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Cryptogenic stroke

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https://www.readbyqxmd.com/read/28626055/ischemic-stroke-what-does-the-histological-composition-tell-us-about-the-origin-of-the-thrombus
#1
Peter B Sporns, Uta Hanning, Wolfram Schwindt, Aglaé Velasco, Jens Minnerup, Tarek Zoubi, Walter Heindel, Astrid Jeibmann, Thomas Ulrich Niederstadt
BACKGROUND AND PURPOSE: The introduction of stent retrievers allows for a complete extraction and histological analysis of human thrombi. Ischemic stroke is a major health issue, and differentiation of underlying causes is highly relevant to prevent recurrent stroke. Therefore, histopathologic analysis of the embolic clots after removal may provide valuable information about underlying pathologies. This study analyzes histological clot composition and aims to identify specific patterns that might help to distinguish causes of ischemic stroke...
June 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28624331/long-term-detection-of-atrial-fibrillation-with-insertable-cardiac-monitors-in-a-real-world-cryptogenic-stroke-population
#2
Paul D Ziegler, John D Rogers, Scott W Ferreira, Allan J Nichols, Mark Richards, Jodi L Koehler, Shantanu Sarkar
BACKGROUND: The long-term incidence of atrial fibrillation (AF) in cryptogenic stroke (CS) patients has been explored in carefully controlled clinical trials but real-world data are limited. We investigated the two-year incidence of AF in real-world clinical practice among a large cohort of patients with an insertable cardiac monitor (ICM) placed for AF detection following CS. METHODS: Patients in the de-identified Medtronic Discovery™ Link database who received an ICM (Reveal LINQ™) for the purpose of AF detection following CS were included and monitored for up to 2years...
June 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28596458/prevalence-of-fabry-disease-and-outcomes-in-young-canadian-patients-with-cryptogenic-ischemic-cerebrovascular-events
#3
Sylvain Lanthier, Gustavo Saposnik, Gerald Lebovic, Karen Pope, Daniel Selchen, David F Moore
BACKGROUND AND PURPOSE: Previous studies reported Fabry disease in 0% to 4% of young patients with cryptogenic ischemic stroke (IS). We sought to determine the prevalence of Fabry and outcomes among young Canadians with cryptogenic IS or transient ischemic attack (TIA). METHODS: We prospectively enrolled individuals aged 18 to 55 with IS or speech or motor TIA, and no cause identified despite predetermined investigation. α-galactosidase-A gene was sequenced for Fabry diagnosis...
June 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28574934/pfo-closure-for-cryptogenic-stroke-a-review-and-clinical-treatment-algorithm
#4
Harsimran S Singh, Farhan Katchi, Srihari S Naidu
With a high prevalence in the general population of approximately 25%, and a prevalence in the cryptogenic stroke population approaching 40%, the propensity of a patent foramen ovale (PFO) to precipitate or enable stroke, especially in young, otherwise healthy individuals, has been the subject of much debate. With proof of concept achieved via imaging modalities documenting thrombus-in-transit, and the development of minimally-invasive percutaneous approaches to closure, multiple observational studies and, more recently, several completed randomized controlled trials have sought to answer the question of when and in whom PFO closure should occur...
