19th July 2023

Ischaemic stroke

The majority of strokes are due to cerebral infarction. Causes of infarction include atherosclerosis, cardioembolic disease, vessel disease, e.g. vasculitis, dissection, venous thrombosis and haematological disease, e.g. sickle cell anaemia and hypercoagulable states. In some cases, there will be no cause identified.

Risk factors include increasing age, personal history of ischaemic stroke, hypertension, smoking, diabetes mellitus, atrial fibrillation, carotid artery stenosis, sickle cell disease and dyslipidaemia.

Classification


Total Anterior Circulation Stroke (TACS)	All 3 of the following criteria are present unilateral weakness and/or sensory deficit of at least two areas of the face, arm and leg homonymous hemianopia higher cerebral dysfunction, e.g. dysphasia, visuospatial disorder
Partial Anterior Circulation Stroke (PACS)	2 of the following criteria are present unilateral weakness (+/or sensory deficit) of face, arm and leg homonymous hemianopia higher cerebral dysfunction, e.g. dysphasia, visuospatial disorder
Lacunar stroke	1 of the following pure motor stroke pure sensory stroke sensorimotor stroke ataxic hemiparesis
Posterior Circulation Stroke (POCS)	1 of the following ipsilateral cranial nerve palsy with contralateral motor and/or sensory deficit bilateral motor and/or sensory deficit disorder of conjugate eye movement cerebellar dysfunction isolated homonymous hemianopia

Table 1: Oxford Community Stroke Project (Bamford)

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