1. Understanding Stroke Slideshow Pictures
2. Take the Stroke Quiz
3. Slideshow: Atrial Fibrillation Causes, Tests, and Treatment

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Brain cells require oxygen and glucose to function. If the blood supply is lost, then nutrient supply is lost, and the brain cells stop working. The blood supply to brain cells can be lost in a few different ways.

• Blood clots can form in one of the tiny arteries of the brain (thrombosis). This is usually preceded by gradual narrowing of the blood vessel by fatty build-up called plaque. Atherosclerosis (atheroma=deposits of cholesterol and fatty tissue + sclerosis + narrowing) of the brain arteries is the same as the narrowing that occurs in heart arteries preceding a heart attack. A blood clot can form if the plaque ruptures, leading to further blockage of the artery.
  
  
• Blood clots can float downstream from the heart and get caught in a tiny blood vessel (embolus). Atrial fibrillation (A fib) is the most common reason for an embolus. In atrial fibrillation, the upper chambers of the heart jiggle and don't beat in a coordinated fashion. This allows blood to become stagnant and form small clots. These clots can embolize to any organ in the body, but the brain is a common target.
  
  
• Debris can occlude the blood vessels and stop blood flow. This debris often breaks off from carotid arteries that are narrowed by the atherosclerotic disease process described above.
  
  
• Blood vessels can leak and cause bleeding within the brain tissue. An intracerebral hemorrhage (intra=within + cerebral= of the brain + hemorrhage=bleeding) is often caused by high blood pressure which can cause small blood vessel walls to become thin and weak.

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