A thrombotic stroke is a type of ischemic stroke that occurs when a blood clot, also called a thrombus, forms and blocks blood flow through the artery in which it formed.   The blood clot may block the flow of oxygen-rich blood to a portion of the brain, causing long-term brain damage . This brain damage caused by a lack of adequate blood supply produces a stroke.

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    Types of Thrombotic Stroke

    A thrombotic stroke may also be called a cerebral thrombosis, a cerebral infarction or a cerebral infarct.

    Thrombotic strokes are divided into two categories based on the size of the area of blockage within the brain: large-vessel thrombosis and small-vessel thrombosis .

    Large-vessel stroke occurs in the larger blood-supplying arteries of the brain, such as the carotid artery or middle cerebral artery . Large-vessel thrombotic strokes typically cause substantial symptoms and long-term effects, such as aphasia (trouble with language) or hemiparesis (weakness of one side of the body.)

    Small-vessel stroke occurs when blood flow is blocked to a small and deep penetrating arterial blood vessel. This type of stroke is also known as a lacunar stroke or a subcortical stroke. A small-vessel thrombus can also result in a brainstem stroke .   Small-vessel strokes are literally small in size, affecting only a limited area of the brain. Depending on the area impacted by a small thrombotic stroke, it can produce minor effects or it can produce substantial handicaps if it impacts a region of the brain that is responsible for important and noticeable physical or cognitive abilities.

    Symptoms and Effects

    A thrombotic stroke can occur in any area of the brain, and the immediate symptoms and long-term effects of a thrombotic stroke correlate with the area of the brain that is affected by a lack of blood supply.

    Symptoms of a thrombotic stroke may include any combination of the following:  

    • Trouble understanding words or trouble speaking
    • Sudden confusion
    • Loss of consciousness
    • Weakness of the face, arm, or leg on one side of the body
    • Numbness of the face, arm, or leg on one side of the body
    • Blurred vision in one or both eyes
    • Double vision
    • Sudden, severe headache
    • Dizziness
    • Difficulty walking
    • Loss of balance or coordination

    Causes and Risk Factors

    There are several causes of thrombotic stroke.

    • Atherosclerosis or narrowing of the blood vessels: A thrombotic stroke is most commonly caused by the narrowing of the arteries in the head or neck. Most often caused by atherosclerosis, the arteries become diseased and irregular. This occurs as a result of high blood pressure, diabetes, and build-up of cholesterol, fat, and debris in sections of the blood vessels. Over time, this material can become "sticky," causing blood cells to collect and form a blood clot. Atherosclerosis and narrowing of the blood vessels in the brain is often referred to as cerebrovascular disease.
    • High blood pressure: Persistently high blood pressure, also called hypertension, may cause disease and narrowing of the blood vessels, predisposing to thrombotic strokes. Hypertension and atherosclerosis are conditions that often occur together, which causes even further damage to the blood vessels.
    • High cholesterol: High cholesterol levels in your body can cause cholesterol and fat to deposit in the blood vessels, exacerbating the risk of thrombotic stroke.
    • Diabetes: Diabetes is a well-known risk factor for thrombotic stroke. It can cause narrowing of large and small blood vessels leading to the formation of a thrombus and consequent stroke.
    • Blood clotting disorders: Some blood clotting disorders make it more likely for excessive blood clots to form, increasing the chances of a thrombotic stroke.
    • Smoking: Smoking is one of the leading risk factors of stroke and heart disease because it causes damage to the blood vessels throughout the body.
    • Recreational drugs: Certain drugs, such as cocaine, methamphetamine , and performance-enhancing substances can promote the slow development of cerebrovascular disease. These drugs may also cause sudden narrowing and or "spasm" of the blood vessels, abruptly closing off blood flow to an area of the brain for a brief period of time.
    • Trauma to the blood vessels of the neck: While it is not common, there are instances in which severe trauma can induce the formation of a blood clot, resulting in stroke
    • Transient ischemic attack: A thrombotic stroke may be preceded by a series of one or more transient ischemic attacks, also known as “mini-strokes” or TIAs . A TIA may last for a few minutes or hours and is often a sign of an impending stroke. The symptoms of a TIA are similar to those of a stroke.

    Stroke Risk Factors in Women

    Guidelines for stroke prevention jointly published by the American Heart Association and American Stroke Association note that certain risk factors, including diabetes, hypertension, migraine with aura and atrial fibrillation, are stronger or more prevalent in women than men.  

    A Word From Verywell

    A thrombotic stroke is among the most common causes of stroke. There are a number of treatments for thrombotic stroke, including blood thinners such as TPA and procedures that can help to dissolve and remove a blood clot. If you or a loved one has experienced a thrombotic stroke, you may need to participate in a post-stroke rehabilitation program , which can help with your recovery.

