The cerebral circulation and cerebrovascular disease II: Pathogenesis of cerebrovascular disease.

Predisposing vascular abnormalities, either genetic or acquired, may also be involved.[ 41 52 53 ] Although arterial dissection of all causes accounts for only 2% of all ischemic strokes, it is still a highly significant cause of CVD among those under 45 years, causing 20% of all strokes in this population.[ 54 ] The manner whereby dissection results in stroke may proceed in multiple fashions: one involves the formation of thromboemboli at the site of injury, and the other involves hemodynamic insufficiency due to occlusion or severe stenosis.[ 41 ] In either case, the initiating event is a tear in the tunica media, through which blood is admitted into the arterial wall.

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