Embolic stroke of undetermined source (ESUS): management
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Embolic stroke of undetermined source (ESUS): management. Brain imaging: CT or MRI, Transcranial Doppler ultrasound. Fully referenced neurology checklist.
Neurological investigations
- Brain imaging: CT or MRI
- Catheter, MR or CT angiography: intracranial and extracranial
- Transcranial Doppler ultrasound
Echocardiogram
Locked: subscribe to see this section.
Cardiovascular MRI
Locked: subscribe to see this section.
Troponin
Locked: subscribe to see this section.
Other cardiac investigations
Locked: subscribe to see this section.
Treatment: Aspirin
Locked: subscribe to see this section.
Treatment: new oral anticoagulants (NOACs)
Locked: subscribe to see this section.
References
- Hart RG, Diener HC, Coutts SB, et al; Cryptogenic Stroke/ESUS International Working Group. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol 2014; 13:429-438.
- de Bruijn SF, Agema WR, Lammers GJ, et al. Transesophageal echocardiography is superior to transthoracic echocardiography in management of patients of any age with transient ischemic attack or stroke. Stroke 2006; 37:2531-2534.
- Walpot J, Pasteuning WH, Hoevenaar M, et al. Transesophageal echocardiography in patients with cryptogenic stroke: does it alter their management? A 3-year retrospective study in a single non-referral centre. Acta Clin Belg 2006; 61:243-248.
- Blum A, Reisner S, Farbstein Y. Transesophageal echocardiography (TEE) vs. transthoracic echocardiography (TTE) in assessing cardio-vascular sources of emboli in patients with acute ischemic stroke. Med Sci Monit 2004; 10:CR521-CR523.
- Katsanos AH, Bhole R, Frogoudaki A, et al. The value of transesophageal echocardiography for embolic strokes of undetermined source. Neurology 2016; 87:988-995.
- And 11 more. Subscribe to see the full list