July 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28570323/neurologic-complications-of-cardiac-and-aortic-disease
#5
James P Klaas
PURPOSE OF REVIEW: This article discusses neurologic complications that can arise from cardiac and aortic disease and dysfunction. RECENT FINDINGS: Advances in the care of patients with cardiac or aortic disease include the use of prolonged cardiac monitoring in cryptogenic stroke and the approval of the use of left atrial appendage closure devices for stroke prevention in patients with atrial fibrillation who are not candidates for anticoagulation. Continuing controversy surrounds patent foramen ovale closure, and new evidence indicates that cognitive impairment following coronary artery bypass grafting surgery may be less common than previously thought...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28570259/propensity-score-matched-comparison-of-the-cera-pfo-occluder-with-the-amplatzer-pfo-occluder-for-percutaneous-closure-of-patent-foramen-ovale-without-echocardiographic-guidance
#6
Mirjam Ulmi, Fabien Praz, George C M Siontis, Andreas Wahl, Stephan Windecker, Heinrich P Mattle, Bernhard Meier
BACKGROUND: Percutaneous patent foramen ovale (PFO) closure has become a routine procedure and was proven to be safe and feasible. In a recently published pooled analysis of randomized trials, percutaneous PFO closure was shown to more effectively reduce recurrent stroke when compared with medical therapy in patients with cryptogenic strokes. However, procedural safety and closure rate are device dependent. METHODS: We performed a propensity-score matched comparison of 28 patients undergoing percutaneous PFO closure using the Cera PFO occluder (CPO) with 28 patients who received the Amplatzer PFO occluder (APO)...
May 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28568903/multidisciplinary-assessment-of-pfo-with-substantial-right-to-left-shunting-and-medium-term-follow-up-after-pfo-device-closure-a-single-center-experience
#7
Lu He, Ge-Sheng Cheng, Ya-Juan Du, Yu-Shun Zhang
OBJECTIVES: To describe the multidisciplinary assessment of patent foramen ovale (PFO) with substantial right-to-left shunting (RLS) and medium-term follow-up after PFO closure for stroke or transient ischemic attack (TIA). BACKGROUND: PFO closure is a therapeutic option to prevent recurrent ischemic event in patients with cryptogenic stroke and TIA. The apparent lack of benefit seen in previous studies was in part due to the inclusion of patients with alternate mechanisms of stroke/TIA...
June 1, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28523236/left-atrial-size-and-risk-of-recurrent-ischemic-stroke-in-a-chinese-population
#8
Jie Xue, Yuanshao Lin, Wensi Huang, Xiaoli Chen, Qian Li, Zhengyi Cai, Wanli Zhang, Yuansheng Ye, Bei Shao
BACKGROUND: Although a number of studies have reported the role of an increased left atrial (LA) size on stroke, limited data are collected about the relationship between LA enlargement and recurrent ischemic stroke in the Chinese population. Our aim was to assess the association of LA size with the risk of stroke recurrence, particularly with recurrent cardioembolic or cryptogenic stroke in ischemic stroke patients. METHODS: The study recruited 313 consecutive patients with acute first-ever ischemic stroke...
May 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28497441/-cryptogenic-stroke-in-a-young-patient-with-heart-disease-and-kidney-failure
#9
B Oyanguren, R Segoviano, E Alegria, E Besada, M Gonzalez-Salaices, M Eimil-Ortiz, C Lopez de Silanes
INTRODUCTION: Fabry's disease is an infrequent metabolic pathology linked to the X chromosome which causes a wide variety of signs and symptoms. CASE REPORT: A 39-year-old male who was admitted to our stroke unit with right-side hemiparesis (1 + 0) and dysarthria (1). The score on the National Institute of Health Stroke Scale was 2. The patient presented angiokeratomas in both thighs. A computerised axial tomography scan of the head showed left thalamic acute infarction...
May 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28495950/carotid-bulb-webs-as-a-cause-of-cryptogenic-ischemic-stroke
#10
P I Sajedi, J N Gonzalez, C A Cronin, T Kouo, A Steven, J Zhuo, O Thompson, R Castellani, S J Kittner, D Gandhi, P Raghavan
BACKGROUND AND PURPOSE: Carotid webs are intraluminal shelf-like filling defects at the carotid bulb with recently recognized implications in patients with recurrent ischemic stroke. We sought to determine whether carotid webs are an under-recognized cause of "cryptogenic" ischemic stroke and to estimate their prevalence in the general population. MATERIALS AND METHODS: A retrospective review of neck CTA studies in young patients with cryptogenic stroke over the past 6 years (n = 33) was performed to determine the prevalence of carotid webs compared with a control group of patients who received neck CTA studies for reasons other than ischemic stroke (n = 63)...
