This does not give me a warm fuzzy feeling at all. I'm sure your doctor has long ago given up on trying to explain your cryptogenic stroke.
http://www.news-medical.net/news/20150804/Cryptogenic-stroke-frequent-and-recurrent.aspx
Cryptogenic ischaemic strokes and transient ischaemic attacks
frequently recur, despite having no identifiable cause, show findings
from the Oxford Vascular Study (OXVASC).
“[I]n view of the high
rate of recurrent cryptogenic stroke, randomised trials of available
preventive treatments, such as the ongoing trials of new anticoagulants,
are justified despite uncertainty about cause”, write the researchers
in The Lancet Neurology.
Patients in the first-phase of
OXVASC, from 2002 to 2010, were classified as having cryptogenic stroke
only if they had no identifiable cause after undergoing at least brain
imaging, electrocardiography and extracranial imaging, and those in the
later phase also had to undergo intracranial vascular imaging, R test
and echocardiography.
Yet
of the total 2555 patients with first ischaemic events, 812 (32%) were
classed as having cryptogenic stroke, report Peter Rothwell (John
Radcliffe Hospital, Oxford, UK) and co-researchers.
In an
accompanying commentary, Jose Ferro (University of Lisbon, Portugal)
says the study highlights the importance of a comprehensive work-up,
noting that the work-up used in OXVASC is not even routine in all of the
UK and Europe, and in developing countries is “a distant mirage”.
He
stresses that neurologists should “not be surprised to find no cause in
a third of ischaemic strokes” but should “not label a patient as having
a cryptogenic stroke before completion of a comprehensive investigation
of possible causes”.
Patients were as likely to die of
cryptogenic stroke as noncardioembolic stroke, with 1-year mortality
rates of 6.0% for a cryptogenic cause, 0.9% for small-vessel disease and
14.7% for large-vessel disease. They also had similar rates of
disability at 6 months.
The cryptogenic stroke group had the
lowest rate of most cardioembolic and atherosclerotic risk factors, and
had fewer risk factors overall than the 668 patients with cardioembolic
stroke and the 597 with noncardioembolic stroke.
Nevertheless,
they were just as likely to have a recurrent ischaemic stroke, with
5-year rates of 23.3% compared with 20.0% to 25.3% for the other groups.
Of
note, 80% of cryptogenic stroke patients in the second phase of OXVASC
underwent ambulatory home cardiac monitoring, but only 6% had paroxysmal
atrial fibrillation lasting longer than 30 seconds.
Ferro says
that this “contrasts with the present enthusiasm for the use of
technology to detect paroxysmal atrial fibrillation and for the
possibility to prevent recurrent cryptogenic stroke with
anticoagulants.”
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