Open AccessESTABLISHING THE CORRECT MANAGEMENT IN A PATIENT WITH MULTIPLE CRYPTOGENIC STROKES: ANTIPLATELET VS ANTICOAGULANT THERAPY
Author(s) -
Ioan-Cristian Lupescu,
Ioana Gabriela Lupescu,
Adriana Octaviana Dulămea
Publication year - 2017
Publication title -
romanian journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 4
eISSN - 2069-6094
pISSN - 1843-8148
DOI - 10.37897/rjn.2017.3.6
Subject(s) - medicine , aspirin , clopidogrel , anticoagulant therapy , cardiology , anticoagulant , ischemic stroke , thrombophilia , stroke (engine) , atrial fibrillation , thrombosis , ischemia , mechanical engineering , engineering
Cryptogenic strokes represent a category of ischemic strokes in which there is no well-defined cause identified. For that matter, choosing between antiplatelet and anticoagulant therapy can be challenging. We present the case of a 44 year old Caucasian male with a history of multiple ischemic strokes, with thrombophilia, but no atrial fi brillation or known cardio-embolic sources, who initially received anticoagulant treatment, which was switched in 2015 with Clopidogrel. Aspirin was added in 2017 after having a TIA in the left MCA territory. Despite dual antiplatelet therapy, the patient developed ischemic stroke in the left MCA territory, for which re-initiation of anticoagulant treatment was decided. Holter ECG, transthoracic and transesophageal echocardiography were performed, but failed to identify a cause.