May 11, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28478812/migraine-white-matter-hyperintensities-and-cerebral-microinfarcts-are-silent-cryptogenic-strokes-and-relate-to-dementia
#11
Arnold E Eggers
No abstract text is available yet for this article.
May 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28476507/old-stroke-as-an-independent-risk-etiology-for-todd-s-paralysis
#12
Kenichiro Sato, Noritoshi Arai, Ayumi Hida, Sousuke Takeuchi
BACKGROUND: Todd's paralysis (TP) is a well-known postictal paresis in which patients present with transient weakness in their limb(s) after seizures. Although recognized as a stroke mimic in clinical practice, the pathophysiological mechanism and clinical features of TP remain unknown. Furthermore, its diagnosis can be erroneous in neurological emergency practice. We aimed to illustrate the clinical features and identify factors associated with TP. METHODS: This single-center, retrospective observational study included consecutive adult patients who presented with convulsive seizure and were referred to an urban tertiary care emergency department between August 2010 and April 2016...
May 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28465966/transcranial-doppler-ultrasound-incremental-diagnostic-role-in-cryptogenic-stroke-part-ii
#13
REVIEW
Antonello D'Andrea, Marianna Conte, Lucia Riegler, Raffaella Scarafile, Rosangela Cocchia, Enrica Pezzullo, Massimo Cavallaro, Marco Di Maio, Francesco Natale, Giuseppe Santoro, Maria Giovanna Russo, Marino Scherillo, Raffaele Calabrò
Transcranial Doppler (TCD) ultrasonography is a noninvasive ultrasound study, which has been extensively applied in both outpatient and inpatient settings. Its main use in current clinical practice is the research for "Paradoxical Embolism," due to migration of thromboembolic material from systemic venous circulation to the left cardiac chambers and arterial circulation through cardiopulmonary shunts such as patent foramen ovale which represents an important cause of cryptogenic stroke, especially in patients under 55 years of age...
July 2016: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28460651/transcatheter-closure-of-the-patent-foramen-ovale-in-children-intermediate-term-follow-up-results
#14
Kutay Sel, Hakan H Aykan, Derya Duman, Ebru Aypar, Süheyla Özkutlu, Dursun Alehan, Tevfik Karagöz
The patent foramen ovale is almost a normal anatomical hole between the atria with ~30% incidence in the general population. It has been suggested that the patent foramen ovale is the cause of some neurological events, which is explained by paradoxical embolism. Transcatheter closure of the patent foramen ovale is a common procedure in adult patients with cerebral ischaemic events, but there are limited data investigating the results in children. Between January, 2005 and February, 2014, 17 patients' patent foramen ovales were closed by the transcatheter approach in our department...
May 2, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28460494/how-to-identify-patients-at-risk-of-silent-atrial-fibrillation-after-cryptogenic-stroke-potential-role-of-p-wave-dispersion
#15
Maurizio Acampa, Pietro Enea Lazzerini, Giuseppe Martini
No abstract text is available yet for this article.
May 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28439982/impaired-endothelial-function-in-patients-with-cryptogenic-stroke-and-patent-foramen-ovale-is-not-affected-by-closure
#16
Maria Lantz, Konstantinos Kostulas, Magnus Settergren, Christina Sjöstrand
INTRODUCTION: Patent foramen ovale (PFO) is associated with cryptogenic stroke (CS) and migraine with aura (MA). Endothelial dysfunction (ED) is a risk factor for development of cardiovascular disease, but might also be involved in migraine pathophysiology. Short-term worsening of migraine has been described after closure of PFO. We evaluated endothelial function in patients with CS and PFO, before and after closure of PFO, and in patients with migraine, whether changes in endothelial function was related to a change in migraine frequency...
