Vinogradov O I, Jablonskij M A, Kuznecov A N
Pirogov National Medical and Surgical Center, Moscow, Russia.
City polyclinic No. 4 of the Balashikha Regional Hospital, Balashikha, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(12. Vyp. 2):42-48. doi: 10.17116/jnevro202012012242.
About 20-40% of ischemic stroke survivors cannot be attributed to a particular pathogenetic subtype despite a thorough diagnostic evaluation (cryptogenic stroke). Most cryptogenic strokes are likely embolic. This understanding is captured by a related concept, termed embolic stroke of undetermined source (ESUS), which is defined as a nonlacunar brain infarct without proximal arterial stenosis or cardioembolic sources. These patients are generally younger, has less disabilities and more favourable prognosis. It is assumed that in this group of patients, anticoagulants may have an advantage over antiplatelet drugs as a means of secondary prevention. Specific methods of treatment and secondary prevention of ESUS has not yet been developed.
尽管进行了全面的诊断评估，但约20%-40%的缺血性中风幸存者无法归因于特定的致病亚型（隐源性中风）。大多数隐源性中风可能是栓塞性的。一个相关概念“不明来源栓塞性中风（ESUS）”体现了这一认识，它被定义为非腔隙性脑梗死，且无近端动脉狭窄或心源性栓塞源。这些患者通常较年轻，残疾较少，预后较好。据推测，在这组患者中，作为二级预防手段，抗凝剂可能比抗血小板药物更具优势。ESUS的具体治疗方法和二级预防措施尚未制定出来。
