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Cryptogenic stroke

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https://www.readbyqxmd.com/read/28178140/utility-of-duranta-a-wireless-patch-type-electrocardiographic-monitoring-system-developed-in-japan-in-detecting-covert-atrial-fibrillation-in-patients-with-cryptogenic-stroke-a-case-report
#1
Hisanao Akiyama, Saki Nukui, Takashi Araga, Masashi Hoshino, Keita Tanaka, Satoru Kashima, Rie Sasaki, Kenji Uchino, Yasuhiro Hasegawa
RATIONALE: Subcutaneous implantable electrocardiographs are highly effective in detecting covert atrial fibrillation (AF) in cryptogenic stroke. However, these invasive devices are not indicated for all cryptogenic stroke patients, and noninvasive improvements over conventional Holter-type ambulatory electrocardiography are needed. We evaluated the clinical application and effectiveness of Duranta (ImageONE Co., Ltd.), a wireless patch-type electrocardiographic monitoring system developed in Japan for chronically ill patients or home-based patients at the end of life...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28157747/cardioembolic-stroke
#2
Cumara B O'Carroll, Kevin M Barrett
PURPOSE OF REVIEW: Cardioembolic stroke is common and disproportionately more disabling than nonembolic mechanisms of stroke. Its incidence is expected to rise because of the age-related incidence of atrial fibrillation and an aging population. This article summarizes the different causes of cardioembolism and outlines current management guidelines. RECENT FINDINGS: Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including ECG, echocardiography, brain imaging, and cardiac monitoring...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28154102/cryptogenic-stroke-research-and-practice
#3
Shadi Yaghi, Richard A Bernstein, Rod Passman, Peter M Okin, Karen L Furie
BACKGROUND: Cryptogenic stroke accounts for 30% to 40% of ischemic stroke. It is essential to determine the possible culprit because this will improve secondary stroke prevention strategies. METHODS: We performed a narrative nonsystematic review of the literature that included randomized trials, exploratory comparative studies, and case series on cryptogenic stroke. RESULTS: There are several possible mechanisms implicated in cryptogenic stroke, including occult paroxysmal atrial fibrillation, patent foramen ovale, aortic arch atherosclerosis, atrial cardiopathy, and substenotic atherosclerosis...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28154101/cardioembolic-stroke
#4
Hooman Kamel, Jeff S Healey
Cardiac embolism accounts for an increasing proportion of ischemic strokes and might multiply several-fold during the next decades. However, research points to several potential strategies to stem this expected rise in cardioembolic stroke. First, although one-third of strokes are of unclear cause, it is increasingly accepted that many of these cryptogenic strokes arise from a distant embolism rather than in situ cerebrovascular disease, leading to the recent formulation of embolic stroke of undetermined source as a distinct target for investigation...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28153345/usefulness-of-the-mrwallets-scoring-system-to-predict-first-diagnosed-atrial-fibrillation-in-patients-with-ischemic-stroke
#5
Antonio Muscari, Andrea Bonfiglioli, Luca Faccioli, Marco Ghinelli, Donatella Magalotti, Francesco Manzetto, Anna Pontarin, Giovanni M Puddu, Luca Spinardi, Eleonora Tubertini, Marco Zoli
Some cryptogenic strokes are caused by undetected paroxysmal atrial fibrillation (AF) and could benefit from oral anticoagulation. In this study, we searched for echocardiographic parameters associated with first diagnosed AF, to form a scoring system for the identification of patients with AF. We examined 571 patients with ischemic stroke (72.7 ± 13.5 years, 50.6% women), subdivided into 4 groups: documented cause without AF, first diagnosed AF, known paroxysmal AF, and permanent AF. All patients underwent transthoracic echocardiography, brain computed tomography scan, carotid/vertebral ultrasound, and continuous electrocardiographic monitoring...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28139007/case-report-of-male-child-with-elevated-lipoprotein-a-leading-to-acute-ischemic-stroke
#6
Patrick M Moriarty, Heather Tennant, Nandhini Sehar, Lauryn Denney, Paola Luna, Francesca Perez-Marques, Apurva Panchal, Michael Abraham, John Leever
Acute ischemic stroke (AIS) in children is rare with almost 40% diagnosed as cryptogenic. One possible mechanism associated with AIS is an elevated Lipoprotein (a) [Lp(a)] level. Here, we discuss the case of an 11-year old boy who presented with multiple thrombotic strokes secondary to elevated Lp(a), which was identified as the only risk factor and immediately treated with lipoprotein apheresis (LA). Eighteen months post-AIS, he is still receiving LA treatments and has made remarkable progress in his recovery without another cerebrovascular event...
