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Embolic Stroke - Oren Zarif - Embolic Stroke


Embolic strokes can be classified into three types on the basis of their etiology. Aortic, cardiac, or artery to artery embolisms are the most common. PFOs can also occur in patients with embolic strokes. The severity of the symptoms depends on the brain area affected. If you have experienced these symptoms, contact your doctor immediately. You will need to undergo urgent medical care if the symptoms persist for more than 24 hours.

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In 2014, a new classification was introduced: embolic stroke of undetermined source (ESUS). This new term is used to define this subgroup of patients who have suffered an ischemic stroke without a known cause. Unlike cryptogenic stroke, this new term was developed to unify the diagnostic workup for patients in this category. Although the diagnosis is difficult, it allows for the development of randomized controlled trials for this population.

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Although no definitive treatment guidelines exist for ESUS, current guidelines recommend antiplatelet therapy for patients with ischemic strokes and heart disease. However, because these two conditions are often confused, it is necessary to use an anticoagulant, such as warfarin. Until further study is conducted, it is not known which therapy will be most effective for these patients. In the meantime, the best treatment options for ESUS include permanent anticoagulation and revascularization.

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Although embolic strokes do not require immediate surgery, they share some of the same symptoms as thrombotic or ischemic strokes. As with thrombotic strokes, it is essential to seek medical attention if you experience any of these symptoms. Sometimes, people have a history of carotid artery disease that causes a blood clot to break off and travel to a small artery in the brain. Another possibility is a heart infection or bacterial infection. A myxoma in the upper chambers of the heart can cause an embolic stroke. Sometimes, an air embolism can occur after an injection, surgery, or lung trauma.

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Regardless of the cause of the stroke, prevention is the most important factor. Although many factors cannot be controlled, you can control your risk for embolic stroke by controlling your cholesterol levels and vascular dysfunction. People over 60 years of age are most at risk. As a general rule, people with high blood pressure are at increased risk for an embolic stroke. Some other risk factors for embolic stroke include atrial fibrillation.

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High-risk cardiac conditions can increase the risk of an embolic stroke. Some high-risk cardiovascular conditions include atrial fibrillation, mechanical prosthetic valves, and dilated myocardiopathy. Minor sources include patent foramen ovale and calcific aortic valve stenosis. For individuals with these risks, etiological studies must be completed. It is important to note that the signs of an embolic stroke vary from patient to patient.

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A large randomized clinical trial called NAVIGATE-ESUS is evaluating the role of direct oral anticoagulants in patients with Embolic Stroke of Undetermined Source. The researchers studied the effects of dabigatran on the risk of embolic stroke by comparing it with an antiplatelet agent. Researchers hope to discover the optimal treatment option for patients with ESUSS. It could also prove to be a useful tool for preventing embolic strokes.

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Medications for an embolic stroke include aspirin or tissue plasminogen activator, which dissolve blood clots and restore blood flow to the affected area of the brain. These medications are only effective if they are administered within the first few hours of stroke. In addition, you may also be prescribed a blood-thinning drug such as aspirin or Coumadin. A blood-thinning drug called clopidogrel can also be administered.

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Patients with atrial fibrillation who undergo ESUS have a lower risk of recurrent strokes than those without. Although most patients who undergo ESUS recover completely, there are still recurrent embolic strokes. These recurrences are often fatal and disabling. An effective antithrombotic strategy requires identifying the underlying cause of the embolic stroke. For patients with a history of atrial fibrillation, rivaroxaban is recommended.

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