A stroke, often referred to as a “brain attack,” is one of the leading causes of death and disability worldwide. Every second counts when it comes to stroke diagnosis, but prevention and early identification of risk factors can save lives and improve recovery outcomes.
To make learning the various causes of stroke easier, the "Medicine is Fun" visual uses a brilliant memory trick — the mnemonic "7 C's". Each “C” corresponds to a different risk factor or causative condition. In this article, we decode these 7 C’s with clinical clarity, real-world examples, and SEO-rich insights.
What Is a Stroke?
A stroke occurs when blood flow to a part of the brain is interrupted or reduced, preventing brain tissue from getting enough oxygen and nutrients. Brain cells begin to die within minutes, making stroke a medical emergency.
There are two main types of stroke:
- Ischemic Stroke – caused by a blockage or clot.
- Hemorrhagic Stroke – caused by bleeding in or around the brain.
There’s also a Transient Ischemic Attack (TIA), often called a mini-stroke, which is a temporary blockage that doesn’t cause permanent damage but is a warning sign of future strokes.
Mnemonic: 7 C’s of Stroke Causes
To help remember uncommon yet clinically significant causes of stroke, especially in young adults, the mnemonic "7 C’s" comes to the rescue. Here's what each “C” stands for:
1. Cocaine Abuse
Cocaine is a powerful vasoconstrictor. It can cause:
- Sudden cerebral vasospasm
- Increased blood pressure
- Ischemia or hemorrhage
Cocaine-related strokes are more common in younger adults and can be both ischemic and hemorrhagic. The effect is immediate and life-threatening.
💡: cocaine stroke risk, drug-induced stroke, vasospasm stroke
2. Cancer / Metastasis
Cancer increases the risk of stroke through:
- Hypercoagulable states
- Non-bacterial thrombotic endocarditis (NBTE)
- Tumor emboli
Some cancers like pancreatic, lung, and brain tumors increase pro-coagulant activity in blood. Paraneoplastic syndromes may also contribute.
💡: cancer-related stroke, stroke in cancer patients, tumor embolism
3. Cardiac Emboli / Hypercoagulability
Strokes from cardiac sources are often embolic strokes and include:
- Atrial fibrillation (most common cause)
- Valvular heart diseases
- Infective endocarditis
- Prosthetic valves
- Cardiomyopathy
Additionally, hypercoagulable states — inherited (e.g., Factor V Leiden, Protein C or S deficiency) or acquired (e.g., antiphospholipid syndrome) — raise stroke risk.
💡: cardioembolic stroke, atrial fibrillation stroke risk, hypercoagulable stroke
4. CNS Infections
Certain infections of the central nervous system (CNS) can lead to inflammation, vasculitis, and subsequent stroke:
- Tuberculosis meningitis
- HIV-associated vasculitis
- Herpes simplex virus
- Fungal infections (especially in immunocompromised)
Infections may cause damage to blood vessel walls, promoting clot formation or hemorrhage.
💡: infection-related stroke, CNS vasculitis, stroke and meningitis
5. Congenital Arterial Lesions
Arteriopathies present from birth may go unnoticed until a stroke occurs:
- Moyamoya disease
- Arteriovenous malformations (AVMs)
- Cerebral aneurysms
These are structural anomalies of cerebral vessels that may rupture or cause turbulent flow and thrombus formation.
💡: congenital stroke causes, AVM and stroke, Moyamoya disease stroke
6. Consanguinity
While consanguinity (marriage within close relatives) is not a direct cause, it increases the risk of autosomal recessive disorders, some of which are associated with stroke:
- Homocystinuria
- Sickle cell disease
- Fabry disease
Children born from consanguineous unions may inherit double alleles for rare genetic pro-thrombotic conditions.
💡: genetic stroke disorders, consanguinity and health risks, inherited stroke causes
7. Hypercoagulation
This refers to increased clotting tendency in blood and overlaps with some of the conditions already listed (e.g., cancer, cardiac emboli). But other standalone causes include:
- Pregnancy
- Oral contraceptive pills (OCPs)
- COVID-19
- Lupus anticoagulant
- Dehydration and sepsis in the elderly
💡: hypercoagulable state and stroke, clotting disorders, stroke risk in pregnancy
Stroke Causes Table (7 C's Mnemonic Breakdown)
| Mnemonic | Full Form | Stroke Mechanism | Common Example(s) |
|---|---|---|---|
| C1 | Cocaine Abuse | Vasospasm, hemorrhage | Cocaine-induced hypertensive crisis |
| C2 | Cancer / Metastasis | Hypercoagulability, emboli | Lung cancer, pancreatic cancer |
| C3 | Cardiac Emboli / Coagulation | Thromboembolism | Atrial fibrillation, valvular heart disease |
| C4 | CNS Infections | Vasculitis, inflammation | Tubercular meningitis, HIV |
| C5 | Congenital Arterial Lesions | Structural defect rupture | Moyamoya, AVM, Berry aneurysm |
| C6 | Consanguinity | Genetic coagulopathies | Sickle cell anemia, Fabry disease |
| C7 | Hypercoagulation | Excess clotting | Lupus, OCP use, cancer, pregnancy |
Stroke in the Young: A Growing Concern
Traditionally, stroke was associated with elderly patients. However, strokes in individuals under 45 years are on the rise due to:
- Drug use (especially cocaine and amphetamines)
- Genetic thrombophilia
- Autoimmune conditions
- Uncontrolled hypertension in young adults
The 7 C’s mnemonic is particularly useful in differential diagnosis of stroke in young patients where conventional causes like atherosclerosis are absent.
How to Remember the 7 C’s More Effectively
- Visual Mnemonics – Use the “Medicine is Fun” image: a tired, punch-drunk brain character holding an ice pack.
- Word Association – Link each “C” to an image or condition you know.
- Use Spaced Repetition – Review after 1 day, 1 week, and 1 month.
- Clinical Case Examples – Practice linking causes to symptoms in hypothetical patients.
- Flashcards or Quizzes – Test yourself or friends with "Which C does this belong to?" scenarios.
Stroke: Warning Signs to Remember (BE FAST)
While this article focuses on causes, quick identification is crucial. Remember BE FAST:
- Balance issues
- Eye vision loss
- Face drooping
- Arm weakness
- Speech difficulty
- Time to call emergency services
Stroke is a time-sensitive emergency. Act fast!
FAQs on Stroke Causes and the 7 C's Mnemonic
What is the most common cause of stroke?
Globally, the most common cause is ischemic stroke due to atherosclerosis. However, in young adults or unusual presentations, causes like those in the 7 C’s mnemonic must be considered.
Can a healthy young person have a stroke?
Yes, especially due to drug abuse (cocaine), congenital heart or vascular defects, or inherited hypercoagulable states.
Are all "C" causes modifiable?
No. Some like congenital arterial lesions or consanguinity-related genetic disorders are not modifiable. However, cocaine abuse, cancer screening, and control of cardiac disease can significantly reduce risk.
How does cancer increase stroke risk?
Through:
- Direct tumor embolism
- Cancer-associated thrombosis (Trousseau syndrome)
- Nonbacterial thrombotic endocarditis
Can infections cause stroke?
Yes. Meningitis, HIV, TB, and fungal CNS infections can cause inflammation or occlusion of cerebral vessels, leading to stroke.
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