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7 Behaviors to Reduce the Risk of a Cryptogenic Stroke - Oren Zarif - Cryptogenic Stroke


The majority of ischemic strokes have no clear cause, so they are classified as "cryptogenic." Those with this diagnosis may be prone to a second or third attack, as a previous stroke increases the risk of a second attack by 16 times. Prevention is crucial to stroke survival, but it becomes even more complicated when the original stroke's cause is unknown. The most common causes of cryptogenic stroke are atrial fibrillation, smoking, and high blood pressure, among others.

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In some cases, the exact cause of a cryptogenic stroke can only be determined through further tests and monitoring. Regardless of the cause of a stroke, it's essential to follow your physician's instructions and follow heart monitoring regimens. Lifestyle changes can also reduce the risk of having a cryptogenic stroke. Here are seven behaviors to help reduce your risk. These behaviors may be simple, but they can help you reduce your chances of suffering from cryptogenic stroke.

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The definition of a cryptogenic stroke is quite broad. It refers to cerebral ischemia whose etiology has been elusive. In general, patients with cryptogenic stroke are younger and have fewer traditional vascular risk factors. Several mechanisms have been proposed, including cardioembolism due to occult atrial fibrillation, cardiovascular structural abnormalities, and hypercoagulable states. Other factors that increase the risk of a cryptogenic stroke include complex aortic plaques, Fabry's disease, and valvular heart disease.

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Using dual antiplatelet therapy is an alternative treatment for patients who have had a cryptogenic stroke. The dual antiplatelet therapy includes aspirin and clopidogrel for 21 days. There are no studies comparing the effects of these drugs in cryptogenic stroke, but they can improve the diagnosis of cryptogenic stroke. However, dual antiplatelet therapy may not be suitable for all patients who have cryptogenic stroke. So, if you suspect a cryptogenic stroke, it is imperative to consult your physician.

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Prolonged monitoring of the rhythm is a necessary part of a comprehensive cryptogenic stroke workup. Most patients are monitored during a stroke unit, and AF may be present even though it is not a risk factor. However, continuous monitoring will increase the yield of detection. Furthermore, wearable devices may allow for longer monitoring and less intrusive monitoring. These are just a few of the potential applications of prolonged monitoring. If you suspect you are having a cryptogenic stroke, it's crucial to know your risk factors.

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The functional outcome of patients with cryptogenic stroke is similar among potential embolic sources. However, whether a cryptogenic stroke is a worse outcome than a cardioembolic stroke is not clear. In a multicenter hospital-based stroke registry cohort study, researchers analyzed the outcomes of 2261 patients with cryptogenic stroke and 2163 with an undetermined source of embolism. While both types of stroke had similar overall outcomes, cancer-associated stroke patients had higher odds of being functionally dependent.

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Despite the lack of conclusive data from studies, aspirin is the standard of care for cryptogenic stroke. An implantable cardiac monitor can detect atrial fibrillation and begin anticoagulation. Unfortunately, anticoagulants have not yet been proven effective in this subgroup, and future research may uncover whether anticoagulation has some merit in cryptogenic stroke prevention. Furthermore, a significant proportion of cryptogenic stroke patients may have been referred to a secondary cause.

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A multivariate regression model was developed to identify the variables that influence the risk of a PFO. Using this score, vascular neurologists could stratify patients by their age, presence of traditional vascular risk factors, and risk of a PFO. Interestingly, a low ROPE score is associated with the presence of a deep infarct. Although a PFO does not cause cryptogenic stroke, it can result in a severe adverse event.

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Identifying the mechanism that causes CS is critical for improving secondary prevention strategies. A thorough evaluation of the cardiac system, including cardiac imaging, is necessary to determine the underlying cause. This information is essential to optimize secondary prevention strategies and identify if a PFO is contributing to a CS. And the most common CS cause is paradoxical embolism of the aorta or PFO. If the underlying causes are found, we can better target therapies for these conditions.

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