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Cryptogenic stroke

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https://www.readbyqxmd.com/read/29457261/angiography-vs-transesophageal-echocardiography-guided-patent-foramen-ovale-closure-a-propensity-score-matched-analysis-of-a-two-center-registry
#1
Paolo Scacciatella, Ilaria Meynet, Mauro Giorgi, Lorenza M Biava, Ivana Matranga, Luigi Biasco, Pierluigi Omedè, Fulvio Orzan, Fiorenzo Gaita
OBJECTIVES: The purpose of this study is to compare the long-term outcomes of patent foramen ovale (PFO) closure using angiography or transesophageal echocardiography as procedural guidance. BACKGROUND: The interventional treatment is emerging as a safe and efficient option for patients with high likelihood of PFO-related cryptogenic stroke and high risk of recurrence. The "gold-standard" guidance technique remains an issue. METHODS: Two cohorts of patients undergoing PFO closure for cryptogenic stroke in two catheterization laboratories of the same institution, using similar inclusion criteria but different guidance, were compared with propensity score matching...
February 19, 2018: Echocardiography
https://www.readbyqxmd.com/read/29440137/basilar-artery-fenestration-an-unusual-possible-cause-of-ischaemic-stroke
#2
Xuan Wu, Aiyu Lin, Jiting Zhu, Bin Cai
Basilar artery fenestration is an uncommon congenital dysplasia and may be associated with ischaemic stroke. We present a case of a previously healthy 36-year-old man who presented with vertigo and vomiting. MRI showed posterior circulation territory infarction. High-resolution magnetic resonance angiography revealed a slit-like fenestration in the basilar artery. This patient had no traditional vascular risk factors or aetiology of cryptogenic stroke. The patient recovered from his neurological deficit after antiplatelet therapy and was given prophylactic aspirin therapy...
February 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29428268/web-of-the-carotid-artery-an-under-recognized-cause-of-ischemic-stroke
#3
Federico Pacei, Luca Quilici, Stephen Mullin, Alessandro Innocenti, Luca Valvassori, Raffaele Nardone, Luciano Bet
Ischemic stroke has rarely been reported in association with a web of the carotid artery. We describe here an additional case of ischemic stroke caused by a carotid web in a young healthy woman. Detection of this vascular abnormality required the use of CT angiography and cerebral digital subtraction angiography. Although there is little evidence regarding the optimal management of this condition, under medical treatment with dual antiplatelet therapy our patient remained free of recurrent stroke events. This case report study illustrates that the web of the carotid artery is an uncommon cause of stroke which should always be considered and ruled out, especially in young patients with otherwise cryptogenic stroke...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29428132/implantable-loop-recorders-for-cryptogenic-stroke-plus-real-world-atrial-fibrillation-detection-rate-with-implantable-loop-recorders
#4
REVIEW
Dan L Musat, Nicolle Milstein, Suneet Mittal
Cryptogenic stroke (CS) represents 10%-40% of ischemic strokes and is associated with significant morbidity and mortality and high risk of recurrence. Undetected atrial fibrillation is an important consideration in these patients. Tools for electrocardiographic monitoring range from 12-lead electrocardiogram to implantable loop recorders (ILRs). ILRs have become an important tool for long-term electrocardiogram monitoring in CS patients. Advancements in ILR technology are needed to ensure more robust connectivity and to help triage incoming data...
March 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29426582/frequency-of-acute-and-subacute-infarcts-in-a-population-based-study
#5
Catherine Arnold Fiebelkorn, Prashanthi Vemuri, Alejandro A Rabinstein, Michelle M Mielke, Scott A Przybelski, Kejal Kantarci, David T Jones, Robert D Brown, David S Knopman, Ronald C Petersen, Clifford R Jack, Jonathan Graff-Radford
OBJECTIVE: To determine the frequency of incidental acute or subacute cerebral infarction (CI) in a population-based study. PATIENTS AND METHODS: We identified 2095 participants aged 50 to 98 years in the population-based Mayo Clinic Study of Aging from October 23, 2009, to October 5, 2016, with a usable diffusion tensor imaging (DTI) sequence (total scans=3230). Acute and subacute infarcts were identified by neuroradiologists. For each participant, vascular risk factors, medications, clinical symptoms, and neurological examination near the time of the CI were abstracted from the medical record...
