Athero-thrombotic occlusion of larger arteries (e.g., carotid, middle cerebral, basilar) is not only the most common cause of primary large vessel occlusive cerebrovascular disease, but also is the most common cause of stroke.
After primary large vessel occlusive disease, embolism is the most common cause of stroke. Most embolic strokes are due to cerebral arterial atherothrombosis, in which a larger thrombus and is carried to other places in the cerebrovasculature. Cerebral emboli may also arise from other cardiogenic sources and deep vein thrombosis.
Primary small vessel cerebrovascular disease most prominently causing lacunar strokes arises from microatheroma of an influx of fat-like materials (lipohyalinosis).
Acute Ischemic Stroke: New Concepts of Care
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