Medicus, Vol. 33 No. 1 Tromboembolije, 2024.
Review article
Cardioembolic Stroke
Zdravka Poljaković
Abstract
Stroke is one of the most frequent neurological diseases, but also one of the most frequent non-communicable diseases generally speaking. Every year about 26 million people suffer from stroke, and epidemiological data tell us that strokes still hold second place in mortality worldwide. Furthermore, stroke-related disability is the leading of all disabilities in the world and in Croatia as well. According to the valid definition of stroke by the World Health Organization, it develops after a sudden break of cerebral circulation which leads to focal neurological deficit lasting for at least 24 hours. Considering etiology, cardioembolic stroke is responsible for at least 25-30% of all strokes, depending on age (more cardioembolic strokes develop with older age) and the level of diagnostic work-up. Furthermore, it seems that the incidence of cardioembolic stroke in the next decades is going to rise. Anticoagulation is essential in secondary prevention of cardioembolic strokes and although there is no doubt for the need of this therapy after cardioembolic stroke, the timing of introducing it after a stroke is still a matter of discussion. Another problem is also a balance between the benefit of therapy in stroke prevention and the hemorrhagic risk due to therapy, in spite of the fact that direct oral anticoagulant drugs generally changed the philosophy of anticoagulant therapy. In the end, functional outcome for the patients after cardioembolic stroke will depend on the possibility of recanalization therapy, and secondary prevention on efficacy of anticoagulation therapy and comorbidity.
Keywords
stroke; cardioembolic stroke; atrial fibrillation; anticoagulation
Hrčak ID:
321774
URI
Publication date:
24.10.2024.
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