February 6, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29422852/recurrent-stroke-in-a-young-woman-with-a-single-pulmonary-arteriovenous-fistula-an-unusual-association
#6
Sandra Sousa, Nuno Vasco Costa, Cátia Carmona, Élia Coimbra, Fernando Pita
Introduction: Cryptogenic stroke is present in about 40% of ischemic stroke patients. Extracardiac shunt related to pulmonary arteriovenous fistula (PAVF) could be a rare potential risk factor for embolic stroke. Most PAVFs are multiple, congenital, and associated with hereditary conditions. On the other hand, isolated PAVFs are rare conditions and an uncommon cause of cryptogenic stoke. Case Report: We describe a case of a young woman without history of respiratory diseases or vascular risk factors, who presented with acute onset of transitory aphasia and right hemiplegia...
September 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/29422265/quality-of-life-after-percutaneous-closure-of-patent-foramen-ovale-in-patients-after-cryptogenic-stroke-compared-to-a-normative-sample
#7
Naqibullah Mirzada, Per Ladenvall, Per-Olof Hansson, Peter Eriksson, Charles Taft, Mikael Dellborg
AIMS: Despite the widespread use of percutaneous closure of patent foramen ovale (PFO) in patients after a cryptogenic stroke, little is known about its impact on health-related quality of life (HRQoL). The aim of this study was to assess HRQoL in these patients compared to PFO patients not considered candidates for percutaneous closure, and to a normal population. METHODS AND RESULTS: A total of 402 patients with cryptogenic stroke or transient ischaemic attack (TIA) who had been referred to our center for PFO closure were invited to a long-term clinical follow-up (mean follow-up 5...
January 31, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29402843/sensitive-detection-of-atrial-fibrillation-in-acute-stroke-patients-by-short-term-bedside-electrocardiography-monitoring-software-analysis
#8
Linda Sarah Ross, Markus Bettin, Simon Kochhäuser, Martin Ritter, Jens Minnerup, Lars Eckardt, Florian Reinke, Ralf Dittrich
BACKGROUND: Atrial fibrillation (AF) is an important cause of stroke. Continuous electrocardiography (ECG) monitoring with software-based analysis algorithms has been suggested to enhance the AF detection rate. We investigated the ability of stroke risk analysis (SRA) in the detection of AF in acute stroke patients. METHODS: Consecutive stroke patients numbering 1,153 were screened. Patients with cardioembolic stroke related to AF (n = 296, paroxysmal n = 63, persistent n = 233) and patients with cryptogenic stroke (n = 309) after standard diagnostic work-up (bedside ECG monitoring, ultrasound, transesophageal echocardiography, 24 h Holter ECG) received SRA during their stay at the Stroke Unit...
January 17, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29383514/closure-of-patent-foramen-ovale-for-cryptogenic-stroke-patients-an-updated-systematic-review-and-meta-analysis-of-randomized-trials
#9
REVIEW
Xuan Niu, Guang Ou-Yang, Peng-Fei Yan, Shu-Lan Huang, Zhen-Tao Zhang, Zhao-Hui Zhang
OBJECTIVE: This systematic review and meta-analysis was performed to investigate the efficacy and safety of transcatheter device closure (TDC) plus anti-thrombotic drugs over medical management alone for patients with cryptogenic stroke and patent foramen oval. METHODS: PubMed, Embase and Cochrane Library database were searched for randomized controlled clinical trials (RCTs). The primary endpoint is the composite of stroke and transient ischemic attack. The secondary endpoints are all-cause mortality, total serious adverse events, atrial fibrillation and bleeding...
