Cryptogenic Stroke
- 3 February 2017
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation Research
- Vol. 120 (3), 527-540
- https://doi.org/10.1161/circresaha.116.308447
Abstract
Background: Cryptogenic stroke accounts for 30% to 40% of ischemic stroke. It is essential to determine the possible culprit because this will improve secondary stroke prevention strategies. Methods: We performed a narrative nonsystematic review of the literature that included randomized trials, exploratory comparative studies, and case series on cryptogenic stroke. Results: There are several possible mechanisms implicated in cryptogenic stroke, including occult paroxysmal atrial fibrillation, patent foramen ovale, aortic arch atherosclerosis, atrial cardiopathy, and substenotic atherosclerosis. The heterogeneity of these mechanisms leads to differences in stroke prevention strategies among cryptogenic stroke patients. Conclusions: A thorough diagnostic evaluation is essential to determine the pathogenesis in cryptogenic stroke. This approach, in addition to risk factor management and lifestyle modifications, will lead to improved stroke prevention strategies in patients with cryptogenic stroke. This will allow for targeted clinical trials to improve stroke prevention strategies in this patient population.Keywords
This publication has 119 references indexed in Scilit:
- LA Volumes and Reservoir Function Are Associated With Subclinical Cerebrovascular Disease: The CABL (Cardiovascular Abnormalities and Brain Lesions) StudyJACC: Cardiovascular Imaging, 2013
- Amino Terminal Pro–B-Type Natriuretic Peptide, Secondary Stroke Prevention, and Choice of Antithrombotic TherapyStroke, 2013
- Outpatient cardiac telemetry detects a high rate of atrial fibrillation in cryptogenic strokeJournal of the Neurological Sciences, 2013
- Prevalence of Nonstenosing, Complicated Atherosclerotic Plaques in Cryptogenic StrokeJACC: Cardiovascular Imaging, 2012
- Recommendations for Imaging of Acute Ischemic StrokeStroke, 2009
- Patent Foramen Ovale in Cryptogenic StrokeStroke, 2009
- Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparisonThe Lancet, 2007
- Transesophageal Echocardiography Is Superior to Transthoracic Echocardiography in Management of Patients of Any Age With Transient Ischemic Attack or StrokeStroke, 2006
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke, 1993
- MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosisThe Lancet, 1991