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From what I understand, strokes are caused by the same thing heart attacks are - atherosclerotic plaques, and APs are caused by high blood cholesterol - APs are literally constituted of cholesterol/foam cells. Has the consensus changed?


Depends on the type of stroke. There are occlusive strokes, which are due to blockage by plaques, and there are hemorrhagic strokes, which are due to vessel failure and bleeding.

Anecdata: My dad died of a hemorrhagic stroke. My mom of an occlusive stroke. No plaques in my dad. A very few in my mom. It's complicated.


While that may be the most common cause, there are many causes of strokes including, in some cases, birth defects that have nothing to do with lifestyle or genetics (as far as we know). See: AVM.


More commonly from dissections of the internal or external carotid or vertebral arteries, which for some bizarre reasons happens less as you age.


Don't take this the wrong way but your statement is incorrect. I don't have time to type out all the various subsets of strokes but Wikipedia is a good initial source. Dissections are fairly uncommon. Far more common are emboli strokes from afib, small vessel atherosclerosis, for example.

Interestingly, dissections as you mention cause ischemic strokes by (generally speaking) flicking off clots that mess things up downstream that form within a pouch made by the dissection (low blood flow + body trying to patch things up = pro-coagulation). Note in this case there is a tear in the artery wall but the wall remains (ie, no blood exits the artery).

This is different than an aneurysm, when the arterial wall bursts and you have bleeding within the brain. That is termed a hemorrhagic stroke.

Source: hospitalist physician for 7 years who has cared for 100s of strokes at a hospital that specializes in neurology.


I was under the impression that those correlations are clear but the causalities are still very much up for debate.


There are two major kinds of stroke, ischemic and hemorrhagic.




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