January 30, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29372390/impact-of-d-dimer-levels-for-short-term-or-long-term-outcomes-in-cryptogenic-stroke-patients
#10
Tomohisa Nezu, Takaya Kitano, Satoshi Kubo, Junichi Uemura, Shinji Yamashita, Takeshi Iwanaga, Takeshi Inoue, Naohisa Hosomi, Hirofumi Maruyama, Masayasu Matsumoto, Kazumi Kimura, Yoshiki Yagita
BACKGROUND: D-dimer levels are used in several clinical settings, such as in predicting venous thrombosis, cardioembolic stroke and cancer status. In the present study, we investigated the associations between plasma D-dimer levels at admission, clinical characteristics and mortality at discharge in cryptogenic stroke patients. We also investigated whether D-dimer levels can predict long-term outcomes in those patients, including those with and without right-to-left shunt (RLS). METHODS: Acute cryptogenic stroke patients (n = 295, 72 ± 13 years old) were consecutively enrolled and retrospectively analyzed...
January 25, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29371436/relationship-between-visceral-infarction-and-ischemic-stroke-subtype
#11
Caitlin Finn, Peter Hung, Praneil Patel, Ajay Gupta, Hooman Kamel
BACKGROUND AND PURPOSE: Most cryptogenic strokes are thought to have an embolic source. We sought to determine whether cryptogenic strokes are associated with visceral infarcts, which are usually embolic. METHODS: Among patients prospectively enrolled in CAESAR (Cornell Acute Stroke Academic Registry), we selected those with a contrast-enhanced abdominal computed tomographic scan within 1 year of admission. Our exposure variable was adjudicated stroke subtype per the Trial of ORG 10172 in Acute Stroke Treatment classification...
January 25, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29357035/cryptogenic-acute-limb-ischemia-a-retrospective-cohort-study-defining-a-previously-undescribed-clinical-entity
#12
Dylan Mart, Joseph Shatzel, Thomas DeLoughery
Acute limb ischemia (ALI) is generally secondary to cardioembolism or progression of peripheral vascular disease, however, a discrete population of patients with ALI exists in which no precipitant is ever established. Unlike cryptogenic arterial occlusion in other arenas, such as cryptogenic stroke, cryptogenic acute limb ischemia (cALI) has not been well-described, and no routine management has been established. The aim of this study is to describe patients with cALI, and the risk of recurrence based on the treatment they received...
January 22, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29356972/patent-foramen-ovale-closure-versus-medical-therapy-in-cases-with-cryptogenic-stroke-meta-analysis-of-randomized-controlled-trials
#13
Elsayed Abo-Salem, Bernard Chaitman, Tarek Helmy, Eric Adjei Boakye, Hassan Alkhawam, Michael Lim
BACKGROUND: PFO is more common in cases with cryptogenic stroke compared to cases with no stroke or stroke of identified etiology. Several randomized controlled trials (RCTs) comparing PFO closure with medical therapy have been published with controversial findings. METHODS: PubMed, Embase and Cochrane library databases were searched for RCT comparing PFO closure with medical therapy including antiplatelet therapy (aspirin or clopidogrel or combination) or anticoagulation...
January 22, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29350100/transorbital-doppler-with-carotid-siphon-monitoring-detects-right-to-left-shunt-effectively
#14
Zhihui Duan, Zhiyuan Yang, Binbin Song, Congmin Ma, Yan Li, Yanjiao Du, Dandan Shang, Shao Li, Jiyu Lou
Background Transtemporal Doppler (TTD) with middle cerebral artery (MCA) is widely used for right-to-left shunt (RLS) detection. However, an alternative method for patients without suitable temporal bone windows should be established. The present study prospectively evaluated the effectiveness of transorbital Doppler (TOD) with carotid siphon (CS) monitoring in detecting RLS. Methods A total of 357 subjects with sufficient temporal bone windows underwent simultaneous TTD with MCA and TOD with CS. After injection of microbubbles, the numbers of artificial high-intensity signals were recorded at rest and after Valsalva maneuver...
