Microembolic Signals in Patients with Cryptogenic Stroke with or without Patent Foramen Ovale

Shariat, Abdolhamid; Yaghoubi, Ehsan; Nemati, Reza; Moaref, Alireza; Aghasadeghi, Kamran; Borhani‐Haghighi, Afshin

doi:10.1016/j.jstrokecerebrovasdis.2011.02.015

Cited by 3 publications

(6 citation statements)

References 20 publications

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“…TCD sonography and monitoring have not shown any significant arterial stenosis and MES, respectively. MES considered silent cerebral emboli that are usually detected during TCD monitoring of the intracranial arteries [ 7 ]. There seems to be another mechanism involved in pathogenesis of neurologic episodes in our case.…”

Section: Discussionmentioning

confidence: 99%

Unusual Neurologic Manifestations of a Patient with Cyanotic Congenital Heart Disease after Phlebotomy

Salimipour

Mehdizadeh

Nemati

et al. 2015

Case Reports in Neurological Medicine

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Secondary erythrocytosis in cyanotic congenital heart disease (CCHD) is a compensatory response to chronic hypoxia which should be managed with caution. CCHD patients, who have compensated erythrocytosis but do not manifest significant neurologic symptoms, may experience secondary life-threatening complications such as stroke in case of inappropriate phlebotomy. This study reports a young man with CCHD who developed frequently repeated transient neurologic deficits with various presentations after one session of phlebotomy. The symptoms resolved a few days after the hematocrit (Hct) level returned to the prephlebotomy level.

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Section: Discussionmentioning

confidence: 99%

Unusual Neurologic Manifestations of a Patient with Cyanotic Congenital Heart Disease after Phlebotomy

Salimipour

Mehdizadeh

Nemati

et al. 2015

Case Reports in Neurological Medicine

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“…A limited number of studies have assessed MES presence in individuals with PFO. Droste et al documented MES in three out of 14 cases, whereas other investigators detected MES in 27% of PFO positive patients and 18% of PFO negative patients (OR = 1.76, P = .327) . In addition, the mean number of MES per hour was higher in PFO cases (.70 ± 1.47 vs. .23 ± .55; P = .026).…”

Section: Cardiac Sourcesmentioning

confidence: 93%

“…Droste et al documented MES in three out of 14 cases, whereas other investigators detected MES in 27% of PFO positive patients and 18% of PFO negative patients (OR = 1.76, P = .327). 108,109 In addition, the mean number of MES per hour was higher in PFO cases (.70 ± 1.47 vs. .23 ± .55; P = .026). Moreover, when PFO was combined with atrial septal aneurysm, MES counts were significantly higher than in all other patient groups.…”

Section: Patent Foramen Ovalementioning

confidence: 94%

“…In addition, the mean number of MES per hour was higher in PFO cases (.70 ± 1.47 vs. .23 ± .55; P = .026). Moreover, when PFO was combined with atrial septal aneurysm, MES counts were significantly higher than in all other patient groups . TCD may also detect fat emboli entering the arterial circulation through a PFO after posttraumatic long‐bone fracture, the so called fat embolism syndrome with central nervous manifestations due to cerebral microembolism.…”

Section: Cardiac Sourcesmentioning

confidence: 99%

“…Moreover, when PFO was combined with atrial septal aneurysm, MES counts were significantly higher than in all other patient groups. 109 TCD may also detect fat emboli entering the arterial circulation through a PFO after posttraumatic long-bone fracture, the so called fat embolism syndrome with central nervous manifestations due to cerebral microembolism. In such cases, emergent PFO closure along with surgical repair of the fracture may eliminate the risk of subsequent deterioration.…”

Section: Patent Foramen Ovalementioning

confidence: 99%

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The Role of Transcranial Doppler Monitoring in Patients with Multi‐Territory Acute Embolic Strokes: A Review

Kargiotis

Psychogios

Safouris

et al. 2019

Journal of Neuroimaging

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Acute multi‐territory, embolic cerebral infarctions are often associated with serious underlying clinical conditions including the presence of highly “active” emboligenic sources causing that in turn may result in high early recurrence rates. Prompt diagnosis, risk stratification, and treatment are substantial for the prevention of subsequent embolization that would result in further clinical deterioration. Among other clinical investigations, transcranial Doppler (TCD) monitoring is highly efficacious for the detection of microembolic signals (MES) that correspond to microthrombi entering the intracranial circulation. The presence and burden of MES, especially in multiple intracranial arteries, is clearly associated with an increased risk of symptomatic, recurrent embolization, and thus can justify a more aggressive treatment approach (clopidogrel load followed by dual antiplatelet therapy or alternatively therapeutic dose of low‐molecular‐weight heparin). In this narrative review, we discuss the most important causes of multi‐territory embolic ischemic strokes and also underscore the utility of TCD as a noninvasive tool for the diagnosis, risk stratification, and treatment.

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Cryptogenic Stroke

Gagliardi¹,

Gagliardi²

2016

Ischemic Stroke - Updates

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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.

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Microembolic Signals in Patients with Cryptogenic Stroke with or without Patent Foramen Ovale

Cited by 3 publications

References 20 publications

Unusual Neurologic Manifestations of a Patient with Cyanotic Congenital Heart Disease after Phlebotomy

Unusual Neurologic Manifestations of a Patient with Cyanotic Congenital Heart Disease after Phlebotomy

The Role of Transcranial Doppler Monitoring in Patients with Multi‐Territory Acute Embolic Strokes: A Review

Cryptogenic Stroke

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