Q; Cryptogenic stroke (CS) requires the documentation of atrial fibrillation?
Cryptogenic stroke is a diagnosis of exclusion. In fact, definition of cryptogenic stroke is an ischemic stroke without any well-defined etiology, including any cardiac source.
Various possible causes for CS has been proposed including undocumented occult paroxysmal atrial fibrillation (AF), paradoxical embolism via patent foramen ovale (PFO), atrial septal defect (ASD), ventricular septal defect (VSD, or via pulmonary arteriovenous malformation (AVM). Other causes include undefined hypercoagulable state due to antiphospholipid antibodies, occult cancer causing hypercoagulabe state and vasculopathies.
1. Saver JL. CLINICAL PRACTICE. Cryptogenic Stroke. N Engl J Med 2016; 374:2065.
2. Hart RG, Diener HC, Coutts SB, et al. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol 2014; 13:429.