Symptoms and Treatment of an Embolic Stroke - Oren Zarif - Embolic Stroke

The symptoms of an embolic stroke vary widely. These include an inability to move limbs and difficulties with simple manipulations. The specific symptoms depend on the area of the brain affected, and these are reasons to call an ambulance. Diagnosis of embolic stroke is complex, and doctors must collect extensive data before making a definitive diagnosis. A physician may also note an unusually rapid heartbeat, blurred vision, or lethargy.

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In general, embolic stroke is the result of blood clots that block the distal cerebral arteries and cause ischemia. Depending on the location of the embolism, it can originate from the heart, the aortic root, or the venous system in the pelvis. However, the most common source is an air bubble or plaque from an artery wall. Some risk factors include atrial fibrillation, mechanical heart valves, or an abnormal heartbeat.

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Emboli may travel from a patient's bloodstream to a particular area of the brain, such as the left ventricle. These emboli can also originate in the heart, which makes an echocardiogram crucial in the early detection and treatment of an embolic stroke. Although the symptoms of an embolic stroke may appear progressively worse over a period of time, the signs of ischemia and hemorrhage may be difficult to differentiate from those of hemorrhage.

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An embolic stroke may be treated through emergency procedures, such as carotid endarterectomy or mechanical clot removal. During the recovery process, doctors can perform surgical procedures to open up arteries. Sometimes, doctors use stents to keep the arteries open. The main goal of rehabilitation is to restore function and strength. There are several ways to treat an embolic stroke, and they all involve rehabilitation and treatment for the patient.

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Regardless of the source, an embolic stroke may be prevented by addressing the underlying cause. Some cardiac conditions are at risk, including atrial fibrillation, aortic stenosis, or mechanical prosthetic valves. Other risk factors for embolic stroke are atrial fibrillation, diabetes, and high blood pressure. The most common identifiable cause of embolic stroke is atrial fibrillation, which increases with age.

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Hemorrhagic transformation, which results from ruptured blood vessels, is associated with worse outcomes. In contrast to ischemic stroke, hemorrhagic stroke is much more common in neonates, where five times as many suffer from it. Moreover, more than a third of neonatal patients experience microbleeds during their subacute period, while adults experience less than 10%. Hemorrhagic stroke is associated with poorer prognoses and higher mortality rates.

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Traditional methods of embolic stroke treatment involve transarterial lodgement of embolus and local thrombin injection after opening a cranial window. While these approaches can be effective in preventing microbleeds, they are difficult to implement in an infant's brain. Furthermore, the underlying mechanisms are unknown. Moreover, the embolus lodges in the cerebral vasculature, causing an infarct size that varies from case to case.

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Angiography is an important diagnostic test. An MRI or CT scan uses powerful magnetic fields and radio frequency pulses to produce detailed pictures of the interior of the body. An MR scan images cerebral vessels and their blood supply. In addition to MRI, blood tests are used to assess the risk of stroke. The levels of hemoglobin and red blood cells may be reduced, which inhibit the flow of oxygen to brain cells. An elevated erythrocyte sedimentation rate indicates inflammation in the vascular wall and may contribute to stroke.

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Antibiotic treatment can reduce the risk of an embolic stroke in patients with a mycotic aneurysm or septic arteritis. However, infective endocarditis is not the cause of most emboli, which accounts for less than 1% of the cases. Although there are no specific guidelines for treating ESUS, current recommendations for antiplatelet therapy are not completely clear. The best course of treatment for a patient with a cerebral embolic stroke is to monitor the heart closely for a minimum of seven days after the stroke.

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Moreover, both thrombotic and embolic stroke may have overlap in risk factors. Nonetheless, a single diagnosis may not be reliable in cases of recurrent stroke, when a patient's risk factors may be the same. Furthermore, the cause of a second stroke may be a different one than the first. Consequently, a more specialized treatment should be sought if the patient's risk factors overlap significantly.

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An embolic stroke is most often caused by atrial fibrillation, an irregular heartbeat that can lead to blood clots. Approximately 2.7 million people in the U.S. suffer from this condition, which causes blood to pool and travel to the brain. Other strokes caused by atrial fibrillation include subarachnoid hemorrhage and cerebral hemorrhage. This article aims to understand these causes and their risk of embolic stroke.