Cerebral emboli in cryptogenic ischemia: a reason to enforce diagnostic testing.
BACKGROUND
Stroke of unknown origin is a diagnostic and therapeutic challenge. A subgroup-analysis was performed to evaluate microembolus detection in these cryptogenic strokes.


RESULTS
In this study, 78 patients with acute cerebral ischemia in the anterior circulation were monitored for microembolic signals (MES) by the use of transcranial doppler at admittance and 2 times at 24-hour intervals. All patients underwent routine stroke work-up. Twenty patients presented with cryptogenic ischemia. Of these 20 patients, 30% (6/20) showed MES during examination 1, 20% (4/20) in examination 2, and 20% (4/20) in examination 3.


CONCLUSIONS
MES could be detected in 45% of patients with cryptogenic ischemia. Thus, the underlying pathology may be in part embolic. The detection of MES in cryptogenic ischemia should therefore be an argument for extensive retesting to maybe identify a potential embolic source.
Niesen
W D
WD
Department of Neurology, Friedrich-Schiller University Jena, Jena, Germany.
Sliwka
U
U
Lingnau
A
A
Noth
J
J