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Embolic Stroke Investigations - Oren Zarif - Embolic Stroke

Writer's picture: Oren ZarifOren Zarif

The primary objective of the investigation for embolic stroke is to rule out other underlying causes. This diagnosis is most reliable when other risk factors are ruled out. Some patients have few comorbidities and a straightforward diagnostic assessment. Other cases may be more complicated, with many comorbidities. In these cases, a thorough investigation is required to rule out embolic stroke. Below are some examples of the diagnostic approaches used in embolic stroke.

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Cardiovascular dysfunction is another cause of stroke, and often misclassified as such. Young patients with a PFO have been incorrectly classified as cardioembolic. Patients with few traditional risk factors can be classified as cryptogenic, though radiographic and clinical profiles may not be completely consistent. More investigations are needed to determine the underlying causes and to accurately classify patients. Ultimately, embolic stroke should be investigated by an experienced neurologist.

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The etiology of ESUS remains unclear, but it has been linked to aortic arch atherosclerosis (AAAC). Aortic arch plaques covered by thrombi serve as nidus for embolic stroke. Patients with AAA plaques have similar recurrence rates compared to those with cardioembolic stroke. However, the incidence of second stroke in ESUS patients is lower.

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When an embolic stroke occurs, the clot travels to the brain by way of the bloodstream. These clots usually form in the heart or upper chest and travel to the brain via the bloodstream. When this happens, the embolus becomes wedged within an artery that branches off into smaller vessels. The embolus then cuts off the blood supply to the brain. Because blood flow is restricted in the brain, the stroke may be fatal.

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Symptoms of an embolic stroke can range from the inability to move limbs to a lack of basic bodily functions. The symptoms of embolic stroke depend on the area of the brain affected. Nevertheless, these symptoms should be cause to call an ambulance. In order to identify the stroke quickly, doctors need to gather several pieces of data, including the patient's medical history. They may also recommend passive gymnastics massage and other therapies to restore basic functions.

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As with thrombotic strokes, embolic strokes are caused by a clot forming inside an artery leading to the brain. Having high cholesterol, atherosclerosis, and atrial fibrillation all increase the risk of an embolic stroke. Another sign of an embolic stroke is a change in balance. Balance problems or trouble standing may also be a sign of an ischemic stroke. You may have blurred or double vision.

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The NAVIGATE-ESUS trial yielded three major findings that should be important to clinicians: First, most patients had a recurrent embolic stroke after ESUS. About three-quarters of these patients met criteria for ESUS. Secondly, about half of these patients did not have atrial fibrillation, which was an uncommon cause of recurrent ischemic strokes. Lastly, rivaroxaban helped patients with atrial fibrillation avoid an embolic stroke.

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Furthermore, TIAs are associated with a higher risk of a full-blown stroke. Therefore, controlling high blood pressure can prevent strokes. However, there is no way to completely eliminate the risk of stroke. If you have experienced TIA, it is essential to seek medical attention immediately. The symptoms of TIAs are similar to the warning signs of a stroke, and the signs and symptoms vary depending on the part of the brain affected.

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