January 31, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28123762/percutaneous-pfo-closure-for-cryptogenic-stroke-in-the-setting-of-a-systematic-cardiac-and-neurological-screening-and-a-standardised-follow-up-protocol
#7
Stéphane Noble, Robert F Bonvini, Fabio Rigamonti, Roman Sztajzel, Fabienne Perren, Philippe Meyer, Hajo Müller, Marco Roffi
BACKGROUND: There are no uniform workup and follow-up (FU) protocols for patients presenting with cryptogenic embolism (CE) who undergo percutaneous closure of a patent foramen ovale (PFO). METHODS: We prospectively performed a systematic cardiac and neurological FU protocol in all patients who underwent percutaneous PFO closure in order to assess the incidence of subsequent cardiac and neurological adverse events. All patients received dual antiplatelet therapy for 6 months and were systematically included in a 12-month standardised FU protocol including: clinical evaluation-transthoracic and transoesophageal echocardiography, 24-hour Holter monitoring and/or 1-week R-test, and transcranial Doppler...
2017: Open Heart
https://www.readbyqxmd.com/read/28116864/pfo-closure-end-of-an-era-or-beginning-of-a-new-chapter
#8
EDITORIAL
Mahmoud I Traina, E Murat Tuzcu
This large long-term retrospective cohort study shows that percutaneous patent foramen ovale (PFO) closure is safe. Higher rates of recurrent stroke or TIA were noted in older patients (age>55) and those with diabetes and hypertension Randomized trials have failed to show significant benefit from PFO closure for cryptogenic stroke though pooled analyses and longer-term follow-up have revealed significant reduction in recurrent strokes. Future studies and longer-term follow-up will need to elucidate which subgroups of patients will benefit from closure...
January 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28106015/relationship-between-mean-platelet-volume-and-ischemic-stroke-in-patients-with-patent-foramen-ovale
#9
Nermin Bayar, Selçuk Küçükseymen, Zehra Erkal, Ramazan Güven, Erkan Köklü, Çağın Mustafa Üreyen, Şakir Arslan
OBJECTIVE: Patent foramen ovale (PFO) is commonly encountered in patients with cryptogenic stroke. Mean platelet volume (MPV), an indicator of platelet reactivity, has been reported in recent trials to be higher in patients with PFO than in normal population. The aim of this study was to investigate whether there is a difference in MPV between patients with PFO and stroke or transient ischemic attack (TIA) and that of patients with asymptomatic PFO. METHODS: Patients with PFO who were younger than 55 years of age were enrolled in this retrospective study...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28049202/aortic-atherosclerosis-determines-increased-retrograde-blood-flow-as-a-potential-mechanism-of-retrograde-embolic-stroke
#10
Thomas Wehrum, Felix Guenther, Werner Vach, Beryl Primrose Gladstone, Sarah Wendel, Alexander Fuchs, Kehzong Wu, Christoph Johannes Maurer, Andreas Harloff
BACKGROUND: Retrograde brain embolization from complex plaques of the proximal descending aorta (DAo) has been identified as a new potential mechanism of stroke. Our purpose was to identify predictors of increased retrograde aortic blood flow indicating an elevated risk of brain embolization from the DAo. METHODS: A total of 485 patients with acute ischemic stroke were prospectively included and underwent transesophageal echocardiography. Blood flow velocities in the proximal DAo were studied using 2D pulse-wave Doppler ultrasound...
