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If the patient is 'low risk' using the CHA 2 DS 2-VASc score (that is, 0 in males or 1 in females), no anticoagulant therapy is recommended. In males with 1 stroke risk factor (that is, a CHA 2 DS 2-VASc score=1), antithrombotic therapy with OAC may be considered, and people's values and preferences should be considered. [24]
Subclinical atrial fibrillation: Detectable in ~2.7-30% of ESUS patients, depending on duration and modality of ECG monitoring. Patent foramen ovale (PFO): Deep vein thrombosis may result in paradoxical embolism in patients with PFO. About 40% of patients with cryptogenic stroke have PFO compared with 25% of the general population.
Fatty infiltration helps explain why obesity is a risk factor for atrial fibrillation in one fifth of patients. [62] Atrial fibrillation increases the risk of heart failure by 11 per 1000, kidney problems by 6 per 1000, death by 4 per 1000, stroke by 3 per 1000, and coronary heart disease by 1 per 1000. [161]
An ischemic stroke's main cause is atherosclerosis. [2] Stroke is commonly caused by atherosclerotic large vessel disease and results from local branch occlusion by plaque, artery-to-artery embolism, or in situ thrombosis , with the latter being the most common cause of anterior cerebral artery infarction. [ 4 ]
Those with atrial fibrillation have a 5% a year risk of stroke, and those with valvular atrial fibrillation have an even higher risk. [130] Depending on the stroke risk, anticoagulation with medications such as warfarin or aspirin is useful for prevention with various levels of comparative effectiveness depending on the type of treatment used ...
Atrial fibrillation causes blood clots to form within the heart, which may travel to the arteries within the brain and cause an embolism. The embolism prevents blood flow to the brain, which leads to a stroke. [26] An aneurysm is an abnormal bulging of small sections of arteries, which increases the risk of artery rupture.
A migrainous infarction is a rare type of ischaemic stroke which occurs in correspondence with migraine aura symptoms. [1] Symptoms include headaches, visual disturbances, strange sensations and dysphasia, all of which gradually worsen causing neurological changes which ultimately increase the risk of an ischaemic stroke. [2]
Brain ischemia has been linked to a variety of diseases or abnormalities. Individuals with sickle cell anemia, compressed blood vessels, ventricular tachycardia, plaque buildup in the arteries, blood clots, extremely low blood pressure as a result of heart attack, and congenital heart defects have a higher predisposition to brain ischemia in comparison to the average population.
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