Thorough diagnostic evaluation including TEE and cardiac monitoring is crucial in cryptogenic stroke to identify the underlying mechanism and guide secondary prevention.
Supports diagnostic pursuit in cryptogenic stroke to guide therapy; leaves open optimal strategies for recurrence reduction.
Cryptogenic, or unexplained, stroke is present in about 30%-40% of ischemic stroke patients. Pursuing a stroke mechanism is important in such patients to better choose therapy to reduce the stroke recurrence risk. Intracranial vessel imaging and cardiac evaluation with transesophageal echocardiogram and outpatient cardiac monitoring may help identify the stroke mechanism. This article highlights the diagnostic yield of various tests in identifying a stroke mechanism in stroke patients whose initial diagnostic evaluation is negative, and the implications for treatment.
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Yaghi et al. (2014) studied this question.
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