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Dual-Task Stroop Paradigm for Detecting Cognitive Deficits in High-Functioning Stroke Patients
Published on: December 16, 2022
Evaluation of the patient with unexplained stroke
1Department of Medicine, Weill Medical College of Cornell University, New York 10068, USA. jok2007@med.cornell.edu
Coronary Artery Disease
|October 17, 2008
Summary
Many ischemic strokes remain unexplained. Cardiac or aortic embolism, often linked to heart or aortic issues, is a likely cause, particularly in younger and older adults. Early diagnosis is key.
Area of Science:
- Neurology
- Cardiology
- Vascular Medicine
Background:
- A significant percentage of ischemic strokes are classified as 'cryptogenic' or unexplained, despite advanced diagnostic tools.
- Potential causes include unrecognized cardiac or aortic embolism, with distinct pathophysiological patterns in different age groups.
Purpose of the Study:
- To highlight the importance of echocardiography in diagnosing cryptogenic ischemic strokes.
- To emphasize the bimodal pathophysiology of cryptogenic stroke, involving interatrial septal abnormalities and aortic/arterial atherothrombotic embolism.
Main Methods:
- Review of diagnostic approaches for cryptogenic ischemic stroke.
- Emphasis on echocardiography, specifically transesophageal echocardiography, as the preferred imaging modality.
- Clinical judgment in guiding therapy pending further trial data.
Main Results:
- Echocardiography is central to evaluating unexplained ischemic stroke.
- Interatrial septal abnormalities are implicated in younger adults, while subclinical aortic and large-artery atherothrombotic embolism are prominent in older individuals.
- Timely and comprehensive evaluation can identify the embolic source.
Conclusions:
- Unrecognized cardiac or aortic embolism is a major contributor to cryptogenic ischemic strokes.
- Transesophageal echocardiography is the diagnostic modality of choice for unexplained ischemic stroke.
- Prompt evaluation and tailored therapy based on clinical judgment are crucial for patient management.
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