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Cryptogenic stroke

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https://www.readbyqxmd.com/read/28049202/aortic-atherosclerosis-determines-increased-retrograde-blood-flow-as-a-potential-mechanism-of-retrograde-embolic-stroke
#1
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
#2
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
#3
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...
December 27, 2016: 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27844195/-event-recorder-in-cryptogenic-stroke-accepted-and-feasible-indications
#12
J Brachmann, M Held
It was proven in multiple studies that about 30 % of cryptogenic strokes are related to clinically silent atrial fibrillation (AF). There is an opportunity for prolonged ECG monitoring mainly through an implanted event recorder after completion of conventional diagnostic methods in an unidentified stroke source. The Crystal AF study has proven, together with other results, improved AF detection through prolonged monitoring for up to 36 months. An implanted event recorder for 2-3 years is suitable for this particular purpose...
December 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27843104/left-atrial-dysfunction-in-the-pathogenesis-of-cryptogenic-stroke-novel-insights-from-speckle-tracking-echocardiography
#13
Darryl P Leong, Emer Joyce, Philippe Debonnaire, Spyridon Katsanos, Eduard R Holman, Martin J Schalij, Jeroen J Bax, Victoria Delgado, Nina Ajmone Marsan
BACKGROUND: Myocardial strain analysis by speckle-tracking echocardiography, which can detect subtle abnormalities in left atrial (LA) function, may offer unique insights into LA pathophysiology in patients with cryptogenic stroke (CS). The aim of this study was to investigate whether LA reservoir strain by speckle-tracking echocardiography, as a measure of LA compliance, is impaired in patients with CS and no history of atrial fibrillation. METHODS: A retrospective case-control study of 742 patients (mean age, 59 ± 13 years; 54% men; 371 with CS and 371 control subjects) was conducted...
January 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27832757/mid-term-results-of-interventional-closure-of-patent-foramen-ovale-with-the-occlutech-figulla-%C3%A2-flex-ii-occluder
#14
Jonas Neuser, Muharrem Akin, Udo Bavendiek, Tibor Kempf, Johann Bauersachs, Julian D Widder
BACKGROUND: Patients with a patent foramen ovale (PFO) who suffered from stroke, TIA or peripheral paradoxical embolism are at substantial risk for recurrent neurologic events and in need for secondary prevention. Interventional closure of PFO has been performed for over 20 years. Numerous devices have been developed and used for treatment. We investigated PFO closure with the third generation Occlutech Figulla(®) Flex II Occluder device. METHODS: Between 2012 and 2015 57 patients (mean age 47...
November 10, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27823712/sleep-apnea-syndrome-and-patent-foramen-ovale-a-dangerous-association-in-ischemic-stroke
#15
Silvia Tur, Mónica de la Peña, Bárbara Vives, Ana Belén Martínez, Arantza Gorospe, Inés Legarda, Maria José Torres, Carmen Jiménez, Joan B Soriano
BACKGROUND: The coexistence of patent foramen ovale (PFO) and sleep apnea syndrome (SAS) might be related to the pathogenesis of cryptogenic stroke (CS). We aimed to determine the prevalence of SAS in patients with cryptogenic stroke and PFO. METHODS: This is a prospective case-control study in which we included ischemic stroke patients consecutively admitted to our hospital's Acute Stroke Unit. Contrast transcranial Doppler (c-TCD) and sleep polygraphy within the first 72 h after stroke onset were performed to detect PFO and SAS...
September 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27817241/role-of-hospitalists-in-the-diagnosis-of-atrial-fibrillation-for-the-management-of-cryptogenic-stroke-patients
#16
Alpesh Amin
Cryptogenic strokes are responsible for significant morbidity and mortality. Identifying the underlying cause of cryptogenic stroke is imperative for appropriate short and long-term management of these patients. In particular, detecting atrial fibrillation in cryptogenic stroke patients may shed insight into the cause of the index stroke, but is also important to identify an important cause of secondary stroke. There is accumulating evidence indicating that monitoring for durations beyond the guideline recommended 30 day-period results in greater atrial fibrillation yield...
December 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27790125/a-case-of-turner-syndrome-with-multiple-embolic-infarcts
#17
Cindy W Yoon, Eungseok Lee, Byung-Nam Yoon, Hee-Kwon Park, Joung-Ho Rha
Only a few cases of Turner syndrome (TS) with ischemic stroke have been reported. Various arteriopathies of the cerebral arteries, including fibromuscular dysplasia, congenital hypoplasia, moyamoya syndrome, and premature atherosclerosis have been assumed to be the cause of ischemic stroke in TS. There has been no case report of a TS patient presenting with an embolic stroke pattern without any cerebral arteriopathy. A 28-year-old woman with TS was referred to our hospital because of abnormal brain magnetic resonance imaging (MRI) findings...
September 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/27766716/d-dimer-as-a-predictor-of-early-neurologic-deterioration-in-cryptogenic-stroke-with-active-cancer
#18
K-W Nam, C K Kim, T J Kim, S J An, A M Demchuk, Y Kim, S Jung, M-K Han, S-B Ko, B-W Yoon
BACKGROUND AND PURPOSE: The occurrence of stroke in cancer patients is caused by conventional vascular risk factors and cancer-specific mechanisms. However, cryptogenic stroke in patients with cancer was considered to be more related to cancer-specific hypercoagulability. In this study, we investigated the potential of the D-dimer level to serve as a predictor of early neurologic deterioration (END) in cryptogenic stroke patients with active cancer. METHODS: We recruited 109 cryptogenic stroke patients with active cancer within 72 h of symptom onset...
January 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/27756556/silent-atrial-fibrillation-and-cryptogenic-strokes
#19
REVIEW
James E Dalen, Joseph S Alpert
A new suspected cause of cryptic strokes is "silent atrial fibrillation." Pacemakers and other implanted devices allow continuous recording of cardiac rhythm for months or years. They have discovered that short periods of atrial fibrillation lasting minutes or hours are frequent and usually are asymptomatic. A meta-analysis of 50 studies involving more than 10,000 patients with a recent stroke found that 7.7% had new atrial fibrillation on their admitting electrocardiogram. In 3 weeks during and after hospitalization, another 16...
October 15, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27694327/nonsustained-atrial-fibrillation-in-ischemic-stroke-patients-and-stroke-free-controls-from-the-perspective-of-stroke-pathophysiology
#20
Ezgi Yetim, Mehmet Akif Topcuoglu, Ugur Canpolat, Rahsan Gocmen, Kader K Oguz, Necla Ozer, Kudret Aytemir, Ethem Murat Arsava
BACKGROUND: Short-lasting (<30 s), nonsustained episodes of atrial fibrillation (NS-AF) are considered a risk factor for future development of paroxysmal or persistent AF. Nonetheless, their causal role in stroke pathogenesis is currently unknown. In this study we determined the frequency of NS-AF, together with the associated clinical and imaging features, in stroke-free controls and ischemic stroke patients. METHODS AND RESULTS: A total of 332 controls, ≥50 years of age and no prior history of stroke or AF, were evaluated with 24-hour Holter monitoring for the presence of <30-s-long AF episodes...
September 30, 2016: Journal of the American Heart Association
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