January 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28028400/transcatheter-closure-of-patent-foramen-ovale-a-single-center-experience
#11
Ivan Milev, Planinka Zafirovska, Zan Zimbakov, Shpend Idrizi, Vilma Ampova-Sokolov, Emilija Gorgieva, Liljana Ilievska, Goce Tosheski, Nikola Hristov, Ljubica Georgievska-Ismail, Tanja Anguseva, Zan Mitrev
BACKGROUND: Percutaneous transcatheter closure (PTC) of patent foramen ovale (PFO) is implicated in cryptogenic stroke, transitional ischemic attack (TIA) and treatment of a migraine. AIM: Our goal was to present our experience in the interventional treatment of PFO, as well as to evaluate the short and mid-term results in patients with closed PFO. MATERIAL AND METHODS: Transcatheter closure of PFO was performed in 52 patients (67.3% women, mean age 40...
December 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28026909/plasma-d-dimer-levels-and-ischaemic-lesions-in-multiple-vascular-regions-can-predict-occult-cancer-in-patients-with-cryptogenic-stroke
#12
Y Gon, M Sakaguchi, J Takasugi, T Kawano, H Kanki, A Watanabe, N Oyama, Y Terasaki, T Sasaki, H Mochizuki
BACKGROUND AND PURPOSE: Cancer patients with cryptogenic stroke often have high plasma D-dimer levels and lesions in multiple vascular regions. Hence, if patients with cryptogenic stroke display such characteristics, occult cancer could be predicted. This study aimed to investigate the clinical characteristics of cryptogenic stroke as the first manifestation of occult cancer and to determine whether plasma D-dimer levels and lesions in multiple vascular regions can predict occult cancer in patients with cryptogenic stroke...
March 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/27998316/decompressive-craniectomy-for-malignant-middle-cerebral-artery-infarction-in-a-16-year-old-boy-a-case-report
#13
Simon Lammy, Paul Fivey, Meharpal Sangra
BACKGROUND: Cryptogenic stroke frequently occurs in younger patients and has a high risk of recurrence. Consequently, secondary prevention is often suboptimal as there is no known risk factor to target. This case demonstrates an unexpected finding of middle cerebral artery infarction and extensive malignant transformation in a 16-year-old boy more than a day post-admission. The lack of a proven culprit lesion makes this case even more intriguing and subsequently raises questions of cryptogenic mechanisms in the context of unrelated trauma...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27941401/new-standards-of-care-in-ischemic-stroke
#14
Bree K Chancellor, Koto Ishida
BACKGROUND: Ischemic arterial strokes of the ophthalmic artery and its branches and posterior cerebral artery are common causes of visual disability. Etiologies of stroke affecting the retina, optic nerve, optic radiation, and visual cortex overlap with other types of ischemic strokes. Stenosis of the internal carotid is the most common cause of central retinal artery occlusion (CRAO). One-fourth of patients with CRAO have cerebral strokes. We report recent developments in the acute treatment and secondary prevention of ischemic stroke of relevance to clinicians who encounter patients with acute vision loss...
December 8, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/27930349/patent-foramen-ovale-with-atrial-septal-aneurysm-is-strongly-associated-with-migraine-with-aura-a-large-observational-study
#15
Roel J R Snijder, Justin G L M Luermans, Albert H de Heij, Vincent Thijs, Wouter J Schonewille, Alexander Van De Bruaene, Martin J Swaans, Werner I H L Budts, Martijn C Post
BACKGROUND: A patent foramen ovale (PFO) with atrial septal aneurysm (ASA) has been identified as a risk factor for cryptogenic stroke. Patients with migraine with aura (MA) appear to be at risk for silent brain infarction, which might be related to the presence of a PFO. However, the association between MA and PFO with ASA has never been reported. We examined this association in a large observational study. METHODS AND RESULTS: Patients (>18 years) who underwent an agitated saline transesophageal echocardiography (cTEE) at our outpatient clinics within a timeframe of 4 years were eligible to be included...
