DOI: 10.12890/2020_001928
Cryptogenic Stroke and Valvular Strands
Authors
cati.castanheira@gmail.com
Keywords
Thrombosis, inferior vena cava syndrome, lumbar pain, nephroblastomaAbstract
Background: Ischaemic stroke can be classified according to its aetiology. In cryptogenic stroke, Lambl’s excrescences should be considered since they can only be detected through transesophageal echocardiography (TEE), which is not routinely performed.
Case description: The authors report the case of a 63-year-old Caucasian man with two ischaemic cerebral events associated with the presence of Lambl’s excrescences in the aortic valve detected with TEE. Switching antiaggregant therapy to anticoagulant therapy allowed the patient to remain asymptomatic throughout a 3-year follow-up.
Conclusion: The lack of protocols for the management of cryptogenic stroke results in a delay in the identification of less frequent causes of stroke, leading to recurrent vascular events, morbidity and loss of functionality. The authors describe a patient who experienced multiple cerebral ischaemic events until the correct diagnosis was made.
References
- Aziz F, Baciewicz FA. Lambl’s excrescences: review and recommendations. Tex Heart Inst J 2007;34:366–368.
- Homma S, Tullio M, Sciacca R, Sacco R, Mohr J, for the PICSS Investigators. Effect of aspirin and warfarin therapy in stroke patients with valvular strands. Stroke 2004;35:1436–1442.
- Wu TY, Gerber IL, Roxburgh RH. Thrombo-embolic cerebral infarction secondary to giant Lambl's excrescence. J Clin Neurosci 2013;20:1632–4.
- Rhee H, Choi H, Kim S, Shin W, Kim S. Acute ischemic stroke in a patient with a native valvular strand. Case Rep Neurol 2010;2:91–95.
- Roldan C, Schevchuck O, Tolstrup K, Roldan P, Macias P, Qualls C, et al. Lambl’s excrescences: association with cerebrovascular disease and pathogenesis. Cerebrovasc Dis 2015;40(0):18–27.
