Stroke Caused by Undetermined Origin: Symptoms, Causes, and Prognosis
A cryptogenic stroke is a type of ischemic stroke where the cause remains unidentified despite comprehensive medical evaluation. This diagnosis is often a diagnosis of exclusion, as standard tests fail to pinpoint a source such as large artery atherosclerosis, cardioembolism, or small vessel occlusion [1][3][4][5].
Common causes and risk factors associated with cryptogenic strokes include:
- Patent Foramen Ovale (PFO): A congenital heart defect that can cause a right-to-left shunt, allowing paradoxical emboli to trigger stroke. PFO is critically associated with cryptogenic strokes, especially in younger adults. Proper evaluation involves collaboration between neurologists and cardiologists to determine if PFO closure could reduce recurrence [1][4].
- Undiagnosed cardiac arrhythmias, especially atrial fibrillation (AF), which is a major risk factor for cardioembolic stroke. AF may be intermittent and missed on initial tests, leading to cryptogenic classification until longer cardiac monitoring reveals it [2].
- Other potential but less definitive causes include thrombophilias, minor vessel disease, subclinical atherosclerosis, and embolic sources not detected by routine imaging or testing.
Risk factors for cryptogenic strokes overlap with those of general ischemic stroke, including hypertension, diabetes, smoking, hyperlipidemia, and age. However, many cryptogenic strokes occur in patients without traditional vascular risk factors, especially if PFO is involved [1][3].
Diagnosing a cryptogenic stroke is a diagnostic challenge. Healthcare professionals must not be able to detect other causes of a stroke despite using the best diagnostic tools for ischemic strokes, which include CT and MRI scans, electrocardiography, echocardiography, cardiac rhythm monitoring, and blood biomarker tests [6].
It is unclear whether risk factors for stroke are different for cryptogenic stroke specifically. However, some research suggests that Hispanic people are 46% more likely to have a cryptogenic stroke, while African Americans are twice as likely compared to the general United States population. More research is necessary to verify these findings [7].
Anticoagulants are a useful form of treatment for cryptogenic stroke, helping prevent a second stroke [8]. It is impossible to prevent a stroke with complete certainty, but avoiding modifiable risk factors can help lower the risk. A stroke is a medical emergency, and anyone with signs of stroke needs immediate medical attention.
Strokes can lead to brain damage, causing long-term neurological impairments that can greatly affect an individual's quality of life, even with treatments. Strokes labeled as cryptogenic are those with causes doctors cannot explain, making the need for continued research in this field crucial.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4213674/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139429/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348306/ [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6083974/ [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6596739/ [6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318369/ [7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283994/ [8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034418/
- Neurological evaluations may confirm a cryptogenic stroke, a type of ischemic stroke with an unidentified cause, as standard tests often fail to pinpoint a source such as large artery atherosclerosis, cardioembolism, or small vessel occlusion.
- Healthcare professionals must exhaustively test patients for potential causes, but if other causes remain undetected, the diagnosis becomes one of exclusion.
- A Patent Foramen Ovale (PFO), a congenital heart defect, is a common cause associated with cryptogenic strokes, especially in younger adults.
- PFO can cause a right-to-left shunt, allowing paradoxical emboli to trigger stroke, and proper evaluation involves cooperation between neurologists and cardiologists.
- Undiagnosed cardiac arrhythmias, particularly atrial fibrillation (AF), which is a major risk factor for cardioembolic stroke, may be missed on initial tests due to their intermittent nature.
- Other less certain causes of cryptogenic strokes include thrombophilias, minor vessel disease, subclinical atherosclerosis, and undetected embolic sources.
- Risk factors for cryptogenic strokes overlap with those of general ischemic stroke, including hypertension, diabetes, smoking, hyperlipidemia, and age.
- However, many cryptogenic strokes occur in patients without traditional vascular risk factors, especially when PFO is involved.
- Diagnosing a cryptogenic stroke is a diagnostic challenge, requiring healthcare professionals to be unable to detect other causes of a stroke despite using advanced diagnostic tools.
- Research suggests that Hispanic people are 46% more likely to have a cryptogenic stroke, while African Americans are twice as likely compared to the general United States population.
- Anticoagulants are a beneficial form of treatment for cryptogenic stroke, helping prevent a second stroke.
- It is impossible to prevent a stroke with complete certainty, but avoiding modifiable risk factors can help lower the risk.
- A stroke is a medical emergency, and anyone with signs of stroke needs immediate medical attention.
- Strokes can lead to brain damage, causing long-term neurological impairments that can affect an individual's quality of life, even with treatments.
- Strokes labeled as cryptogenic are those with causes doctors cannot explain, making the need for continued research in this field crucial.
- Neurology, cardiology, fitness and exercise, skin care, eye health, hearing, mental health, women's health, and nutrition are just a few of the many health and wellness areas that benefit from ongoing research and therapies and treatments in order to improve the understanding and treatment of various medical conditions, chronic diseases, and neurological disorders, such as stroke.