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    Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

    1. American Stroke Association. Ischemic stroke .

    2. Tsai HH, Kim JS, Jouvent E, Gurol ME. Updates on prevention of hemorrhagic and lacunar strokes . J Stroke. 2018;20(2):167-179. doi:10.5853/jos.2018.00787

    3. American Stroke Association. Types of stroke .

    4. American Stroke Association. Atherosclerosis and stroke .

    5. Menet R, Bernard M, Elali A. Hyperlipidemia in stroke pathobiology and therapy: Insights and perspectives . Front Physiol. 2018;9:488. doi:10.3389/fphys.2018.00488

    6. Pan B, Jin X, Jun L, Qiu S, Zheng Q, Pan M. The relationship between smoking and stroke: A meta-analysis . Medicine (Baltimore). 2019;98(12):e14872. doi:10.1097/MD.0000000000014872

    7. Centers for Disease Control and Prevention. Types of stroke .

    8. Bushnell C, McCullough LD, et al. Guidelines for the prevention of stroke in women: A statement for healthcare professionals from the American Heart Association/American Stroke Association . Stroke. 2014 May;45(5):1545-88. doi: 10.1161/01.str.0000442009.06663.48.

    Additional Reading

    • Harvard Health. Thrombotic stroke .

    • Spacek M, Zemanek D, Hutyra M, Sluka M, Taborsky M. Vulnerable atherosclerotic plaque - review of current concepts and advanced imaging . Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2018 Mar;162(1):10-17. doi:10.5507/bp.2018.004

    How does thrombosis cause stroke?
    A thrombotic stroke is a type of ischemic stroke that occurs when a blood clot, also called a thrombus, forms and blocks blood flow through the artery in which it formed. 1 The blood clot may block the flow of oxygen-rich blood to a portion of the brain, causing long-term brain damage. more
    What causes stroke like symptoms but is not a stroke?
    “Under the age of 50, most stroke mimics are migraines, epilepsy, seizures, multiple sclerosis or high blood pressure that causes swelling in the brain,” he said. “Over the age of 50, most patients experiencing a stroke mimic are the result of epilepsy, metabolic derangement or a mass lesion in the brain.” more
    What looks like a stroke but is not a stroke?
    One of the most common stroke mimics is a seizure, which researchers believe account for as many as 20% of all stroke mimics. Other common stroke mimics include migraines, syncope, sepsis, brain tumor and metabolic derangement (low sodium or low blood sugar). more
    What is the difference between a small stroke and a mini-stroke?
    A transient ischaemic attack or TIA is also known as a mini-stroke. It is the same as a stroke, except that the symptoms only last for a short amount of time. This is because the blockage that stops the blood getting to your brain is temporary. more
    Does a mini-stroke mean you will have a stroke?
    A TIA usually lasts only a few minutes and doesn't cause permanent damage. Often called a ministroke, a TIA may be a warning. About 1 in 3 people who has a TIA will eventually have a stroke, with about half occurring within a year after the TIA . more
    What is the difference between a mini-stroke and a mild stroke?
    A transient ischaemic attack or TIA is also known as a mini-stroke. It is the same as a stroke, except that the symptoms only last for a short amount of time. This is because the blockage that stops the blood getting to your brain is temporary. more
    What can cause stroke like symptoms but is not a stroke?
    Conditions That Look Like a Stroke
    • Seizures.
    • Migraine.
    • Low or High Blood Sugar.
    • Bell's Palsy.
    • Brain Tumors.
    • Multiple Sclerosis (MS)
    • Conversion Disorder.
    • Sepsis and Other Infections.
    Is a silent stroke the same as a mini stroke?
    A silent stroke differs from a transient ischemic attack (TIA). In TIA symptoms of stroke are exhibited which may last from a few minutes to 24 hours before resolving. A TIA is a risk factor for having a major stroke and subsequent silent strokes in the future. more
    How long do stroke symptoms last before a stroke?
    Stroke symptoms typically last more than 24 hours, and may or may not resolve, even with therapy. Some stroke symptoms may never resolve or get better. TIA symptoms last for a short time. Symptoms can begin to resolve in about 1 to 5 minutes, which is typical, but some may take about 24 hours to resolve. more
    What causes stroke symptoms but not a stroke?
    Low or High Blood Sugar Low blood sugar can look a lot like a stroke. You may feel like you're just not all together mentally. You might feel clumsy or not be able to move one side of your body. And it can make you dizzy, give you tingling around your mouth, and cause a headache. more
    How long after a mini-stroke can you have a stroke?
    Experiencing TIA is a warning that you may be at high risk for a stroke. To address this risk, it should be treated immediately. One out of every three people who experience TIA end up having an ischemic stroke within one year of the TIA. Often, the stroke occurs within a few days or weeks following the TIA. more

    Source: www.verywellhealth.com

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