Unusual Causes of Stroke

I am pleased to serve as the guest editor of this issue of Practical Neurology, providing updates on several uncommon causes of stroke. Although ischemic and hemorrhagic stroke are leading causes of death and disability, it is important to remember that these vascular events are secondary to other diseases. The overall management of individuals with either ischemic or hemorrhagic stroke is influenced greatly by the underlying cause. Although atherosclerosis and cardiac diseases, such as atrial fibrillation, are common etiologies of ischemic stroke, several other diseases that are acquired or of genetic origin may also cause stroke.

In this issue, several internationally recognized experts provide updates about some of the less common causes of stroke. We begin with Mitchell S. V. Elkind discussing the broader category of Atrial Cardiomyopathies and Stroke, an expanded understanding of atrial fibrillation. Next, Ilana E. Green, Andrew M. Southerland, and Bradford B. Worrall share an update on Fibromuscular Dysplasia and Stroke, including the presentation and management of the condition. The importance of Infectious Causes of Stroke, and how to recognize and treat bacterial, viral, and fungal infections is ably covered by Jennifer E. Fugate. Next, we cover a genetically driven cause of stroke: Moyamoya Disease by Alaa Montaser and Edward Smith. We then turn to immune-related strokes with my contribution on Takayasu Disease and finish with Susac Syndrome, now shown to be an autoimmune disease, by Ilka Kleffner, Catharina C. Gross, Marius Ringlestein, Jörg Rehrmann, MD Markus Kraemer, and Jan Dörr.

Although these diseases are uncommon, they occur with enough frequency that the neurologist should be aware of their clinical features, the ways to diagnose them, and the best treatment options to prevent recurrent vascular events. I hope the reader finds these updates to be useful and a resource that can be used in the future.