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Arterial ischemic stroke AIS - Coggle Diagram
Arterial ischemic stroke AIS
risk factors
arteriopathies >50%
focal or transient cerebral arteriopathy (FCA, TCA)
unilateral
IC arteriopathy - distal internal carotid artery and proximal middle/anterior cerebral artery
lenticulostriate infarct - basal ggl
narrowing/banding/striae/stenosis of affected artery
serial imaging: instability in 3-6, stability/improvement >6 mo
(non-progressive)
association with viral upper respirory infection
postvaricella angiopathy PVA: lenticulostriate artery, within 12 mo
adults: after herpes zoster ophtalmicus - reactivation from trigeminal ggl, spread to proximal cerebral arteries
childhood primary angiitis of CNS cPACNS
unilateral large vessel ~ TCA
bilateral: both large and small vessel types, anterior or posterior, progressive, agressive immunotherapy
angiogram negative: headache, seizures, cognitive decline, behavioral/personality change - MRI multifocal enhancing lesions -definitive diagnosis brain biopsy
systemic vasculitis, connective tissue diseases: Kawasaki, Henoch-Schönlein, polyarteritis nodosa, Wegener granulomatosis, SLE, Bechet, mixed connective tissue disorder, Sjorgren, inflammatory bowel disease, Takayasu
dissection, physical injury
Moyamoya sy
congenital/genetic arteriopathies
treatment of angiitis:antivirals, corticosteroid, immunosuppressive cyclophosphamide, azathioprine, mycophenolate - pediatric rheumatologist!
infections: herpes viruses, bacterial/tuberculous meningitis, mycoplasma, toxoplasmosis, rocky mountain fever, Lyme, cryptococcus, Japanese encephalitis, coxsackie B4 and A9, influenza A, enterovirus, parvovirus B19, HIV, chlamydia
screeining
infections: serology, virology, PCR
hematological blood work
inflammatory: CRP, ESR
vasculitic markers: ANA, extractable nuclear antigens, complement
CSF
cardiac
sickle cell disease
other
Reference: Swaiman 2019