December 1, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27906659/recurrent-cryptogenic-stroke-in-young-adult-linked-to-congenital-left-ventricular-diverticulum
#16
Nicolas Gaillard, Frederic Targosz, Jean Louis Bertrand, Denis Sablot, Zoubir Mourad Bensalah
No abstract text is available yet for this article.
November 15, 2016: Neurology
https://www.readbyqxmd.com/read/27899752/patent-foramen-ovale-and-cryptogenic-strokes-in-the-stroke-in-young-fabry-patients-study
#17
Roman Huber, Ulrike Grittner, Frank Weidemann, Vincent Thijs, Christian Tanislav, Christian Enzinger, Franz Fazekas, Markus Wolf, Michael G Hennerici, Dominick J H McCabe, Jukaa Putaala, Turgut Tatlisumak, Christoph Kessler, Bettina von Sarnowski, Peter Martus, Edwin Kolodny, Bo Norrving, Arndt Rolfs
BACKGROUND AND PURPOSE: A patent foramen ovale (PFO) is disproportionately prevalent in patients with cryptogenic stroke. Without alternative explanations, it is frequently considered to be causative. A detailed stratification of these patients may improve the identification of incidental PFO. METHODS: We investigated the PFO prevalence in 3497 transient ischemic attack and ischemic stroke patients aged 18 to 55 years in the prospective multicenter SIFAP1 study (Stroke in Young Fabry Patients 1) using the ASCO classification...
January 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27887791/cryptogenic-stroke-and-nonstenosing-intracranial-calcified-atherosclerosis
#18
Hooman Kamel, Gino Gialdini, Hediyeh Baradaran, Ashley E Giambrone, Babak B Navi, Michael P Lerario, James K Min, Costantino Iadecola, Ajay Gupta
OBJECTIVE: Because some cryptogenic strokes may result from large-artery atherosclerosis that goes unrecognized as it causes <50% luminal stenosis, we compared the prevalence of nonstenosing intracranial atherosclerotic plaques ipsilateral to cryptogenic cerebral infarcts versus the unaffected side using imaging biomarkers of calcium burden. METHODS: In a prospective stroke registry, we identified patients with cerebral infarction limited to the territory of one internal carotid artery (ICA)...
November 23, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27873022/current-rare-indications-and-future-directions-for-implantable-loop-recorders
#19
Simon Wechselberger, Christopher Piorkowski, Matthias Pohl
The scope of application for implantable loop recorders has shifted away from the evaluation of unclear palpitations and syncope episodes to more complex conditions. This article focuses on rare indications of growing importance such as rhythm monitoring after ablation of atrial fibrillation or after cryptogenic stroke. Furthermore, forthcoming applications in various clinical settings are described, e. g., arrhythmia detection after myocardial infarction, after catheter-based valve interventions, in heart failure, and in cardiomyopathies...
December 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27861421/current-and-emerging-uses-of-insertable-cardiac-monitors-evaluation-of-syncope-and-monitoring-for-atrial-fibrillation
#20
Todd T Tomson, Rod Passman
Insertable cardiac monitors (ICMs) have provided clinicians with a superb tool for assessing infrequent or potentially asymptomatic arrhythmias. ICMs have shown their usefulness in the evaluation of unexplained syncope, providing high diagnostic yields in a cost-effective manner. While unexplained syncope continues to be the most common reason for their use, ICMs are increasingly being used for the monitoring of atrial fibrillation (AF). Recent trials have demonstrated that a substantial proportion of patients with cryptogenic stroke have AF detected only by the prolonged monitoring provided by ICMs...
January 2017: Cardiology in Review
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