Intracranial Embolism Health Channel

Definition

Stroke secondary to cardiogenic embolism is a loss of brain function caused by blood clots that develop in the heart and travel to the brain.

See also: Stroke

Alternative Names

Stroke secondary to atrial fibrillation; Cardioembolic stroke

Causes, incidence, and risk factors

A stroke is an interruption of the blood supply to any part of the brain. Strokes secondary to cardiogenic embolism are caused by moving blood clots (emboli) that develop in the heart. These clots travel through the bloodstream and become stuck in small arteries in the brain.

This type of stroke typically occurs suddenly, with immediate and severe loss of brain functions. It is not associated with type of activity, and can occur at any time.

Heart arrhythmias (such as atrial fibrillation) are commonly seen with this disorder, and are often the cause of the embolus. A heart muscle that is not beating strongly or regularly may result in blood remaining in the heart area, causing a clot to form. The clot can break off and travel to the brain.

Risks for stroke secondary to cardiogenic embolism include:

• History of heart valve replacement
• Arrhythmias (especially atrial fibrillation)
• Infective endocarditis
• Heart attack
• Mitral valve prolapse
• Other heart valve disorders
• Ischemic cardiomyopathy
• Blood clots anywhere in the body

Symptoms

Symptoms of stroke occur suddenly and include:

• Numbness or weakness of the face, arm, or leg (especially on one side of the body)
• Tingling or other abnormal sensations
• Confusion, trouble speaking, or understanding speech
• Problems seeing out of one or both eyes
• Dizziness
• Loss of coordination and balance, which can cause trouble walking
• Severe headache

Other symptoms may include:

• Vertigo (abnormal sensation of movement)
• Swallowing difficulties
• