulbar palsy">Pseudobulbar palsy</a></li> <li><a href="/wiki/Hereditary_spastic_paraplegia" title="Hereditary spastic paraplegia">Hereditary spastic paraplegia</a></li></ul></li></ul> <ul><li><a href="/wiki/Lower_motor_neuron" title="Lower motor neuron">LMN</a> only: <ul><li><a href="/wiki/Distal_hereditary_motor_neuronopathies" title="Distal hereditary motor neuronopathies">Distal hereditary motor neuronopathies</a></li> <li><a href="/wiki/Spinal_muscular_atrophies" title="Spinal muscular atrophies">Spinal muscular atrophies</a> <ul><li><a href="/wiki/Spinal_muscular_atrophy" title="Spinal muscular atrophy">SMA</a></li> <li><a href="/wiki/Spinal_and_bulbar_muscular_atrophy" title="Spinal and bulbar muscular atrophy">SMAX1</a></li> <li><a href="/wiki/X-linked_spinal_muscular_atrophy_type_2" title="X-linked spinal muscular atrophy type 2">SMAX2</a></li> <li><a href="/wiki/Distal_spinal_muscular_atrophy_type_1" title="Distal spinal muscular atrophy type 1">DSMA1</a></li> <li><a href="/wiki/Congenital_distal_spinal_muscular_atrophy" title="Congenital distal spinal muscular atrophy">Congenital DSMA</a></li> <li>Spinal muscular atrophy with lower extremity predominance (SMALED) <ul><li><a href="/wiki/Spinal_muscular_atrophy_with_lower_extremity_predominance_1" title="Spinal muscular atrophy with lower extremity predominance 1">SMALED1</a></li> <li><a href="/wiki/Spinal_muscular_atrophy_with_lower_extremity_predominance_2A" title="Spinal muscular atrophy with lower extremity predominance 2A">SMALED2A</a></li> <li><a href="/wiki/Spinal_muscular_atrophy_with_lower_extremity_predominance_2B" title="Spinal muscular atrophy with lower extremity predominance 2B">SMALED2B</a></li></ul></li> <li><a href="/wiki/Pontocerebellar_hypoplasia" title="Pontocerebellar hypoplasia">SMA-PCH</a></li> <li><a href="/wiki/Spinal_muscular_atrophy_with_progressive_myoclonic_epilepsy" title="Spinal muscular atrophy with progressive myoclonic epilepsy">SMA-PME</a></li></ul></li> <li><a href="/wiki/Progressive_muscular_atrophy" title="Progressive muscular atrophy">Progressive muscular atrophy</a></li> <li><a href="/wiki/Progressive_bulbar_palsy" title="Progressive bulbar palsy">Progressive bulbar palsy</a> <ul><li><a href="/wiki/Fazio%E2%80%93Londe_disease" title="Fazio–Londe disease">Fazio–Londe</a></li> <li><a href="/wiki/Infantile_progressive_bulbar_palsy" title="Infantile progressive bulbar palsy">Infantile progressive bulbar palsy</a></li></ul></li></ul></li></ul> <ul><li>both: <ul><li><a href="/wiki/Amyotrophic_lateral_sclerosis" class="mw-redirect" title="Amyotrophic lateral sclerosis">Amyotrophic lateral sclerosis</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"><link 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databases</a> <a href="https://www.wikidata.org/wiki/Q12202#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">National</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><a rel="nofollow" class="external text" href="https://d-nb.info/gnd/4052588-0">Germany</a></li><li><a rel="nofollow" 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alt="Powered by MediaWiki" width="88" height="31" loading="lazy"></a></li> </ul> </footer> </div> </div> </div> <div class="vector-settings" id="p-dock-bottom"> <ul></ul> </div><script>(RLQ=window.RLQ||[]).push(function(){mw.config.set({"wgHostname":"mw-web.codfw.main-5c59558b9d-h4xtq","wgBackendResponseTime":155,"wgPageParseReport":{"limitreport":{"cputime":"3.169","walltime":"3.519","ppvisitednodes":{"value":18724,"limit":1000000},"postexpandincludesize":{"value":812581,"limit":2097152},"templateargumentsize":{"value":11440,"limit":2097152},"expansiondepth":{"value":14,"limit":100},"expensivefunctioncount":{"value":20,"limit":500},"unstrip-depth":{"value":1,"limit":20},"unstrip-size":{"value":1114605,"limit":5000000},"entityaccesscount":{"value":1,"limit":400},"timingprofile":["100.00% 3060.693 1 -total"," 64.80% 1983.213 1 Template:Reflist"," 36.05% 1103.260 196 Template:Cite_journal"," 7.80% 238.825 33 Template:Cite_web"," 6.39% 195.575 1 Template:Harvnb"," 5.36% 164.016 30 Template:Cite_book"," 4.92% 150.569 11 Template:Navbox"," 3.65% 111.852 2 Template:Short_description"," 3.31% 101.290 1 Template:Medical_condition_classification_and_resources"," 3.14% 96.227 9 Template:Fix"]},"scribunto":{"limitreport-timeusage":{"value":"2.053","limit":"10.000"},"limitreport-memusage":{"value":10416621,"limit":52428800},"limitreport-logs":"anchor_id_list = table#1 {\n [\"CITEREFAckleyLadwigKelley2010\"] = 1,\n [\"CITEREFAdamsBendixenKappelleBiller1993\"] = 1,\n [\"CITEREFAl-Shahi_SalmanLabovitzStapf2009\"] = 1,\n [\"CITEREFAllidaHsiehCoxPatel2023\"] = 1,\n [\"CITEREFAlperMalone-MosesMcLellanPrasad2015\"] = 1,\n [\"CITEREFAmerican_College_of_Emergency_Physicians2013\"] = 1,\n [\"CITEREFAndersenOlsenDehlendorffKammersgaard2009\"] = 1,\n [\"CITEREFAnonymous2013\"] = 1,\n [\"CITEREFAnonymous2014\"] = 1,\n [\"CITEREFAntithrombotic_Trialists\u0026#039;_Collaboration2002\"] = 1,\n [\"CITEREFArmstrongGronsethAndersonBiller2013\"] = 1,\n [\"CITEREFAroorSinghGoldstein2017\"] = 1,\n [\"CITEREFAshrafian2010\"] = 1,\n [\"CITEREFAyFurieSinghalSmith2005\"] = 1,\n [\"CITEREFBakradzeLiberman2018\"] = 1,\n [\"CITEREFBalasubramanianKleinBurdet2010\"] = 1,\n [\"CITEREFBamford2000\"] = 1,\n [\"CITEREFBamfordSandercockDennisBurn1991\"] = 1,\n [\"CITEREFBarclayStevensonPoluhaRipat2015\"] = 1,\n [\"CITEREFBarnhart1995\"] = 1,\n [\"CITEREFBartolucciHoward2006\"] = 1,\n [\"CITEREFBathKrishnan2014\"] = 1,\n [\"CITEREFBathLeeEverton2018\"] = 1,\n [\"CITEREFBeckettPetersFletcherStaessen2008\"] = 1,\n [\"CITEREFBellolioGilmoreGanti2014\"] = 1,\n [\"CITEREFBergerRoncaglioniAvanziniPangrazzi2006\"] = 1,\n [\"CITEREFBongersde_Maatvan_GoorBhagwanbali2006\"] = 1,\n [\"CITEREFBorgesFernandesOliveira_Dos_PassosRego2022\"] = 1,\n [\"CITEREFBowers2004\"] = 1,\n [\"CITEREFBradyAliVandenbergWilliams2022\"] = 1,\n [\"CITEREFBradyKellyGodwinEnderby2016\"] = 1,\n [\"CITEREFBrecht1999\"] = 1,\n [\"CITEREFBurnDennisBamfordSandercock1997\"] = 1,\n [\"CITEREFBushnellKernanSharriefChaturvedi2024\"] = 1,\n [\"CITEREFBushnellMcCulloughAwadChireau2014\"] = 1,\n [\"CITEREFCampbellMaRinglebParsons2019\"] = 1,\n [\"CITEREFCenter_for_Drug_Evaluation_and_Research\"] = 1,\n [\"CITEREFChalelaKidwellNentwichLuby2007\"] = 1,\n [\"CITEREFChambersDonnan2005\"] = 1,\n [\"CITEREFChapmanMehndirattaJohansenMcMurry2014\"] = 1,\n [\"CITEREFChenZhaoXuGuo2021\"] = 1,\n [\"CITEREFCiaccioLewisBivianoIyer2017\"] = 1,\n [\"CITEREFClarke2014\"] = 1,\n [\"CITEREFClarkeHalseyLewingtonLonn2010\"] = 1,\n [\"CITEREFCoffeyCummingsStarksteinRobinson2000\"] = 1,\n [\"CITEREFCondieBowers2008\"] = 1,\n [\"CITEREFCorreiaMeyerEskandariMichel2016\"] = 1,\n [\"CITEREFCoulthardSingh-CurryHusain2006\"] = 1,\n [\"CITEREFDe_LimaSaconatoAtallahda_Silva2014\"] = 1,\n [\"CITEREFDebSharmaHassan2010\"] = 1,\n [\"CITEREFDonnanFisherMacleodDavis2008\"] = 1,\n [\"CITEREFDormandyCharbonnelEcklandErdmann2005\"] = 1,\n [\"CITEREFDubinskyLai2006\"] = 1,\n [\"CITEREFDuffyGajreeLanghorneStott2013\"] = 1,\n [\"CITEREFDupreLibmanDupreKatz2014\"] = 1,\n [\"CITEREFEderleBrown2006\"] = 1,\n [\"CITEREFEllekjaerHolmenIndredavikTerent1997\"] = 1,\n [\"CITEREFEmbersonLeesLydenBlackwell2014\"] = 1,\n [\"CITEREFEzekowitzStrausMajumdarMcAlister2003\"] = 1,\n [\"CITEREFFairheadMehtaRothwell2005\"] = 1,\n [\"CITEREFFalsoCattaneoFogliaZucchini2017\"] = 1,\n [\"CITEREFFeiginForouzanfarKrishnamurthiMensah2014\"] = 1,\n [\"CITEREFFeiginRinkelLawesAlgra2005\"] = 1,\n [\"CITEREFFingerBollerTyler2010\"] = 1,\n [\"CITEREFFisher1968\"] = 1,\n [\"CITEREFFregniPascual-Leone2007\"] = 1,\n [\"CITEREFFryerLukerMcDonnellHillier2016\"] = 1,\n [\"CITEREFFusterRydénCannomCrijns2006\"] = 1,\n [\"CITEREFGBD_2015_Disease_and_Injury_Incidence_and_Prevalence_Collaborators2016\"] = 1,\n [\"CITEREFGBD_2015_Mortality_and_Causes_of_Death_Collaborators2016\"] = 1,\n [\"CITEREFGaillard\"] = 1,\n [\"CITEREFGeorgeCrottyGelinasDevos2014\"] = 1,\n [\"CITEREFGoldsteinAdamsAlbertsAppel2006\"] = 1,\n [\"CITEREFGoldsteinSimel2005\"] = 1,\n [\"CITEREFGomez1993\"] = 1,\n [\"CITEREFGorelick1987\"] = 1,\n [\"CITEREFGoyalMenonvan_ZwamDippel2016\"] = 1,\n [\"CITEREFGuerciniAcciarresiAgnelliPaciaroni2008\"] = 1,\n [\"CITEREFGueyffierBoisselBoutitiePocock1997\"] = 1,\n [\"CITEREFGueyffierBulpittBoisselSchron1999\"] = 1,\n [\"CITEREFHackam2016\"] = 1,\n [\"CITEREFHackshawMorrisBonifaceTang2018\"] = 1,\n [\"CITEREFHalkesvan_GijnKappelleKoudstaal2006\"] = 1,\n [\"CITEREFHalkesvan_GijnKappelleKoudstaal2007\"] = 1,\n [\"CITEREFHallidayMansfieldMarroPeto2004\"] = 1,\n [\"CITEREFHamiltonChrysikouCoslett2011\"] = 1,\n [\"CITEREFHankey1999\"] = 1,\n [\"CITEREFHaoTampiO\u0026#039;DonnellForoutan2018\"] = 1,\n [\"CITEREFHarbisonHossainJenkinsonDavis2003\"] = 1,\n [\"CITEREFHarbisonMasseyBarnettHodge1999\"] = 1,\n [\"CITEREFHarriganDeveikis2012\"] = 1,\n [\"CITEREFHartCatanesePereraNtaios2017\"] = 1,\n [\"CITEREFHartHalperinMcBrideBenavente2000\"] = 1,\n [\"CITEREFHartPearceAguilar2007\"] = 1,\n [\"CITEREFHebertGazianoHennekens1995\"] = 1,\n [\"CITEREFHeilman2014\"] = 1,\n [\"CITEREFHeoYoukSeo2021\"] = 1,\n [\"CITEREFHerderscheêHijdraAlgraKoudstaal1992\"] = 1,\n [\"CITEREFHill2005\"] = 1,\n [\"CITEREFHuNiuWinkelmayer2018\"] = 1,\n [\"CITEREFInstitute_for_Quality_and_Efficiency_in_Health_Care_(IQWiG)\"] = 1,\n [\"CITEREFInternet_Stroke_Center\"] = 1,\n [\"CITEREFIsoJacobsWentworthNeaton1989\"] = 1,\n [\"CITEREFIwasawaIchijoIshibashiYokota2016\"] = 1,\n [\"CITEREFJohnsonLanesWentworthSatterfield1999\"] = 1,\n [\"CITEREFJohnston2007\"] = 1,\n [\"CITEREFJonasFeltnerAmickSheridan2014\"] = 1,\n [\"CITEREFJungMattle2019\"] = 1,\n [\"CITEREFJüttlerUnterbergWoitzikBösel2014\"] = 1,\n [\"CITEREFKaufmanMilstein2012\"] = 1,\n [\"CITEREFKernanOvbiageleBlackBravata2014\"] = 1,\n [\"CITEREFKidwellChalelaSaverStarkman2004\"] = 1,\n [\"CITEREFKidwellSaverSchubertEckstein1998\"] = 1,\n [\"CITEREFKidwellWarach2003\"] = 1,\n [\"CITEREFKolata2018\"] = 1,\n [\"CITEREFKopito2001\"] = 1,\n [\"CITEREFKothariPancioliLiuBrott1999\"] = 1,\n [\"CITEREFKristiánSiesjö1996\"] = 1,\n [\"CITEREFKumar2009\"] = 1,\n [\"CITEREFKurthChabriatBousser2012\"] = 1,\n [\"CITEREFKuźmaLouridaMooreLevine2018\"] = 1,\n [\"CITEREFKyuBachmanAlexanderMumford2016\"] = 1,\n [\"CITEREFLangeFlynnRizzo2009\"] = 1,\n [\"CITEREFLanghorneRamachandra2020\"] = 1,\n [\"CITEREFLarssonVirtamoWolk2011\"] = 1,\n [\"CITEREFLaverLangeGeorgeDeutsch2017\"] = 1,\n [\"CITEREFLawMorrisWald2009\"] = 1,\n [\"CITEREFLawrenceCelestino_JuniorMatozinhoGovan2017\"] = 1,\n [\"CITEREFLearySaver2003\"] = 1,\n [\"CITEREFLebedevaUsheninGuraryGilev2022\"] = 1,\n [\"CITEREFLeeHongSaver2010\"] = 1,\n [\"CITEREFLeeOvbiageleHongWu2015\"] = 1,\n [\"CITEREFLeighOishiHsuLindquist2013\"] = 1,\n [\"CITEREFLeysHénonMackowiak-CordolianiPasquier2005\"] = 1,\n [\"CITEREFLimAlexander2009\"] = 1,\n [\"CITEREFLiuDingLengPu2018\"] = 1,\n [\"CITEREFLo_EH2008\"] = 1,\n [\"CITEREFLoetscherPotterWongdas_Nair2019\"] = 1,\n [\"CITEREFLongleyHazeltonHealPollock2021\"] = 1,\n [\"CITEREFMackenzie2011\"] = 1,\n [\"CITEREFMandrola2018\"] = 1,\n [\"CITEREFMartin2009\"] = 1,\n [\"CITEREFMedical_Research_Council_Working_Party1985\"] = 1,\n [\"CITEREFMerwick_ÁWerring2014\"] = 1,\n [\"CITEREFMistryMistryNakawahChitale2017\"] = 1,\n [\"CITEREFMiwaHoshiHougakuTanaka2010\"] = 1,\n [\"CITEREFMohrChoiGrottaWolf2004\"] = 1,\n [\"CITEREFMorrisAyabeInoueSakai2017\"] = 1,\n [\"CITEREFMurrayButtnerPrice2012\"] = 1,\n [\"CITEREFMüllerLyrerBrownBonati2020\"] = 1,\n [\"CITEREFNational_Institute_of_Neurological_Disorders_and_Stroke_(NINDS)1999\"] = 1,\n [\"CITEREFNaviIadecola2018\"] = 1,\n [\"CITEREFNealMacMahonChapman2000\"] = 1,\n [\"CITEREFNorDavisSenShipsey2005\"] = 1,\n [\"CITEREFNouhRemkeRuland2014\"] = 1,\n [\"CITEREFO\u0026#039;ReganWuAroraPerri2008\"] = 1,\n [\"CITEREFO\u0026#039;Sullivan2007\"] = 1,\n [\"CITEREFOdierMichel2014\"] = 1,\n [\"CITEREFOsterweil2006\"] = 1,\n [\"CITEREFPaciaroniAgnelliMicheliCaso2007\"] = 1,\n [\"CITEREFPegaNáfrádiMomenUjita2021\"] = 1,\n [\"CITEREFPollockBaerCampbellChoo2014\"] = 1,\n [\"CITEREFPollockFarmerBradyLanghorne2014\"] = 1,\n [\"CITEREFPollockHazeltonHendersonAngilley2012\"] = 1,\n [\"CITEREFPowersRabinsteinAckersonAdeoye2018\"] = 1,\n [\"CITEREFPsatyLumleyFurbergSchellenbaum2003\"] = 1,\n [\"CITEREFReithJørgensenNakayamaRaaschou1997\"] = 1,\n [\"CITEREFReynoldsLewisNolenKinney2003\"] = 1,\n [\"CITEREFRinglebChatellierHackeFavre2008\"] = 1,\n [\"CITEREFRoos2012\"] = 1,\n [\"CITEREFRopperSamuelsKleinPrasad2023\"] = 1,\n [\"CITEREFRothwellAlgraChenDiener2016\"] = 1,\n [\"CITEREFRothwellEliasziwGutnikovFox2003\"] = 1,\n [\"CITEREFRothwellEliasziwGutnikovWarlow2004\"] = 1,\n [\"CITEREFSandersLowensternBorreChatterjee2018\"] = 1,\n [\"CITEREFSardarChatterjeeGiriKundu2015\"] = 1,\n [\"CITEREFSaundersSandersonHayesJohnson2020\"] = 1,\n [\"CITEREFSaver2006\"] = 1,\n [\"CITEREFSaverGoyalvan_der_LugtMenon2016\"] = 1,\n [\"CITEREFScadding2011\"] = 1,\n [\"CITEREFSchiller1970\"] = 1,\n [\"CITEREFSchürksRistBigalBuring2009\"] = 1,\n [\"CITEREFSebökNiftrikLohausEsposito2021\"] = 1,\n [\"CITEREFSenelickRossiDougherty1994\"] = 1,\n [\"CITEREFShahLeeMcAllisterHunter2015\"] = 1,\n [\"CITEREFShuaibHachinski1991\"] = 1,\n [\"CITEREFSilvaBorgesSantiagoLucena2020\"] = 1,\n [\"CITEREFSimardSahuquilloShethKahle2011\"] = 1,\n [\"CITEREFSirvenMalamut2008\"] = 1,\n [\"CITEREFSloanKittnerRigamontiPrice1991\"] = 1,\n [\"CITEREFSmithEnglishJohnston2012\"] = 1,\n [\"CITEREFSnell2006\"] = 1,\n [\"CITEREFSpence2006\"] = 1,\n [\"CITEREFStaessenGasowskiWangThijs2000\"] = 1,\n [\"CITEREFStam2005\"] = 1,\n [\"CITEREFStanford_Hospital_\u0026amp;_Clinics\"] = 1,\n [\"CITEREFSteinerJuvelaUnterbergJung2013\"] = 1,\n [\"CITEREFStollHamann2002\"] = 1,\n [\"CITEREFStrandgaard1996\"] = 1,\n [\"CITEREFStrattonSansomBrown-MajorAnderson2020\"] = 1,\n [\"CITEREFStrausMajumdarMcAlister2002\"] = 1,\n [\"CITEREFSudlowMasonMauriceWedderburn2009\"] = 1,\n [\"CITEREFThe_Allhat_Officers_and_Coordinators_for_the_Allhat_Collaborative_Research_Group2002\"] = 1,\n [\"CITEREFThe_National_Institute_Of_Neurological_Disorders_And_Stroke_Rt-Pa_Stroke_Study_Group1995\"] = 1,\n [\"CITEREFThiemeMehrholzPohlBehrens2013\"] = 1,\n [\"CITEREFThomasCoupeCrossTan2019\"] = 1,\n [\"CITEREFThompson1996\"] = 1,\n [\"CITEREFThomson2009\"] = 1,\n [\"CITEREFTongPatrieTongEvans2017\"] = 1,\n [\"CITEREFTowfighiSaver2011\"] = 1,\n [\"CITEREFU.S._Preventive_Services_Task_Force2007\"] = 1,\n [\"CITEREFVermeerKoudstaalOudkerkHofman2002\"] = 1,\n [\"CITEREFVespaMartinZuccarelloAwad2013\"] = 1,\n [\"CITEREFVillarosaSingletonJohnson1993\"] = 1,\n [\"CITEREFWang2010\"] = 1,\n [\"CITEREFWannametheeShaperWhincupWalker1995\"] = 1,\n [\"CITEREFWardlawMurrayBergedel_Zoppo2012\"] = 1,\n [\"CITEREFWardlawMurrayBergedel_Zoppo2014\"] = 2,\n [\"CITEREFWarlowvan_GijnDennisWardlaw2008\"] = 1,\n [\"CITEREFWestHeskethVailBowen2005\"] = 1,\n [\"CITEREFWestoverMcBrideHaley2007\"] = 1,\n [\"CITEREFWhisnant1996\"] = 1,\n [\"CITEREFWhiteleySlotFernandesSandercock2012\"] = 1,\n [\"CITEREFWilsonAdamsRobertsonMurphy2015\"] = 1,\n [\"CITEREFWitykLlinas2007\"] = 1,\n [\"CITEREFWolfAbbottKannel1987\"] = 1,\n [\"CITEREFWorld_Health_Organisation1978\"] = 1,\n [\"CITEREFYermanGanSin2007\"] = 1,\n [\"CITEREFYewCheng2009\"] = 1,\n [\"CITEREFZhouTangWuLu2011\"] = 1,\n [\"CITEREFZiganshinaAbakumovaNurkhametovaIvanchenko2023\"] = 1,\n}\ntemplate_list = table#1 {\n [\"Authority control\"] = 1,\n [\"CNS diseases of the nervous system\"] = 1,\n [\"Cerebrovascular diseases\"] = 1,\n [\"Citation needed\"] = 5,\n [\"Cite book\"] = 30,\n [\"Cite journal\"] = 196,\n [\"Cite news\"] = 3,\n [\"Cite report\"] = 1,\n [\"Cite web\"] = 33,\n [\"Clarify\"] = 1,\n [\"Clear\"] = 1,\n [\"Col div\"] = 1,\n [\"Col-begin\"] = 1,\n [\"Col-break\"] = 2,\n [\"Col-end\"] = 1,\n [\"Colend\"] = 1,\n [\"Commons category\"] = 1,\n [\"Cs1 config\"] = 1,\n [\"Div col\"] = 1,\n [\"Div col end\"] = 1,\n [\"EMedicine2\"] = 3,\n [\"Harvnb\"] = 1,\n [\"ICD10\"] = 2,\n [\"ICD9\"] = 1,\n [\"Infobox medical condition (new)\"] = 1,\n [\"Legend\"] = 23,\n [\"Main\"] = 3,\n [\"Medical citation needed\"] = 2,\n [\"Medical condition classification and resources\"] = 1,\n [\"MedlinePlusEncyclopedia\"] = 1,\n [\"More medical citations needed\"] = 1,\n [\"NICE\"] = 1,\n [\"Ndash\"] = 1,\n [\"Other uses\"] = 1,\n [\"Pp-semi-indef\"] = 1,\n [\"Quotation needed\"] = 1,\n [\"Refbegin\"] = 1,\n [\"Refend\"] = 1,\n [\"Reflist\"] = 1,\n [\"Short description\"] = 1,\n [\"Subscription required\"] = 1,\n [\"TOC limit\"] = 1,\n [\"Unreferenced section\"] = 1,\n [\"Verify source\"] = 1,\n [\"Webarchive\"] = 2,\n}\narticle_whitelist = table#1 {\n}\n","limitreport-profile":[["?","380","18.1"],["dataWrapper 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