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Cryptogenic Stroke: Anatomy of the Stroke Work-Up

Mary P Amatangelo1

  • 1Neurology, Stroke, Neurocritical Care, Brigham and Women's Hospital, 15 Francis Street, BB 335, Boston, MA 02115, USA.

Critical Care Nursing Clinics of North America
|February 5, 2020
PubMed

Insights

Cryptogenic stroke (CS) lacks a clear cause in 15-40% of ischemic stroke cases, posing a clinical challenge. Tailored investigations are crucial for effective secondary prevention strategies.

Area of Science:

  • Neurology
  • Cardiology
  • Vascular Medicine

Background:

  • Ischemic stroke diagnosis has advanced, yet a significant portion remains cryptogenic.
  • Cryptogenic stroke (CS) represents 15% to 40% of all ischemic strokes.
  • CS is diagnosed by exclusion after standard stroke work-up.

Purpose of the Study:

  • To highlight the diagnostic and therapeutic challenges posed by cryptogenic stroke.
  • To emphasize the need for individualized investigations in CS cases.
  • To underscore the importance of tailored secondary prevention strategies.

Main Methods:

  • Review of current diagnostic criteria and work-up for ischemic stroke.
  • Analysis of the definition and prevalence of cryptogenic stroke.
  • Discussion of individualized diagnostic approaches.

Main Results:

  • Cryptogenic stroke remains a significant clinical challenge despite advances in stroke understanding.
  • A substantial percentage of ischemic strokes (15-40%) are classified as cryptogenic.
  • Standard work-up is insufficient for identifying the cause in CS cases.

Conclusions:

  • Cryptogenic stroke necessitates a diagnosis of exclusion.
  • Further investigations must be individualized based on clinical evaluation.
  • Tailored secondary prevention is essential for managing cryptogenic stroke effectively.

Keywords:
Cardiac monitoringCryptogenic strokeDiagnostic testingEmbolic Stroke of Undetermined Etiology (ESUS)HypercoagulableImagingIschemic stroke

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