Main strock type:
♦️Artery to Artery embolism;
🔹Vulnerable plaque ruptures & causes clot formation
🔹Occludes the artery & distal blood flow
🔹Makes a wedge shape
♦️Distal hypoperfusion;
🔹At the border zones
🔹Remember borderzones almost look like a fancy letter H
🔹for Hypoperfusion = two vertical lines (ant, internal watershed) that have curls at each end (ant & post external watersheds)
♦️ Vasculitis;
🔹Inflammation ofvessel wall
🔹Idiopathic, autoimmune, or infectious
🔹Remember: Vascu-LIGHT-us = tons of little regions LIGHT up on DWI
🔹Remember Vascu-LITE-us = usually in LITE vessels or small vessel territories
♦️ Impingement on perforatos;
🔹Large vessel plaque covers opening of small perforator in its wall
🔹Perforators affect the Ps = pons, putamen (lenticulostriate)
🔹Small vessel dz
🔹Many different pathologies that cause occlusion of small, unnamed vessels
🔹Remember: Small & subcortical both start w/-tend to be subcortical
♦️Cardioembolic;
🔹Emboli from heart stasis or vegetations
🔹Remember: Emboli & everywhere both start w/E = emboli go everywhere
🔹So now you know how different etiologies have different distributions on MRI.
JYOTI