Thrombosis and Cerebrovascular Disease

Vascular endothelial-hemostatic interactions are important in maintaining uninterrupted cerebral blood flow. Alterations in the integrity of the endothelium of brain-supplying arteries may compromise flow secondary to platelet aggregation, activation of the coagulation system, or changes in the erythrocyte or leukocyte constituents of the blood with consequent thrombotic occlusion leading to cerebral ischemic tissue injury [1–3]. The majority of acute strokes are pathogenetically related to atherothrombotic or thromboembolic events [4–6]. The location and extent of the territory suffering ischemia is determined by the presence, the type and the degree of arterial collateralization [7–8]. Hemorheologic considerations may also affect the extent of cerebral tissue injury. This review outlines the role of thrombosis in acute stroke, some of the characteristics of the cerebrovascular anatomy important for the development of ischemic stroke, and the basis for the use of antithrombotic agents in the treatment of cerebral ischemia.

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