Ratajczak‐Tretel B, Lambert AT, Atar D, Aamodt AH. Cryptogenic stroke and TIA: Suggested diagnostic approach while waiting for evaluation and treatment guidelines.
Acta Neurol Scand 2022;
145:641-646. [PMID:
35146751 PMCID:
PMC9303324 DOI:
10.1111/ane.13590]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/13/2022] [Accepted: 01/21/2022] [Indexed: 01/25/2023]
Abstract
Background
Empiric strategies for secondary prevention in cryptogenic stroke and cryptogenic TIA are lacking. The best therapy to prevent recurrence depends on the cause of stroke. Attempting a correct diagnosis is therefore the fundamental goal of stroke treatment. Further investigation into the source of embolism if suspected, and determination of the etiology, even if demanding, is the needed prerequisite for optimal secondary prevention and risk reduction.
Aims
This paper discusses evaluation and treatment of cryptogenic stroke in light of recent years’ clinical trials results and developments in cardiology and neuroradiology. No ethical approval was needed for this work.
Results
Cardioembolism due to paroxysmal atrial fibrillation, patent foramen ovale, or cardiomyopathy; occult atherosclerosis from unstable plaques and hypercoagulable conditions seem to be the most common underlying causes to be revealed by further investigations. Treatment of these conditions can reduce the stroke recurrence significantly.
Conclusions
An individual approach and targeted diagnostics using advanced medical technologies in selected patients, who may benefit from a tailored treatment regimen, can help reveal a probable cause in the majority of strokes and TIAs previously classified as cryptogenic.
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