acute_ischemic_stroke_etiology [Neurosurgery Wiki]

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The cerebral metabolic rate of oxygen consumption ([[CMRO2]]) arises from [[neuron]]s utilizing energy for two functions: 

1) maintenance of cell integrity ([[homeostasis]]) which normally accounts for ≈ 40% of energy consumption, and 2) conduction of electrical impulses. The occlusion of an artery produces a central core of ischemic tissue where the [[CMRO2]] is not met. The oxygen deficiency precludes aerobic [[glycolysis]] and [[oxidative phosphorylation]]. [[ATP]] production declines and cell homeostasis cannot be maintained, and within minutes irreversible cell death occurs; a so-called [[cerebral infarction]]. Surrounding this central core is the [[penumbra]], where collateral flow (usually through [[leptomeningeal vessels]]) provides marginal [[oxygenation]] which may impair cellular function without immediate irreversible damage. Cells in the penumbra may remain viable for hours.
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Cerebral [[ischemia]] due to [[cerebral vasospasm]] is a feared complication in patients following [[aneurysmal subarachnoid hemorrhage]] (SAH). 


see [[Posttraumatic cerebral infarction]].

see [[Malignant middle cerebral artery infarction]].

Brain infarction results from a focal decrease in [[cerebral blood flow]]. 

A [[tandem occlusion]] is an uncommon presentation of [[acute ischemic stroke]] that involves occlusion of the extracranial [[internal carotid artery]] (EICA) and concomitant occlusion of either the intracranial ICA and/or [[middle cerebral artery]]