Is It Possible to Identify Cardioembolic Origin from Clinical Presentation in Patients Suffering Stroke?
It is not possible to identify a cardioembolic origin according to the initial clinical presentation. Neither abrupt onset of the neurologic deficit, nor the location of the infarct are helpful in determining the origin of the stroke. Abrupt onset of a maximal neurologic deficit occurs in a significant number of patients with ischemic stroke due to other causes, such as carotid origin. Regarding the location of the infarct, it is also not possible to identify cardioembolic origin. Even though cardiogenic emboli most commonly lodge in the midcerebral artery or its branches, emboli to the vertebrobasilar or anterior cerebral artery can also, albeit rarely, occur. The size of the stroke is not helpful. Artery-to-artery emboli from proximal sources such as the carotid arteries may have similar presentation as those of cardioembolic origin. Eventually, hemorrhagic transformation is not specific for cardioembolic stroke, even though large areas of hemorrhagic transformation are more common w
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