Clarion call for histopathological clot analysis in "cryptogenic" ischemic stroke: implications for diagnosis and treatment

被引：20
|
作者：
Bhaskar, Sonu [1 ,2 ,3 ,4 ,5 ,6 ]
Cordato, Dennis [1 ,4 ,7 ]
Cappelen-Smith, Cecilia [1 ,4 ,7 ]
Cheung, Andrew [4 ,8 ,9 ]
Ledingham, David [1 ]
Celermajer, David [10 ]
Levi, Christopher [1 ,2 ,3 ,4 ,5 ,7 ]
机构：
[1] Liverpool Hosp, Dept Neurol & Neurophysiol, Liverpool, NSW, Australia
[2] Western Sydney Univ, Sch Med, South West Sydney Clin Sch, THRI, Sydney, NSW, Australia
[3] SPHERE, Sydney, NSW, Australia
[4] Ingham Inst Appl Med Res, Sydney, NSW, Australia
[5] John Hunter Hosp, Dept Neurol, Newcastle, NSW, Australia
[6] Univ Newcastle, Sch Med & Publ Hlth, Fac Hlth & Med, Callaghan, NSW, Australia
[7] Univ New South Wales, South Western Sydney Clin Sch, Sydney, NSW, Australia
[8] Liverpool Hosp, Dept Intervent Neuroradiol, Liverpool, NSW, Australia
[9] Prince Wales Hosp, Dept Intervent Neuroradiol, Randwick, NSW, Australia
[10] Univ Sydney, Heart Res Inst, Royal Prince Alfred Hosp, Dept Cardiol, Sydney, NSW, Australia
来源：
ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY | 2017年 / 4卷 / 12期
关键词：
INFECTIVE ENDOCARDITIS; EMBOLIC EVENTS; ASPIRIN; TRIAL; THROMBECTOMY;
D O I：
10.1002/acn3.500
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
Diagnosis, treatment, and secondary management of cryptogenic stroke patients pose a formidable challenge. The scenario is further complicated in patients with native and prosthetic valvular heart disease. We present a case study of a 36-year-old man who received intravenous thrombolysis (IV-tPA) and endovascular thrombectomy (EVT) for presumed "cryptogenic" complete middle cerebral artery infarction who made a surprisingly excellent clinical recovery despite poor baseline and postintervention neuroimaging. Retrospective gram stain of his clot confirmed a diagnosis of infective endocarditis. This raises an important issue regarding need for more routine histopathological analysis of clot retrieved after EVT in "cryptogenic" stroke patients particularly those with valvular heart disease.
引用
收藏
页码：926 / 930
页数：5
相关论文
共 50 条
  • [31] The Left Atrium Emptying Fraction Improves Diagnosis of Paroxysmal Atrial Fibrillation After Cryptogenic Ischemic Stroke
    Biering-Sorensen, Tor
    Christensen, Louisa M.
    Krieger, Derk W.
    Mogelvang, Rasmus
    Skov, Jan
    Hojberg, Soren
    Host, Nis
    Karlsen, Finn M.
    Christensen, Hanne
    CIRCULATION, 2013, 128 (22)
  • [32] Analysis of the potential mechanisms of cryptogenic stroke. A hospital-based study of the etiological subtypes of ischemic stroke
    Tsakadze, N.
    Moore, K.
    Ziegler, C.
    Remmel, K.
    EUROPEAN JOURNAL OF NEUROLOGY, 2008, 15 : 79 - 79
  • [33] Clot removal devices in acute ischemic stroke: A systematic review and meta-analysis
    Stead, L.
    Gilmore, R.
    ANNALS OF EMERGENCY MEDICINE, 2006, 48 (04) : S21 - S22
  • [34] Pathogenic role of microRNAs in atherosclerotic ischemic stroke: Implications for diagnosis and therapy
    Jiang, Qidi
    Li, Yiran
    Wu, Quanli
    Huang, Li
    Xu, Jiasheng
    Zeng, Qingfu
    GENES & DISEASES, 2022, 9 (03) : 682 - 696
  • [35] Histologically interpretable clot radiomic features predict treatment outcomes of mechanical thrombectomy for ischemic stroke
    Tatsat R. Patel
    Briana A. Santo
    Ammad A. Baig
    Muhammad Waqas
    Andre Monterio
    Elad I. Levy
    Adnan H. Siddiqui
    Vincent M. Tutino
    Neuroradiology, 2023, 65 : 737 - 749
  • [36] Medium Vessel Occlusion and Acute Ischemic Stroke A Call for Treatment Paradigm Reappraisal
    Mistry, Eva A.
    Dumont, Aaron S.
    STROKE, 2020, 51 (11) : 3200 - 3202
  • [37] Histologically interpretable clot radiomic features predict treatment outcomes of mechanical thrombectomy for ischemic stroke
    Patel, Tatsat R.
    Santo, Briana A.
    Baig, Ammad A.
    Waqas, Muhammad
    Monterio, Andre
    Levy, Elad I.
    Siddiqui, Adnan H.
    Tutino, Vincent M.
    NEURORADIOLOGY, 2023, 65 (04) : 737 - 749
  • [38] Endovascular Treatment for Acute Ischemic Stroke: Updates and Future Implications
    Gao, Jie
    Dai, Qiliang
    Liu, Xinfeng
    INTERVENTIONAL NEUROLOGY, 2015, 4 (1-2) : 43 - 47
  • [39] PHARMACOECONOMIC ANALYSIS OF NAFTIDROFURYL FOR ISCHEMIC STROKE TREATMENT
    Belousov, D.
    Cheberda, A.
    VALUE IN HEALTH, 2016, 19 (03) : A44 - A45
  • [40] Glycolic acid copolymer in diagnosis and treatment of patients with ischemic stroke
    Wu, Yongsheng
    Lin, Jingqian
    Ge, Zhonglin
    APPLIED NANOSCIENCE, 2022, 13 (5) : 3559 - 3570
12345