Causes, Treatment of Cryptogenic Stroke Still Uncertain, Survey Finds

Nearly 60% of health care professionals felt uncertain that their treatment would prevent another stroke.

Preventing a second stroke is very important, as it is 16 times more likely to be fatal. However, when a health care provider is unable to identify the cause of the first stroke, preventing a second becomes increasingly difficult.

According to a survey conducted by the American Heart Association/American Stroke Association, 51 to 70% of physicians, depending on their specialty, felt uncertain about the best approaches to identifying the underlying causes of cryptogenic stroke. Only about 50% of health care professionals felt they were adequately prepared to treat patients with the condition, whose etiology remains unknown even after extensive testing.

“The ability to discern the causes of cryptogenic strokes has profound implications for preventing secondary strokes and improving patient outcomes,” said Mary Ann Bauman, MD, chair of the American Stroke Association Advisory Committee, in a news release.

The survey polled 652 health care professionals total, including 250 neurologists, 250 cardiologists, 50 hospitalists, 51 primary care physicians, and 51 stroke coordinators. The survey sought to identify the professionals’ degree of knowledge of cryptogenic stroke, including possible underlying causes, diagnosis, and treatment.

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Only 16% of neurologists said they were extremely confident when diagnosing cryptogenic stroke, and nearly six in 10 neurologists and cardiologists said they only felt somewhat or not confident that their selected treatment will prevent another stroke. Among potential causes, atrial fibrillation is at the top of the list, with nine in 10 health care professionals deeming it important to look for, however many said they struggle to detect atrial fibrillation. Other common causes of cryptogenic stroke include patent foramen ovale, and various blood clotting disorders.

“We know that collaboration between those who serve cryptogenic stroke patients which is likely to require educating healthcare providers and the scientific community about cryptogenic stroke, appropriate work up, applicable studies and outcomes,” Dr. Bauman said. “This is important, because stroke is the fifth leading cause of death in the U.S. and a leading cause of severe, long-term disability.”


  1. American Stroke Association News Release