ArticleAnnals of Indian Academy of Neurology2025
Embolic Stroke of Undetermined Source (ESUS): Prevalence, Risk Factors, and Diagnostic Insights from a Prospective German Cohort.
Article in Annals of Indian Academy of Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Covert macrovascular disease and early outcome after ischemic cerebrovascular events.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Observational
- Revisiting the Obesity Paradox: Stroke Subtype-Specific Associations of BMI and WHR with Functional Outcome.Cerebrovascular diseases extra · 2026Article
- Digital Health-Enabled Monitoring Strategies for Atrial Fibrillation Detection after Embolic Stroke of Undetermined Source: A Cost-Effectiveness Analysis of Implantable Loop Recorders, Wearable Devices, and Usual Care.Cerebrovascular diseases (Basel, Switzerland) · 2025Article
- Circadian Blood Pressure Phenotyping Identifies Subtype-Specific Risk and Outcomes in Acute Ischemic Stroke: A Prospective Study.Translational stroke research · 2025Article
- Cardioembolic stroke versus embolic stroke of undetermined source: early severity and long-term outcomes in a prospective cohort.BMC neurology · 2025Article
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5 authors.
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Abstract
BACKGROUND AND
objectivesEmbolic stroke of undetermined source (ESUS) was introduced to standardize the classification of cryptogenic strokes with presumed embolic origin. However, ESUS comprises a heterogeneous group with diverse clinical and diagnostic features. This study aimed to characterize ESUS within a prospective stroke cohort and compare it with other defined ischemic stroke subtypes.
methodsIn this prospective, single-center study, patients with acute ischemic stroke or transient ischemic attack (TIA) were enrolled over 6 months. Stroke etiology was classified according to established criteria, including ESUS definitions based on the exclusion of major cardioembolic sources, ≥50% large-artery stenosis, and small-vessel disease. All patients underwent neuroimaging, vascular diagnostics, and cardiological workup, including echocardiography and rhythm monitoring.
resultsOf 714 patients, 98 (13.7%) met ESUS criteria. ESUS patients were younger (median 67 vs. 74 years), predominantly male (61.2%), and had fewer prior strokes or TIAs (11.2% vs. 27.6%, P < 0.001) than nonESUS patients. Hypertension (72.2%) and obesity (54.2%) were common. Stroke severity at discharge was lower in ESUS (National Institutes of Health Stroke (NIHSS) 1.9 ± 2.3) compared to cardioembolic (4.8 ± 3.7) and atherosclerotic strokes (3.5 ± 3.1) ( P < 0.05), and no in-hospital deaths occurred in the ESUS group ( P = 0.02). While overall diagnostic imaging rates were similar across groups, transesophageal echocardiography was performed more frequently in ESUS (38.8%).
conclusionsESUS accounted for 18% of ischemic strokes and represents a distinct, clinically relevant subgroup with unique demographic and outcome profiles. These findings support the refinement of ESUS classification and the need for individualized diagnostic and secondary prevention strategies.
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