Determining the cause of an acute ischemic stroke is critical to the treatment of the patient, especially to prevent further strokes. Embolic strokes of undetermined cause (ESUS), ie, nonlacunar cryptogenic strokes, account for 9% to 25% of ischemic strokes, and the average recurrence rate of 4.5% per year is relatively high despite preventive treatment with antithrombotic agents.
Recent studies have shown that new clinical strategies and imaging techniques can improve the detection of the etiology of ESUS. Prolonged cardiac monitoring and contrast-enhanced cardiac magnetic resonance imaging (CE -CMR) may help to better detect cardioembolic stroke in ESUS patients. Recent studies have shown that certain morphological features of plaques on ultrasound, CTA, or high-resolution MRI vessel wall imaging (HR -VWI) are significantly more common in ESUS patients ipsilateral to the stroke side. However, in ESUS patients it is still unclear which diagnostic measures are actually "correct".
Occult atrial fibrillation (AF) is one of the most common causes of stroke of unclear etiology. It has been hypothesized that oral anticoagulation may reduce the risk of recurrent stroke in ESUS, which has been tested in two large randomized controlled trials: NAVIGATE ESUS and RE - SPECT ESUS. In ESUS patients without atherosclerotic lesions, the hypothesis that oral anticoagulation might reduce the risk of stroke recurrence seems rational. However, in ESUS patients with atherosclerosis, further studies are needed to prove the combined use of low-dose anticoagulation with antiplatelet agents.
Our aim is to investigate the advanced imaging and treatment strategy in ESUS patients to better classify the etiology of stroke and obtain a good prognosis for these patients.
This Research Topic aims to collect Original Research, Reviews, and Brief Reports on new imaging techniques and new treatment strategies in ESUS. The following topics are welcome and authors are encouraged to employ imaging techniques when discussing ESUS:
- New imaging techniques to characterize plaques in the aortic arch, carotid artery, and intracranial atherosclerotic plaques
- Advanced clinical and imaging techniques for detecting occult atrial fibrillation;
- Combining vascular imaging and clinical information to refine stroke risk stratification in patients with ESUS;
- Examining neuroimaging data using Artificial Intelligence and Machine Learning in ESUS patients;
- Reviews or Meta-analysis summarizing the clinical and imaging characteristics of ESUS patients;
- Novel antithrombotic strategies in ESUS;
- Pharmacological treatment of ESUS;
- Cross-sectional and longitudinal studies of vulnerable atherosclerotic plaques in ESUS;
- Patent foramen ovale as a stroke etiology;
- Hypercoagulability in cryptogenic stroke
Determining the cause of an acute ischemic stroke is critical to the treatment of the patient, especially to prevent further strokes. Embolic strokes of undetermined cause (ESUS), ie, nonlacunar cryptogenic strokes, account for 9% to 25% of ischemic strokes, and the average recurrence rate of 4.5% per year is relatively high despite preventive treatment with antithrombotic agents.
Recent studies have shown that new clinical strategies and imaging techniques can improve the detection of the etiology of ESUS. Prolonged cardiac monitoring and contrast-enhanced cardiac magnetic resonance imaging (CE -CMR) may help to better detect cardioembolic stroke in ESUS patients. Recent studies have shown that certain morphological features of plaques on ultrasound, CTA, or high-resolution MRI vessel wall imaging (HR -VWI) are significantly more common in ESUS patients ipsilateral to the stroke side. However, in ESUS patients it is still unclear which diagnostic measures are actually "correct".
Occult atrial fibrillation (AF) is one of the most common causes of stroke of unclear etiology. It has been hypothesized that oral anticoagulation may reduce the risk of recurrent stroke in ESUS, which has been tested in two large randomized controlled trials: NAVIGATE ESUS and RE - SPECT ESUS. In ESUS patients without atherosclerotic lesions, the hypothesis that oral anticoagulation might reduce the risk of stroke recurrence seems rational. However, in ESUS patients with atherosclerosis, further studies are needed to prove the combined use of low-dose anticoagulation with antiplatelet agents.
Our aim is to investigate the advanced imaging and treatment strategy in ESUS patients to better classify the etiology of stroke and obtain a good prognosis for these patients.
This Research Topic aims to collect Original Research, Reviews, and Brief Reports on new imaging techniques and new treatment strategies in ESUS. The following topics are welcome and authors are encouraged to employ imaging techniques when discussing ESUS:
- New imaging techniques to characterize plaques in the aortic arch, carotid artery, and intracranial atherosclerotic plaques
- Advanced clinical and imaging techniques for detecting occult atrial fibrillation;
- Combining vascular imaging and clinical information to refine stroke risk stratification in patients with ESUS;
- Examining neuroimaging data using Artificial Intelligence and Machine Learning in ESUS patients;
- Reviews or Meta-analysis summarizing the clinical and imaging characteristics of ESUS patients;
- Novel antithrombotic strategies in ESUS;
- Pharmacological treatment of ESUS;
- Cross-sectional and longitudinal studies of vulnerable atherosclerotic plaques in ESUS;
- Patent foramen ovale as a stroke etiology;
- Hypercoagulability in cryptogenic stroke
