Stroke risk factors and etiologies include which of the following?

• A. Cerebral thrombi/emboli
• B. Atherosclerosis
• C. Hypertension
• D. All of the above

Answer: (D)

Stroke can result from both blocked vessels and ruptured vessels. Cerebral thrombi and emboli are direct causes of ischemic stroke, where blood flow is suddenly obstructed in a vessel supplying the brain. Atherosclerosis sets the stage by thickening and narrowing arteries; these plaques can rupture or erode, leading to thrombosis or embolization that cuts off blood flow. Hypertension damages vessel walls and makes them prone to rupture, a key mechanism for intracerebral hemorrhage, while also driving small-vessel disease that can produce lacunar ischemic strokes. Because each factor contributes to stroke risk or its underlying mechanisms, the best choice is all of the above. Controlling hypertension, in particular, has a major impact on reducing overall stroke risk.