Biomarker Profile for Cryptogenic Stroke - Oren Zarif - Cryptogenic Stroke
The clinical manifestations of cryptogenic stroke are not completely understood. A recent study published in Neurology provides a new biomarker profile to help distinguish between ischemic and cryptogenic stroke. It highlights the importance of a thorough diagnostic evaluation in patients with cryptogenic stroke. This biomarker has great potential to help clinicians diagnose and treat cryptogenic stroke. However, further research is needed to determine whether this marker is helpful in treating this condition.
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While the exact cause of a cryptogenic stroke is not yet known, lifestyle factors such as smoking, high-fat diet, and major stress, lack of exercise, and pregnancy may all increase the risk of having a stroke. In addition, men and women who are taking testosterone therapy or post-menopausal hormone therapy may also be at a higher risk. Regardless of the cause, researching the causes can help you discover underlying health conditions you might not have thought of before.
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Cardiovascular disease such as atrial fibrillation is one of the most common causes of cryptogenic stroke. AF can be intermittent, making diagnosis difficult. Prolonged outpatient monitoring will increase the chance of detecting atrial fibrillation and potentially preventing cryptogenic stroke. This monitoring can be done through a wearable device. In addition, these devices may help physicians identify patients with AF early enough for an effective treatment plan. When a cryptogenic stroke occurs, physicians should be proactive rather than reactive.
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In fact, studies of new risk factors for cryptogenic stroke should prompt a revision of the term and definition. These studies should help clarify any lingering diagnostic doubts as well as suggest new clinical approaches. While cryptogenic stroke may account for a significant proportion of ischemic stroke, it should not be considered a diagnosis for any patient with a prior ischemic stroke. There are also many undiagnosed causes of cryptogenic stroke.
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Thrombigraphy is an important diagnostic test in identifying thrombi in the body. Transthoracic echocardiography (TEE) and transoesophageal echocardiograms (TEE) can detect intra-cardiac sources of stroke. TEE is superior in detecting valvular abnormalities, such as vegetation's left atrial thrombus. The test can also assess the aortic arch in patients of any age. The study also identified common modifiable risk factors for cryptogenic stroke.
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During the ESUS procedure, a paradoxical embolism may be responsible for a cryptogenic stroke. It may occur in younger patients without typical stroke risk factors. Studies indicate that paradoxical embolism through PFO can cause stroke. In patients who have PFO, agitated saline contrast is a diagnostic tool. However, only TEE can visualize the PFO directly. Several important management questions must be addressed for these patients.
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The treatment of cryptogenic stroke depends on its risk factor. Anticoagulation is an important step in cryptogenic stroke prevention. The standard of care is aspirin, but patients with cryptogenic stroke should be considered for anticoagulation if they are noncardioembolic. Despite this, anticoagulation does not seem to be an effective treatment for cryptogenic stroke. However, patients with this complication may benefit from antithrombotic medication.
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During the ischemic phase of cryptogenic stroke, a number of risk factors have not been identified. In the early stages of cryptogenic stroke, a patient may have experienced atrial fibrillation and had no other cardiovascular risk factors. This can result in a cryptogenic stroke, in which the cause of the stroke is unknown. Typically, patients with cryptogenic stroke are younger and do not have any traditional vascular risk factors. However, there are several mechanisms that are considered to be associated with the occurrence of cryptogenic stroke. Some of these include sub-stenotic large vessel disease, cardiac structural abnormalities, and hypercoagulable states. In addition, patients with cryptogenic stroke are at increased risk of recurrent stroke.
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Cardioembolic sources of cryptogenic stroke include mitral annular calcification, aortic valve stenosis, and sick sinus syndrome. Other cardiac structures may include atherosclerotic plaques and cancer-associated emboli. However, it is still important to identify the source of the cryptogenic stroke in order to improve secondary prevention strategies. This requires a comprehensive assessment of the patient's cardiac system. For this purpose, a comprehensive evaluation should be performed, including cardiac imaging and monitoring.