Cryptogenic Stroke

Abstract

Introduction: To emphasize the importance of this kind of stroke, to focus on secondary stroke prevention and to recognize that the etiology of stroke is fundamental for proper prevention. In this chapter, the history of this stroke subtype is described and its actual specific denomination: embolic stroke undetermined source (ESUS).Objectives: To define "cryptogenic stroke," the main characteristics and therapeutics proposals.Discussion: The following main characteristics of this kind of stoke are presented here: the incidence in several countries and international statistics, the specific physiopathology of this kind of stroke, the different methods for its correct diagnosis and the importance of exhaustive cardiac investigation, the main cause of ESUS with special focus in the importance of paroxysmal atrial fibrillation. The new therapeutic options (anticoagulants versus antiplatelets) are presented and discussed based on the recent trials.Conclusion: Importance of correct definition of the stroke etiology for its appropriate secondary prevention; would anticoagulation be better than antiaggregation for adequate prevention? We look forward to the results of recent trials in this field.

Cerebrovascular Accidents Related to Snakebites in the Amazon—Two Case Reports

“…This leakage can lead to clinical manifestations that are related to the volume of blood transported to the extravascular space and to the location of the hemorrhage. 13,14 The signs and symptoms observed in our study, such as lower levels of consciousness, were compatible with brain damage and indicated a suspected stroke. These manifestations appear in patients with persistently depressed sensorium and focal neurological deficits that begin early and then develop into cerebrovascular lesions after snakebite envenomation, as was observed in our 2 cases.…”