Strokes with an unclear cause are often triggered by embolisms – a healing practice

Stroke: The exact cause often remains unclear

According to specialists, about one in four remains ischemic stroke to die it causes in the darkness. Years ago, scientific studies showed that in many of these cases, Embolism as an underlying cause. Experts are now reporting the new findings.

More than a quarter of a million people in Germany suffer a stroke every year. Much of these diseases can be traced back to diseases of the cardiovascular system. But in about every fifth blow, the cause remains in obscurity. The journal “Nature Reviews Neurology” now reports, among other things, new possible therapeutic suggestions for some patients.

The cause of every fifth stroke is unclear

According to a recent report from the Faculty of Medicine of the University of Duisburg-Essen (UDE), the exact cause of around 20 percent of all strokes is unclear.

What initially like “cryptogenic stroke‘was defined in 2014 by an international working group as a so-called’ embolic stroke of unspecified origin ‘(ESUS).

According to the information, the concept of ESUS is based on the observation that most cryptogenic strokes cause one embolic origin to have. The possible sources of these embolisms are different.

Some patients have two or more potentials causes of stroke at the same time, in others it is not possible to find a clear cause despite intensive diagnostics.

Look at the most differentiated affected ones

The advances in stroke research do so according to Prof. Dr. Hans Christoph Diener, Emeritus Professor of Neurology at the EDU Faculty of Medicine, it is now possible to take a more differentiated look at the large group of ESUS patients.

The expert proposes in the journal “Nature Reviews Neurology” together with his American and Greek colleagues adjustment of the current ESUS concept.

For example, the authors argue that patients with a patent foramen ovale (PFO) or other clinical and / or anatomical symptoms high-risk characteristics and under the age of 60 should no longer be considered cases of ESUS.

Furthermore, the international team of neurologists suggests that some patients with ESUS should have a ECG monitoring performed to rule out previously unrecognized paroxysmal atrial fibrillation.

Some people may benefit from therapy

As stated in the communication, ongoing studies aim to help clarify whether patients with atrial heart diseaseover 75 years of age and / or with renal insufficiency and ESUS benefit from oral anticoagulation.

Doctors suspect that the ESUS subgroups affected the cohort of an oral anticoagulant therapy using NOACs such as dabigatran, apixaban, or rivaroxaban instead of aspirin to prevent recurrence of ischemic stroke.

This Results however, for subgroups, they must be confirmed before they can be used clinically.

“The results of these ongoing studies could change the concept of ESUS by clearly defining new subgroups for which treatment concepts are adapted.”explains Prof. Dr. Hans Christoph Diener.

According to the expert, such subgroups could include patients “Be with atrial heart disease, supracardiac atherosclerosis or high-rate atrial episodes.” (A.D)

Information on the author and source

This text corresponds to the specifications of the specialist medical literature, medical guidelines and current studies and has been verified by medical professionals.


  • Faculty of Medicine of the University of Duisburg-Essen: Race from nowhere – research and treatment concept of embolic stroke of indeterminate origin (ESUS) on the test bench, (accessed 11 June 2022), Faculty of Medicine of the University of Duisburg- Essen
  • Hans-Christoph Diener, J. Donald Easton, Robert G. Hart, Scott Kasner, Hooman Kamel and George Ntaios: Review and update of the concept of embolic stroke of indeterminate origin; in: Nature Reviews Neurology, (veröffentlicht: 10.05.2022), Nature Reviews Neurology

Important note:
This article contains general advice only and is not to be used for self-diagnosis or treatment. It cannot replace a visit to the doctor.

About the author


Leave a Comment