Stroke with an unclear cause often triggered by embolism

Stroke: The exact cause often remains unclear

According to experts, almost one in four remains ischemic the strokes cause in the darkness. Years ago, scientific studies had shown that in many of these cases, heartburn as the root cause. Experts are now reporting on the new findings.

In Germany, more than a quarter of a million people suffer a stroke every year. A large proportion of these diseases can be traced to diseases of the cardiovascular system. But in almost every fifth tremor, the cause remains in the dark. in the magazine”Nature Reviews NeurologyAmong other things, new potential treatments are now being suggested for some of those affected.

Cause of every fifth stroke unclear

as of present message According to the Faculty of Medicine of the University of Duisburg-Essen (UDE), the exact cause of about 20 percent of all strokes is unclear.

what in the beginning”cryptogenic stroke‘ was defined in 2014 by an international working group as the so-called ’embolic stroke of undetermined origin’ (ESUS).

According to information, the concept of ESUS is based on the observation that most cryptogenic strokes cause a embolic origin to keep. The possible sources of these embolisms are varied.

Some patients have two or more potential due to stroke Also, in others no clear cause can be found despite a thorough diagnosis.

See affected people more differentiated

in advance stroke research Pro. Do this according to Dr. It is now possible to take a more differentiated look at a larger group of ESUS patients, says Hans Christoph Diener, Professor Emeritus of Neurology in UDE’s Medical Faculty.

The expert, together with US and Greek colleagues, proposes in the journal “Nature Review Neurology” Adjustment of the current ESUS concept.

For example, the authors advocate that patients with patent foramen ovale (PFO) or other clinical and/or anatomical high risk symptoms And people under the age of 60 should no longer be treated as ESUS cases.

In addition, the international team of neurologists suggests that some patients with ESUS may have A. should be ECG monitoring performed to exclude previously unrecognized paroxysmal atrial fibrillation.

Some people may benefit from therapy

As stated in the communication, the purpose of the ongoing studies is to help clarify whether patients with atrial cardiopathiesThose over 75 years of age and/or with renal impairment and ESUS benefit from oral anticoagulants.

Doctors suspect that subgroups of ESUS affected the group of oral anticoagulant therapy Using NOACs such as dabigatran, apixaban or rivaroxaban instead of aspirin to prevent recurrence of ischemic stroke.

This Result However, for subgroups, they must be confirmed before they can be used clinically.

“The results of these ongoing studies may change the concept of ESUS by clearly defining new subgroups for which treatment concepts are adapted.”, explains Prof. Dr. Hans Christoph Diener.

According to the specialist, patients in such subgroups can include “Live with atrial cardiopathy, supracardiac atherosclerosis, or high-frequency episodes of atrial fibrillation.” (advertisement)