January 19, 2018: Neurological Research
https://www.readbyqxmd.com/read/29335719/adding-patent-foramen-ovale-closure-to-antiplatelet-therapy-reduced-stroke-after-cryptogenic-stroke
#15
(no author information available yet)
No abstract text is available yet for this article.
January 16, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29335718/adding-patent-foramen-ovale-closure-to-antiplatelet-drugs-reduced-ischemic-stroke-after-cryptogenic-stroke
#16
Mark J Alberts
No abstract text is available yet for this article.
January 16, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29335335/closure-of-patent-foramen-ovale-versus-medical-therapy-in-patients-with-cryptogenic-stroke-or-transient-ischemic-attack-updated-systematic-review-and-meta-analysis
#17
George Ntaios, Vasileios Papavasileiou, Dimitrios Sagris, Konstantinos Makaritsis, Konstantinos Vemmos, Thorsten Steiner, Patrik Michel
BACKGROUND AND PURPOSE: Previous systematic reviews and meta-analyses compared the efficacy and safety of patent foramen ovale (PFO) closure versus medical treatment in patients with cryptogenic stroke or transient ischemic attack (TIA). Recently, new evidence from randomized trials became available. METHODS: We searched PubMed until September 24, 2017, for trials comparing PFO closure with medical treatment in patients with cryptogenic stroke/TIA using the items: stroke or cerebrovascular accident or TIA and patent foramen ovale or paradoxical embolism and trial or study...
January 15, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29332603/previous-use-of-statins-and-atrial-electrical-remodeling-in-patients-with-cryptogenic-stroke
#18
Maurizio Acampa, Pietro Enea Lazzerini, Francesca Guideri, Rossana Tassi, Andrea Lo Monaco, Giuseppe Martini
BACKGROUND: In the general population the leading cause of cardioembolic stroke is atrial fibrillation (AF). A silent AF is also the possible cause of many cryptogenic strokes. P wave dispersion (PWD), a predictor of AF, has been proposed as a marker of silent AF occurrence in these strokes. PWD correlates with high-sensitive C-reactive protein levels reflecting the role of inflammation in promoting a slowed and inhomogeneous atrial conduction. Statins have a multitude of additional effects beyond lipid lowering, in particular anti-inflammatory effects that may influence atrial conduction...
January 10, 2018: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/29332308/transcatheter-closure-of-patent-foramen-ovale-for-secondary-prevention-of-ischemic-stroke-quantitative-synthesis-of-pooled-randomized-trial-data
#19
Abdul Hakeem, Mehmet Cilingiroglu, Angelos Katramados, Konstantinos Dean Boudoulas, Cezar Iliescu, Betul Gundogdu, Konstantinos Marmagkiolis
OBJECTIVES: To evaluate the safety and efficacy of percutaneous device closure of patent foramen ovale (PFO) for secondary prevention of ischemic stroke BACKGROUND: Stroke remains the leading cause of serious long-term disability in the United States. The effectiveness of a percutaneous PFO closure in the prevention of recurrent cryptogenic strokes has not been established. METHODS: We performed a literature search using PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Google Scholar, and Internet-based sources from January 2003 to September 2017...
January 14, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29331613/internal-carotid-artery-web-as-the-cause-of-recurrent-cryptogenic-ischemic-stroke
#20
Jon Antigüedad-Muñoz, Patricia de la Riva, Gorka Arenaza Choperena, Amaia Muñoz Lopetegi, Naiara Andrés Marín, Gorka Fernández-Eulate, Manuel Moreno Valladares, Maite Martínez Zabaleta
Carotid artery web is considered an exceptional cause of recurrent ischemic strokes in the affected arterial territory. The underlying pathology proposed for this entity is an atypical fibromuscular dysplasia. We present the case of a 43-year-old woman with no cardiovascular risk factors who had experienced 2 cryptogenic ischemic strokes in the same arterial territory within an 11-month period. Although all diagnostic tests initially yielded normal results, detailed analysis of the computed tomography angiography images revealed a carotid web; catheter angiography subsequently confirmed the diagnosis...
January 10, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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