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Transesophageal echocardiographic findings in subcortical and cortical stroke
R A Falcone1, E P Shapiro, J C Jangula
1Johns Hopkins Bayview Medical Center, Baltimore, Maryland 21224, USA. rfalcone@jhmi.edu
Insights
Subcortical stroke often stems from multiple causes, not just small vessel disease. Transesophageal echocardiography reveals cardiac and aortic issues, highlighting its importance in diagnosing stroke etiology.
Area of Science:
- Neurology
- Cardiology
- Vascular Medicine
Background:
- Subcortical stroke has been historically attributed primarily to intracranial small vessel disease.
- This traditional view may not fully encompass the diverse origins of subcortical stroke.
Purpose of the Study:
- To investigate the prevalence of cardiac and aortic sources of emboli in patients diagnosed with subcortical stroke.
- To evaluate the role of transesophageal echocardiography in identifying potential etiological factors for subcortical stroke.
Main Methods:
- Utilized transesophageal echocardiography to assess cardiac structures and the aorta in patients with subcortical stroke.
- Analyzed findings for evidence of aortic atherosclerotic disease and other potential embolic sources.
Main Results:
- Transesophageal echocardiographic findings, including aortic atherosclerotic disease, were frequently observed in patients with subcortical stroke.
- These findings suggest that cardiac and aortic conditions are common contributors to subcortical stroke.
Conclusions:
- Subcortical stroke likely has a multifactorial etiology, involving both small vessel disease and embolic sources from the heart and aorta.
- Transesophageal echocardiography is a valuable diagnostic tool for identifying these contributing factors in patients with subcortical stroke.
Abstract:
Historically, subcortical stroke is believed to be secondary to intracranial small vessel disease. In this study, transesophageal echocardiographic findings such as aortic atherosclerotic disease and other potential cardiac sources of emboli were common in patients with subcortical stroke, supporting a multifactorial etiology for subcortical stroke and a role for transesophageal echocardiography in this patient population.