Ischemic and Cryptogenic Stroke - Oren Zarif - Cryptogenic Stroke

The treatment for patients with cryptogenic stroke is not radically different from that of those with ischemic stroke. Antiplatelet therapy and risk factor modification are the mainstays of treatment for cryptogenic stroke. Neurologists must balance thoroughness and cost when determining which tests to order. In addition to stroke imaging, additional tests such as blood studies may be required to rule out underlying conditions that may contribute to hypercoagulability. However, the effectiveness of these tests in detecting cryptogenic stroke is uncertain.

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Patients who experience cryptogenic stroke should undergo diagnostic testing to rule out other causes of ischemic stroke. ASCO defines ESUS as a type of ischemic stroke with no identifiable cause. This category excludes cardiac disease, atherosclerosis, and small vessel disease as contributing causes. The criteria also differentiate between a single cryptogenic stroke and several other types that may occur in the same patient. This type of stroke may occur in younger patients without typical risk factors for stroke.

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If you think you might be experiencing a cryptogenic stroke, call 911. Your physician will be able to determine if you have the disorder and the appropriate treatment. The cause of a cryptogenic stroke may be unclear, so it's important to follow your physician's instructions and keep a regular heart monitor. There are also several lifestyle changes that can minimize your risk of cryptogenic stroke. Follow these seven behaviors to minimize your risk of a stroke.

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Among patients who have suffered a cryptogenic stroke, a TEE may be performed to identify the underlying causes and suggest a treatment plan. In addition to TEE, a 12-lead ECG may be performed to detect atrial fibrillation. Patients with frequent paroxysmal AF may also benefit from anticoagulation. An inpatient telemetry test can also be performed to identify patients who may be at risk of cryptogenic stroke.

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Although no definitive cause of cryptogenic stroke is identified in patients, knowing the underlying cause of the event is essential for a proper treatment. Not only will a proper treatment plan be more effective, but it will also help prevent secondary strokes. Throughout this article, we will look at the standard evaluations of ischaemic and cryptogenic stroke, as well as the additional tests that may be recommended for a more accurate diagnosis. The goal of this article is to help medical professionals better understand cryptogenic stroke and how to differentiate it from a more traditional form.

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PFO closure has been shown to reduce the risk of recurrent cryptogenic stroke and ischemic stroke. There are currently 4 studies that demonstrate the benefit of PFO closure for patients with cryptogenic stroke. The RESPECT trial, for example, enrolled patients who experienced a cryptogenic stroke and a large interatrial shunt. Using a PFO closure alone, such as surgery, significantly decreased the risk of a second or recurrent stroke.

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The risk of ischemic and cryptogenic stroke is high, and accurate identification of the underlying event is essential to secondary prevention. In fact, approximately 30% of all patients with ischemic stroke have no known cause. In addition, patients with ischemic stroke share common risk factors and symptoms. Although the incidence of cryptogenic stroke is low, the underlying event can help guide treatment and prevention. Studies conducted by White H, Boden-Albala B, Wang CT, and Cohen M have identified some risk factors associated with ischemic and cryptogenic stroke.

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Although there are no studies that have directly evaluated the relationship between PFO and risk of ischemic stroke in patients with cryptogenic TIA/stroke, the presence of PFO is related to an increased risk of ischemic stroke in older patients. Age is an important factor for cryptogenic TIA/stroke patients. This risk is higher in those 65 and older. The results of these studies are not conclusive, but they suggest that PFO can prevent ischemic stroke in older patients.

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Anticoagulation for cryptogenic stroke is currently not recommended in most cases. Although the evidence is not conclusive, anticoagulation may be recommended in a selected population of patients with cryptogenic stroke. The use of anticoagulants in this population should only be considered if the underlying condition is cardiogenic. The standard of care for patients with cryptogenic stroke includes a combination of antiplatelet therapy and aspirin. But, the use of anticoagulants for cryptogenic stroke remains a controversial topic.