ReviewNature reviews. Neurology2022
Review and update of the concept of embolic stroke of undetermined source.
Review in Nature reviews. Neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 5 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- Serum biomarkers insights into occult atrial fibrillation related to embolic strokes of undetermined source: a narrative review.BMC neurology · 2026Pooled it
- Risks of stroke and myocardial infarction after retinal artery occlusion and their time dependence: a systematic review and meta-analysis.Journal of neurology · 2025Pooled it
- Anticoagulants or antiplatelets for secondary prevention of cryptogenic stroke: an updated systematic review and meta-analysis.Heart (British Cardiac Society) · 2025Pooled it
- Risk Stratification Tools to Guide a Personalized Approach for Cardiac Monitoring in Embolic Stroke of Undetermined Source.Journal of the American Heart Association · 2023Pooled it
- Unraveling Mechanisms of Cryptogenic Stroke at the Genetic Level: A Systematic Literature Review.Journal of the American Heart Association · 2023Pooled it
- Combined therapy with contralateral controlled functional electrical stimulation and transcranial direct current stimulation for early post-stroke hand dysfunction.Biomedical engineering online · 2025Trial
- Anticoagulation Treatment Response Among Phenotypic ESUS Clusters: Evidence From CASPR.Annals of clinical and translational neurology · 2026Article
- Timing of insertable cardiac monitor implantation after embolic stroke of undetermined source and its impact on atrial fibrillation detection: A target trial emulation analysis.International journal of stroke : official journal of the International Stroke Society · 2026Observational
- Thrombus composition identifies distinct etiologic phenotypes in embolic stroke of undetermined source.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Cerebral Infarction: Epidemiology, Classification, Mechanisms, Diagnosis, and Management.MedComm · 2026Review
- Prolonged QT interval and risk of recurrent stroke in the Atrial Cardiopathy and Antithrombotic Drugs in Prevention After Cryptogenic Stroke (ARCADIA) trial.Heart (British Cardiac Society) · 2026Article
- Coronary atherosclerotic burden in patients with embolic stroke of undetermined source.European stroke journal · 2026Article
- Brain-gut communication and potential applications of microecological treatments in stroke.Frontiers in neuroscience · 2026Review
- Cryptogenic stroke: definitions and management.Hematology. American Society of Hematology. Education Program · 2025Review
- Machine learning-based classification of carotid plaques via ultrasound: a systematic review and meta-analysis of diagnostic performance.International journal of emergency medicine · 2025Review
- Left atrial appendage function by strain and structure is associated with thromboembolic risk in patients with cryptogenic stroke and TIA.Open heart · 2025Observational
- A novel stroke classification model based on EEG feature fusion.Scientific reports · 2025Article
- Sex Differences in Embolic Stroke of Undetermined Source: Echocardiographic Features and Clinical Outcomes.European journal of neurology · 2025Observational
- Enlarged perivascular spaces as vascular health indicators: correlations with clinical and imaging data in young and middle-age stroke patients.Neuroradiology · 2025Article
- Use of optical coherence tomography in selected patients with recurrent cryptogenic stroke: A case series and technical discussion.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 6 institutions in 4 countries.
Funding
Abstract
Ischaemic strokes have traditionally been classified according to the TOAST criteria, in which strokes with unclear aetiology are classified as cryptogenic strokes. However, the definition of cryptogenic stroke did not meet the operational criteria necessary to define patient populations for randomized treatment trials. To address this problem, the concept of embolic stroke of undetermined source (ESUS) was developed and published in 2014. A hypothesis that underpinned this concept was that most strokes in patients with ESUS are caused by embolic events, perhaps many cardioembolic, and that anticoagulation would prevent secondary ischaemic events. On this basis, two large randomized trials were conducted to compare the non-vitamin K antagonist oral anticoagulants (NOACs) dabigatran and rivaroxaban with aspirin. Neither NOAC was superior to aspirin in these trials, although subgroups of patients with ESUS seemed to benefit specifically from anticoagulation or antiplatelet therapy. The neutral results of the trials of anticoagulation and insights into ESUS from research conducted since the concept was introduced warrant reassessment of the ESUS construct as a research concept and a treatment target. In this Review, we discuss the evidence produced since the concept of ESUS was introduced, and propose updates to the criteria and diagnostic algorithm in light of the latest knowledge.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.