Current approaches to diagnosis and prevention of ishemic stroke.

Author:

Kutlubaev M. A.1,Khasanova E. N.1

Affiliation:

1. G.G. Kuvatov Republican clinical hospital

Abstract

Etiology ofembolic stroke is very heterogeneous. It could be related to large vessel disease, small vessel disease, thromboembolism of cardiac origin. Clarification of etiology of stroke is important prerequisite for adequate selection of its secondary prevention measures. Standard work-up allows identification of its etiology in 60-90% of cases. 1n the rest 10-40% of cases stroke is considered cryptogenic. The majority of cryptogenic strokes are embolic. In keeping with this, a concept of embolic stroke of undetermined source (ESUS) was suggested. 1n the paper authors review most sigificant causes of ESUS. Occult atrial fibrillation is one of the common cause of ESUS. 1t could be detected only by means of long term ECG monitoring. Standard 24-hour ECG monitoring after stroke detects around 5% of cases ofpreviously unknown paroxysmal atrial fibrillation, while long-term monitoring of ECG allows detection ofparoxysmal atrial fibrillation in 15% of cases. Patent foramen ovale could lead to stroke in patients with deep vein thrombosis in the legs and pelvis due to paradoxical embolism. Atherosclerosis of aortic arch is observed in the half ofpeople older than 45 years. Large, ulcerated, non-calcified or floating atheromas could cause a stroke. Malignant tumors could lead to cerebral embolism through non-bacterial thrombotic endocarditis. Tumor embolism into cerebral arteries could also be seen in rare cases. The rate of cerebral embolism is high in mixomas. Approaches to diagnosis and secondary prevention of ESUS are discussed in the paper.

Publisher

Medical Informational Agency Publishers

Subject

General Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3