Yaghi Shadi, Elkind Mitchell S V
Department of Neurology, College of Physicians and Surgeons (SY, MSVE), and Department of Epidemiology, Mailman School of Public Health (MSVE), Columbia University, New York, NY.
Neurol Clin Pract. 2014 Oct;4(5):386-393. doi: 10.1212/CPJ.0000000000000086.
Cryptogenic, or unexplained, stroke is present in about 30%-40% of ischemic stroke patients. Pursuing a stroke mechanism is important in such patients to better choose therapy to reduce the stroke recurrence risk. Intracranial vessel imaging and cardiac evaluation with transesophageal echocardiogram and outpatient cardiac monitoring may help identify the stroke mechanism. This article highlights the diagnostic yield of various tests in identifying a stroke mechanism in stroke patients whose initial diagnostic evaluation is negative, and the implications for treatment.
隐源性卒中,即不明原因的卒中,约占缺血性卒中患者的30%-40%。对于此类患者,探寻卒中机制对于更好地选择治疗方法以降低卒中复发风险至关重要。颅内血管成像以及经食管超声心动图和门诊心脏监测等心脏评估可能有助于确定卒中机制。本文重点介绍了在初始诊断评估为阴性的卒中患者中,各种检查在确定卒中机制方面的诊断价值以及对治疗的影响。