MedWatch: Cryptogenic Stroke

Stroke can cause lifelong problems for patients who survive.

From weakness to blindness, coordination or orientation, the effects can be debilitating.

But now there’s a new way to help doctors find the cause of certain strokes, and hopefully prevent another one from happening.

Michelle Dunaway shows us how in this month’s MedWatch report.

"A stroke is a circumstance where part of the brain does not get an adequate oxygen supply," says Kersti Bruining, M.D.

Stroke is not an uncommon term or an uncommon occurrence, but doctors can’t always pinpoint the cause to the brain.

"A cryptogenic stroke is a stoke that occurs and we don’t have a reason or something that is of high suspicion that led to the stroke," explains Colleen Sabatine, N.P., electrophysiology advance practice provider.

While catching a stroke early and treating the patient is the first priority, learning what may have caused it is also high on the list.

"If the neurology team does not find another reason for a stroke it can be termed a cryptogenic stroke. At that point, the cardiology services that work within the hospital are contacted and they can arrange for an implantable cardiac monitor to be placed in the patient for monitoring atrial fibrillation to be a possible link to their stroke," says Sabatine.

Atrial fibrillation is basically an abnormal heart rhythm.

"When a person is in the hospital after a stroke for two, or three, or four days, we don’t always find that abnormal heart rhythm, but we now know from some really good research that if we track someone’s heartbeat long enough for several months we often can pick that up and, if we can pick that up, then there’s treatment for that to hopefully prevent another stroke from happening," explains Dr. Bruining.

The implantation is simple, takes just ten minutes and most people don’t even notice it’s there.

Then the patient goes home to recover.

"The device is monitored on a monthly basis. It automatically sends reports to the device clinic which is then analyzed. They are also heart stop alarms, so if there are significant findings that are notified right then the same day," says Sabatine.

If the monitor detects atrial fibrillation in the patient, there’s a very good chance it caused the stroke.

"We know AFib creates an environment inside the heart that makes it likely to form a clot, and if that clot forms within the heart, an easy place for the clot to go is from the heart to the brain," explains Sabatine.

Since Munson Medical Center started using this new technology they say 25 to 30 percent of cryptogenic strokes turn out to be caused by AFib.

Doctors turn to blood thinners to greatly reduce the chances of those patients having another stroke.

"Thirty percent of these people we previously couldn’t offer anything specific for now have a direct treatment or a direct potential treatment if they have an abnormal heart rhythm. So it’s really very exciting, and I think it offers a great amount of hope for people to prevent a second stroke from happening," says Dr. Bruining.

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