Etiology of Cryptogenic Stroke
Ischemic stroke is a heterogeneous syndrome with a plurality of potential etiological factors. The routine diagnosis does not always allow the cause of acute cerebrovascular accident to be found, in such cases we talk about cryptogenic ischemic stroke, which incidence is 20-40%. The category of pati...
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| Format: | Article |
| Language: | Russian |
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Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department
2019-11-01
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| Series: | Неотложная медицинская помощь |
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| Online Access: | https://www.jnmp.ru/jour/article/view/691 |
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| author | G. R. Ramazanov T. A. Magomedov L. T. Khamidova N. V. Rybalko S. S. Petrikov N. A. Shamalov |
| author_facet | G. R. Ramazanov T. A. Magomedov L. T. Khamidova N. V. Rybalko S. S. Petrikov N. A. Shamalov |
| author_sort | G. R. Ramazanov |
| collection | DOAJ |
| description | Ischemic stroke is a heterogeneous syndrome with a plurality of potential etiological factors. The routine diagnosis does not always allow the cause of acute cerebrovascular accident to be found, in such cases we talk about cryptogenic ischemic stroke, which incidence is 20-40%. The category of patients with cryptogenic stroke was first characterized and assigned to a separate group in the database of the National Institute of Neurological Diseases and Stroke in the USA, and later in the TOAST study. The diagnosis of cryptogenic stroke is usually based on the exclusion of well-known causes of acute cerebrovascular accidents, such as atherosclerosis, cardiac arrhythmias, arterial hypertension. Due to the considerable variability of concepts for cryptogenic stroke, the term ESUS (Embolic Stroke of Undetermined Source) appeared in 2014 and formulated criteria which accurately characterized these patients: non-lacunar cerebral infarction by CT and/or MRI, no atherosclerotic lesion stenosing a stroke-associated artery of more than 50%, no sources of high-risk cardioembolism, no other causes of stroke such as dissection of the artery supplying the area of infarction in the brain, migraine, arteritis. Among the potential causes and sources of cerebral embolism in patients with cryptogenic stroke are heart, veins of lower extremities and pelvis, nonstenosing atherosclerosis of brachiocephalic artery, atheroma of aortic arch, paradoxical embolism non-atherosclerotic vasculopathy, monogenic diseases, hypercoagulable states, and others. We should note that there is a lot of studies on the possible causes of cryptogenic stroke in the available literature, but no common approach to classification of etiologic factors and examination algorythms were developed. The high incidence of cryptogenic stroke, the significant heterogeneity of its etiopathogenetic mechanisms and the need for differentiated approaches to the secondary prevention of this type of acute cerebrovascular accident determine the relevance of further studies in this field. |
| format | Article |
| id | doaj-art-fb1d8a89b17f448f9466d54bf68d8a17 |
| institution | DOAJ |
| issn | 2223-9022 2541-8017 |
| language | Russian |
| publishDate | 2019-11-01 |
| publisher | Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department |
| record_format | Article |
| series | Неотложная медицинская помощь |
| spelling | doaj-art-fb1d8a89b17f448f9466d54bf68d8a172025-08-20T03:18:30ZrusSklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentНеотложная медицинская помощь2223-90222541-80172019-11-018330231410.23934/2223-9022-2019-8-3-302-314531Etiology of Cryptogenic StrokeG. R. Ramazanov0T. A. Magomedov1L. T. Khamidova2N. V. Rybalko3S. S. Petrikov4N. A. Shamalov5N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentFederal Center for Cerebrovascular Pathology and Stroke, the Ministry of Health of Russian FederationIschemic stroke is a heterogeneous syndrome with a plurality of potential etiological factors. The routine diagnosis does not always allow the cause of acute cerebrovascular accident to be found, in such cases we talk about cryptogenic ischemic stroke, which incidence is 20-40%. The category of patients with cryptogenic stroke was first characterized and assigned to a separate group in the database of the National Institute of Neurological Diseases and Stroke in the USA, and later in the TOAST study. The diagnosis of cryptogenic stroke is usually based on the exclusion of well-known causes of acute cerebrovascular accidents, such as atherosclerosis, cardiac arrhythmias, arterial hypertension. Due to the considerable variability of concepts for cryptogenic stroke, the term ESUS (Embolic Stroke of Undetermined Source) appeared in 2014 and formulated criteria which accurately characterized these patients: non-lacunar cerebral infarction by CT and/or MRI, no atherosclerotic lesion stenosing a stroke-associated artery of more than 50%, no sources of high-risk cardioembolism, no other causes of stroke such as dissection of the artery supplying the area of infarction in the brain, migraine, arteritis. Among the potential causes and sources of cerebral embolism in patients with cryptogenic stroke are heart, veins of lower extremities and pelvis, nonstenosing atherosclerosis of brachiocephalic artery, atheroma of aortic arch, paradoxical embolism non-atherosclerotic vasculopathy, monogenic diseases, hypercoagulable states, and others. We should note that there is a lot of studies on the possible causes of cryptogenic stroke in the available literature, but no common approach to classification of etiologic factors and examination algorythms were developed. The high incidence of cryptogenic stroke, the significant heterogeneity of its etiopathogenetic mechanisms and the need for differentiated approaches to the secondary prevention of this type of acute cerebrovascular accident determine the relevance of further studies in this field.https://www.jnmp.ru/jour/article/view/691cryptogenic strokeparadoxical embolismopen oval windowfabry diseaseaortic atheroma |
| spellingShingle | G. R. Ramazanov T. A. Magomedov L. T. Khamidova N. V. Rybalko S. S. Petrikov N. A. Shamalov Etiology of Cryptogenic Stroke Неотложная медицинская помощь cryptogenic stroke paradoxical embolism open oval window fabry disease aortic atheroma |
| title | Etiology of Cryptogenic Stroke |
| title_full | Etiology of Cryptogenic Stroke |
| title_fullStr | Etiology of Cryptogenic Stroke |
| title_full_unstemmed | Etiology of Cryptogenic Stroke |
| title_short | Etiology of Cryptogenic Stroke |
| title_sort | etiology of cryptogenic stroke |
| topic | cryptogenic stroke paradoxical embolism open oval window fabry disease aortic atheroma |
| url | https://www.jnmp.ru/jour/article/view/691 |
| work_keys_str_mv | AT grramazanov etiologyofcryptogenicstroke AT tamagomedov etiologyofcryptogenicstroke AT ltkhamidova etiologyofcryptogenicstroke AT nvrybalko etiologyofcryptogenicstroke AT sspetrikov etiologyofcryptogenicstroke AT nashamalov etiologyofcryptogenicstroke |