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Embolic Stroke of Uncommon Causes-A Case Series Report from an Acute Stroke Unit
Mihaiela Lungu1,2,3, Anamaria Ionescu4, Luminita Lăcrămioara Apostol5,6
1Neurological Department, "St. Ap. Andrew" County Emergency Clinical Hospital in Galati, 800578 Galati, Romania.
Background:
Beyond the well-known etiologies of ischemic stroke associated with recognized vascular risk factors, the literature describes a spectrum of uncommon causes with low prevalence but significant diagnostic and therapeutic implications.
Materials And Methods:
A case series report of seven rare etiopathogenic mechanisms (in patients aged 25-85) who presented within a 3-year interval (2022-2025) to our stroke unit at the Neurological Department-"St. Ap. Andrew" County Emergency Clinical Hospital in Galati, Romania.
Results:
The seven uncommon embolic stroke cases included three patients with infectious cerebral ischemia (hydatid cyst with double simultaneous embolism, mycotic aneurysm of the carotid artery, syphilis-associated stroke), three cases of rare cardioembolic strokes (patients with Lambl excrescences, cor triatriatum, left ventricular non-compaction), as well as one patient with multiple etiological associations triggering acute stroke.
Conclusions:
Rare etiologies of ischemic stroke should be actively considered when classical vascular risk factors are absent, particularly in young patients. Comprehensive diagnostic evaluation is mandatory, especially in cases of embolic stroke of undetermined source (ESUS). Such cases represent significant diagnostic and therapeutic challenges and require a multidisciplinary approach to optimize patient outcomes.
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