The Medical City Institute of Neurological Sciences
4/F Podium Bldg., The Medical City, Ortigas Ave. Pasig City

Operating Hours: Open daily from 8:00AM to 5:00PM except Sundays and Holidays (All procedures are by appointment only)

Contact Numbers
(632) 8-988-1000/(632) 8-988-7000 loc. 6270

PATIENT SERVICES

Cryptogenic Stroke Treatment in the Philippines

What is Cryptogenic Stroke?

A cryptogenic stroke is a type of stroke where the exact cause remains unclear, even after extensive testing. The term "cryptogenic" means "of unknown origin," indicating that despite efforts to identify the underlying reason, doctors cannot pinpoint a definite cause. These strokes fall under the broader category of ischemic strokes, which are caused by a blockage in blood flow to the brain, resulting in damage to brain cells.

What Factors Cause Cryptogenic Stroke?

While the cause of cryptogenic stroke is not definitively known, several potential factors may contribute to these unexplained strokes. These include:

• Undetected Atrial Fibrillation: Atrial fibrillation (AFib) is a common risk factor for ischemic stroke because it can cause blood clots to form in the heart, which may then travel to the brain. In cryptogenic strokes, AFib may be present but go undetected because it occurs intermittently. Prolonged monitoring of heart rhythm is sometimes necessary to identify these episodes of AFib.


• Patent Foramen Ovale (PFO): A PFO is a small hole between the upper chambers of the heart (the atria) that typically closes after birth. However, in some individuals, the hole remains open, allowing blood clots to bypass the lungs and travel directly to the brain, causing a stroke. This condition is found more frequently in people with cryptogenic strokes.


• Blood Clotting Disorders: Some cryptogenic strokes may be related to undiagnosed blood clotting disorders, where the blood tends to form clots more easily. Conditions like antiphospholipid syndrome or genetic mutations affecting clotting may go unnoticed unless specifically tested for.


• Atherosclerosis in Small Vessels: Although larger arteries are often checked during stroke evaluations, small vessel disease, or blockages in the smaller arteries of the brain, can sometimes be missed. This can lead to strokes without a clearly identified cause.


• Paroxysmal Emboli: Paroxysmal emboli are blood clots that form and dissolve intermittently, making them difficult to detect. These emboli can travel through the bloodstream and block a blood vessel in the brain, causing a stroke.

What are the Symptoms of Cryptogenic Stroke?

Cryptogenic stroke symptoms are the same as those of other types of ischemic strokes. The onset is typically sudden, and the symptoms may vary depending on which part of the brain is affected, including the following:

• Sudden weakness or numbness: This usually occurs on one side of the body, affecting the face, arm, or leg.


• Difficulty speaking or understanding speech: A person having a stroke may suddenly struggle to find words, speak clearly, or comprehend others.


• Vision problems: Blurred vision or the loss of vision in one or both eyes can be a sign of a stroke.


• Dizziness or loss of balance: People experiencing a stroke may feel lightheaded, have trouble walking, or lose coordination.


• Severe headache: A sudden, intense headache with no known cause can be a symptom, especially if it is accompanied by other stroke indicators.


• Confusion or disorientation: Cryptogenic strokes can cause sudden confusion, memory loss, or an inability to follow directions.

How is Cryptogenic Stroke Treated?

The treatment for cryptogenic stroke is similar to that of other types of strokes, but it often includes additional strategies to prevent future strokes, given the uncertainty of the cause. Key components of treatment and prevention include:

• Thrombolytic therapy: If caught early, a medication called tissue plasminogen activator (tPA) may be given to dissolve the clot and restore blood flow to the brain. This treatment must be administered within a few hours of symptom onset.


• Mechanical thrombectomy: In cases where tPA is not an option or is ineffective, a mechanical thrombectomy may be performed. This procedure involves removing the clot from the blood vessel using a catheter.


• Heart Monitoring: Since intermittent AFib can be a hidden cause of cryptogenic strokes, long-term monitoring of the heart rhythm is often recommended.


• Closure of a Patent Foramen Ovale (PFO): If a PFO is found, doctors may recommend a procedure to close the hole. This can be done using a minimally invasive procedure where a device is inserted via a catheter to seal the opening between the heart's atria.


• Blood Thinners: To reduce the risk of future strokes, blood-thinning medications like aspirin, clopidogrel, or anticoagulants such as warfarin or newer drugs like apixaban may be prescribed.


• Rehabilitation: After the acute treatment phase, many stroke survivors require rehabilitation, which may include physical therapy, occupational therapy, and speech therapy to regain lost skills and improve their quality of life.