Evaluation of the patient with unexplained stroke

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Despite increasing sophistication of brain imaging, neurovascular evaluation, and laboratory testing, a sizable proportion of ischemic strokes defy etiologic classification. Many, if not most, of such 'cryptogenic' strokes may stem from unrecognized cardiac or aortic embolism, with a bimodal pathophysiology potentially dominated by interatrial septal abnormalities in young adults, and by subclinical aortic and large-artery atherothrombotic embolism in older individuals. Echocardiography is the centerpiece of the diagnostic evaluation of unexplained ischemic stroke, and unless contraindicated, transesophageal echocardiography is currently the modality of choice. Comprehensive and timely evaluation is essential to identify the potential emboligenic substrate, and, pending randomized trial data, to institute appropriate therapy based on best clinical judgment.

Original languageEnglish (US)
Pages (from-to)535-540
Number of pages6
JournalCoronary Artery Disease
Volume19
Issue number7
DOIs
StatePublished - Nov 2008
Externally publishedYes

Fingerprint

Stroke
Embolism
Transesophageal Echocardiography
Neuroimaging
Echocardiography
Young Adult
Arteries
Therapeutics

Keywords

  • Aortic atheroma
  • Atrial septal anerusym
  • Echocardiography
  • Embolism
  • Patent foramen ovale
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Evaluation of the patient with unexplained stroke. / Kizer, Jorge.

In: Coronary Artery Disease, Vol. 19, No. 7, 11.2008, p. 535-540.

Research output: Contribution to journalArticle

@article{af08455e5e6f436d869402063db2da76,
title = "Evaluation of the patient with unexplained stroke",
abstract = "Despite increasing sophistication of brain imaging, neurovascular evaluation, and laboratory testing, a sizable proportion of ischemic strokes defy etiologic classification. Many, if not most, of such 'cryptogenic' strokes may stem from unrecognized cardiac or aortic embolism, with a bimodal pathophysiology potentially dominated by interatrial septal abnormalities in young adults, and by subclinical aortic and large-artery atherothrombotic embolism in older individuals. Echocardiography is the centerpiece of the diagnostic evaluation of unexplained ischemic stroke, and unless contraindicated, transesophageal echocardiography is currently the modality of choice. Comprehensive and timely evaluation is essential to identify the potential emboligenic substrate, and, pending randomized trial data, to institute appropriate therapy based on best clinical judgment.",
keywords = "Aortic atheroma, Atrial septal anerusym, Echocardiography, Embolism, Patent foramen ovale, Stroke",
author = "Jorge Kizer",
year = "2008",
month = "11",
doi = "10.1097/MCA.0b013e32830eabb6",
language = "English (US)",
volume = "19",
pages = "535--540",
journal = "Coronary Artery Disease",
issn = "0954-6928",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Evaluation of the patient with unexplained stroke

AU - Kizer, Jorge

PY - 2008/11

Y1 - 2008/11

N2 - Despite increasing sophistication of brain imaging, neurovascular evaluation, and laboratory testing, a sizable proportion of ischemic strokes defy etiologic classification. Many, if not most, of such 'cryptogenic' strokes may stem from unrecognized cardiac or aortic embolism, with a bimodal pathophysiology potentially dominated by interatrial septal abnormalities in young adults, and by subclinical aortic and large-artery atherothrombotic embolism in older individuals. Echocardiography is the centerpiece of the diagnostic evaluation of unexplained ischemic stroke, and unless contraindicated, transesophageal echocardiography is currently the modality of choice. Comprehensive and timely evaluation is essential to identify the potential emboligenic substrate, and, pending randomized trial data, to institute appropriate therapy based on best clinical judgment.

AB - Despite increasing sophistication of brain imaging, neurovascular evaluation, and laboratory testing, a sizable proportion of ischemic strokes defy etiologic classification. Many, if not most, of such 'cryptogenic' strokes may stem from unrecognized cardiac or aortic embolism, with a bimodal pathophysiology potentially dominated by interatrial septal abnormalities in young adults, and by subclinical aortic and large-artery atherothrombotic embolism in older individuals. Echocardiography is the centerpiece of the diagnostic evaluation of unexplained ischemic stroke, and unless contraindicated, transesophageal echocardiography is currently the modality of choice. Comprehensive and timely evaluation is essential to identify the potential emboligenic substrate, and, pending randomized trial data, to institute appropriate therapy based on best clinical judgment.

KW - Aortic atheroma

KW - Atrial septal anerusym

KW - Echocardiography

KW - Embolism

KW - Patent foramen ovale

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=55749107633&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=55749107633&partnerID=8YFLogxK

U2 - 10.1097/MCA.0b013e32830eabb6

DO - 10.1097/MCA.0b013e32830eabb6

M3 - Article

VL - 19

SP - 535

EP - 540

JO - Coronary Artery Disease

JF - Coronary Artery Disease

SN - 0954-6928

IS - 7

ER -