Open AccessClarion call for histopathological clot analysis in “cryptogenic” ischemic stroke: implications for diagnosis and treatment
Author(s) -
Bhaskar Sonu,
Cordato Dennis,
CappelenSmith Cecilia,
Cheung Andrew,
Ledingham David,
Celermajer David,
Levi Christopher
Publication year - 2017
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.500
Subject(s) - medicine , clarion , stroke (engine) , ischemic stroke , pathology , cardiology , intensive care medicine , ischemia , artificial intelligence , engineering , mechanical engineering , computer science
Diagnosis, treatment, and secondary management of cryptogenic stroke patients pose a formidable challenge. The scenario is further complicated in patients with native and prosthetic valvular heart disease. We present a case study of a 36‐year‐old man who received intravenous thrombolysis ( IV ‐ tPA ) and endovascular thrombectomy ( EVT ) for presumed “cryptogenic” complete middle cerebral artery infarction who made a surprisingly excellent clinical recovery despite poor baseline and postintervention neuroimaging. Retrospective gram stain of his clot confirmed a diagnosis of infective endocarditis. This raises an important issue regarding need for more routine histopathological analysis of clot retrieved after EVT in “cryptogenic” stroke patients particularly those with valvular heart disease.