What is a Cryptogenic Stroke? - Oren Zarif - Cryptogenic Stroke

A cryptogenic stroke occurs when blood flow to the brain is blocked by a clot or other blood clotting factor. About 25% of all strokes are cryptogenic. These are the most common types of stroke and can be prevented with a healthy lifestyle. Cryptogenic stroke can cause loss of speech, movement, memory, and even death. Most people suffering from a cryptogenic stroke are younger than 60 years old. If you suspect that you may have experienced one, call 911 immediately. Your physician will determine what type of stroke you've suffered and determine how to treat it.

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Cardioembolic mechanisms have also been discussed as possible causes of cryptogenic stroke. Although they are the most common cause of stroke, they are often missed due to a lack of research or because patients have other conditions such as paroxysmal atrial fibrillation. In addition to cardiac monitoring, basic laboratory tests such as hemoglobin A and clotting factors are needed to determine the cause of cryptogenic stroke. Cardioembolic strokes also affect the general population.

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While the exact cause of a cryptogenic stroke is unknown, certain contributing factors can be identified and managed to prevent a recurrence of the stroke. A PFO, or hole in the heart that never closes, is one such contributing factor. PFO closure, which is performed as an outpatient procedure, can reduce the risk of stroke. Another common cause of cryptogenic stroke is an irregular heart rhythm called A-Fib. Treatment for A-Fib is available in the form of blood thinners or an implantable device.

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The definition of a cryptogenic stroke is based on the TOAST classification, which is a computerized algorithm to determine phenotypic and causative subtypes of ischemic stroke. There are five major categories of stroke, including large artery atherosclerosis, cardio-aortic embolism, and small artery occlusion. ASCOD grades the chances of a cause. A cryptogenic stroke, on the other hand, has no known cause.

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Since most cryptogenic strokes do not have a clear underlying cause, identifying the exact cause is a difficult task. Researchers are working on ways to identify cryptogenic stroke and improve care for these patients. Although there are no definitive tests for cryptogenic stroke, it is possible to use the sBNP level as a biomarker. If this proves to be useful, it can be used to identify patients with AF who may be suffering from cryptogenic stroke.

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Among the best ways to diagnose a cryptogenic stroke is to conduct a comprehensive workup. A complete neurological exam, 24-hour ECG monitoring, screening for thrombophilia, magnetic resonance angiography, and transcranial and neck Doppler ultrasound are recommended for patients suffering from cryptogenic stroke. Each patient was monitored for at least four months following insertion of the device. The researchers divided patients into groups based on the presence of AF.

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There is no definitive treatment for cryptogenic stroke, although standard of care recommends aspirin for all patients. However, studies have shown that anticoagulation may have a greater role than antiplatelet therapy in the prevention of secondary strokes in patients with PFO. A clinical trial, the PFO in Cryptogenic Stroke Study (PICSS), compared warfarin with aspirin for secondary stroke prevention. Nevertheless, this study is not definitive and further studies are needed to determine the best antithrombotic therapy.

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The Scripps Cryptogenic Stroke Program is located at the La Jolla campus of Scripps Memorial Hospital. It also includes the Prebys Cardiovascular Institute and Scripps Clinic John R. Anderson V Medical Pavilion. The heart care facility on the La Jolla campus is among the best in the San Diego area. Its 90-year history of scientific breakthroughs and medical breakthroughs makes it one of the largest cardiovascular medicine centers on the West Coast.

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Although the mechanism for CS remains unclear, most likely causes of CS are closely related to the cardiac system. Comprehensive evaluation of the cardiac system is required to identify the cause of the stroke and improve the secondary prevention measures. Cardiac imaging and cardiac monitoring are essential for this purpose. And, as the research progresses, the research community will continue to discover more methods to prevent cryptogenic strokes. The next step will be to find a treatment that works for each patient.