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Embolic Stroke

In the majority of patients, emboli are thrombotic in nature and can be formed in an artery, cardiac chamber, heart valve, or vein. Less frequently, emboli may consist of nonthrombotic material, whereas in certain cases they may contain both thrombotic and nonthrombotic material, as it may occur in infected vegetations, valvular calcifications, and other pathologies.

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 What are the primary causes of embolic stroke?

Cardiogenic embolism (20% of ischemic strokes), large-artery atherosclerosis (20%), and small-vessel disease (25%) are the main causes of embolic stroke, with approximately 30% remaining cryptogenic despite thorough evaluation.

Articles of Interest

Cardioembolic stroke: everything has changed

Historically, because of the difficulty of using warfarin safely and effectively, many patients with cardioembolic stroke who should have been anticoagulated were instead given ineffective antiplatelet therapy (or no antithrombotic therapy). With the arrival of new oral anticoagulants that are not significantly more likely than aspirin to cause severe haemorrhage, everything has changed.

Embolic Stroke of Undetermined Source

That most cryptogenic ischemic strokes are embolic is not a new concept. However, there has been little progress in the secondary prevention for most patients with cryptogenic ischemic stroke in recent decades. The ESUS construct, a repackaging of nonlacunar cryptogenic stroke, was developed to identify patients with cryptogenic stroke in whom the underlying mechanism is likely thromboembolic and to facilitate the design of randomized trials.

Embolic stroke – Life with Disease

Embolic stroke occurs when a blood clot or other debris travels through the bloodstream from one part of the body and blocks a blood vessel in the brain, cutting off oxygen to brain tissue. This life-threatening medical emergency is one of the most common types of stroke and requires immediate treatment to prevent permanent brain damage or death. Understanding the outlook, potential complications, and how this condition affects daily life can help patients and families navigate recovery and adapt to new challenges.

Paradoxical Emboli as a Cause of Stroke

Cerebrovascular embolic strokes are responsible for significant morbidity. 40% of strokes have no inciting cause and are thought to be the result of paradoxical emboli (PDE) passing into the arterial system by way of intra-cardiac or pulmonary vascular defects.

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StatPearls

There are three main mechanisms that can cause an ischemic stroke; thrombosis, hypoperfusion, or embolic phenomena. Embolic strokes occur when clots migrate from the source to block more distal cerebral arteries causing cessation of brain tissue perfusion and ischemia. The embolic source can be cardiac, aortic, arterial, from a venous origin in the pelvis or lower limbs with the presence of a cardiac shunt resulting in paradoxical embolism, or an unknown source