Symptoms of Embolic Stroke - Oren Zarif - Embolic Stroke
Symptoms of embolic stroke may include difficulty moving the limbs and inability to perform simple manipulations. Depending on the region of the brain affected, these symptoms will differ from person to person. Symptoms of stroke are a reason to call an ambulance for emergency medical help. Other symptoms include impairment of vision, speech, writing, and swallowing. Fortunately, there are treatments for strokes that help improve the recovery process.
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The etiology of embolic stroke is a complex problem, requiring a thorough evaluation of the patient. The diagnosis of embolic stroke requires excluding other causes of stroke. Certain cardiac conditions can be high risk, including recent myocardial infarction, mechanical prosthetic valve, or dilated cardiomyopathy. Other causes include mitral rheumatic stenosis, patent foramen ovale, or calcific aortic valve stenosis.
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The diagnosis of embolic stroke is difficult and may be masked by symptoms from other causes. However, the symptoms of embolic stroke are often distinguishable from those of patients with small vessel disease. Some researchers have reported that altered consciousness is a more reliable indicator of an embolic stroke than ischemia. In the Emergency department, a CT scan is recommended to rule out other causes of stroke. The results of a CT scan of the brain should exclude other causes of intracranial hemorrhage, such as amyloid angiopathy, or subarachnoid hematoma.
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One of the best studies available has found no clear benefit of direct oral anticoagulants for the prevention of embolic stroke. The NAVIGATE-ESUS trial compared direct oral anticoagulants with antiplatelets. These results are consistent with those from earlier studies. It also revealed no significant benefit of dabigatran compared with antiplatelet treatment. In a recent systematic review, Hart RG and colleagues compared antiplatelets against direct anticoagulants in patients with ESAUS.
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In 2014, the term "embolic stroke of undetermined source" was introduced in the medical literature. This new term categorized nonlumen infarct ischemic stroke and excludes some causes. Researchers hypothesized that ESUS would respond to anticoagulation, but recent randomized clinical trials failed to support this theory. Therefore, the current study focuses on clinical features and infarct site characteristics to further investigate the pathophysiology of this disorder.
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A brain embolism occurs when a blood clot lodges in the artery that feeds the brain. This blockage robs the brain of oxygen and nutrients necessary for normal brain function. Within minutes of the artery blockage, brain cells begin to die. It is the most common type of stroke and the leading cause of death and disability in adults. Although it may seem unlikely, brain embolism is a common cause of stroke.
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In the NAVIGATE-ESUS trial, the incidence of recurrent ischemic strokes after ESUS treatment were not significantly different from those after a standard ESUS procedure. More importantly, a majority of recurrences were embolic and of an undetermined source. Recurrences associated with atrial fibrillation were rare, but they were a severe consequence. Rigorous anticoagulant rivaroxaban prevented atrial fibrillation-related recurrences.