June 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28438866/soluble-urokinase-type-plasminogen-activator-receptor-predicts-all-cause-5-year-mortality-in-ischemic-stroke-and-tia
#17
Juha Onatsu, Mikko Taina, Pirjo Mustonen, Marja Hedman, Antti Muuronen, Otso Arponen, Miika Korhonen, Pekka Jäkälä, Ritva Vanninen, Kari Pulkki
AIM: We evaluated soluble urokinase-type plasminogen activator receptor (suPAR) levels in different stroke subtypes and assessed their prognostic value regarding 5-year outcomes. MATERIALS AND METHODS: The study included 117 stroke patients (81 males; mean=age 61±11 years) with suspected cardioembolic stroke whose plasma suPAR concentration was assessed. Altogether, 20 (17.1%) patients suffered from stroke as a result of cardioembolism, 12 (10.3%) from large-artery atherosclerosis, 9 (7...
May 2017: In Vivo
https://www.readbyqxmd.com/read/28436306/cardiac-magnetic-resonance-imaging-has-limited-additional-yield-in-cryptogenic-stroke-evaluation-after-transesophageal-echocardiography
#18
Ava L Liberman, Rizwan E Kalani, Jessie Aw-Zoretic, Matthew Sondag, Vistasp J Daruwalla, Sumeet S Mitter, Richard Bernstein, Jeremy D Collins, Shyam Prabhakaran
Background The use of cardiac magnetic resonance imaging is increasing, but its role in the diagnostic work-up following ischemic stroke has received limited study. We aimed to explore the added yield of cardiac magnetic resonance imaging to identify cardio-aortic sources not detected by transesophageal echocardiography among patients with cryptogenic stroke. Methods A retrospective single-center cohort study was performed from 01 January 2009 to 01 March 2013. Consecutive patients who had both a stroke protocol cardiac magnetic resonance imaging and a transesophageal echocardiography preformed during a single hospitalization were included...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28431610/duration-of-paroxysmal-atrial-fibrillation-in-cryptogenic-stroke-is-not-associated-with-stroke-severity-and-early-outcomes
#19
Chrissoula Liantinioti, Konstantinos Tympas, Aristeidis H Katsanos, John Parissis, Maria Chondrogianni, Christina Zompola, Georgios Papadimitropoulos, Michael Ioakeimidis, Sokratis Triantafyllou, Andromaxi Roussopoulou, Konstantinos Voumvourakis, John Lekakis, Gerasimos Filippatos, Leonidas Stefanis, Georgios Tsivgoulis
The current definition of paroxysmal atrial fibrillation (PAF) requires an arbitrary cut-off of >30s, but in clinical practice cryptogenic stroke (CS) patients with PAF duration of ≤30s are not usually excluded from anticoagulation therapy. We sought to evaluate the clinical relevance of short-duration (≤30s) PAF in CS. Consecutive CS patients with no prior AF history and sinus-rhythm on baseline electrocardiography (ECG) were prospectively evaluated over a three-year period. Baseline stroke severity was assessed by NIHSS-scores...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28415099/p594contrast-transthoracic-echocardiography-as-a-gatekeeper-for-patent-foramen-ovale-closure
#20
M Muratori, G Italiano, E Innocenti, L Fusini, M Mapelli, G Tamborini, S Ghulam Ali, P Gripari, A Maltagliati, F Celeste, M Pepi
Background.: The presence of patent foramen ovale (PFO) has been linked to many illness, including cryptogenic stroke, transient ischemic attack, migraine, platypnea-orthodeoxia syndrome and decompression sickness in scuba divers. Transesophageal echocardiography is the gold standard technique for the visualization of atrial septal anatomy, but it is a secondary level exam, not always available, with additional associated costs and not completely free from procedural risks. Standard transthoracic echocardiography (TTE) has a too low sensitivity for PFO screening...
December 1, 2016: European Heart Journal Cardiovascular Imaging
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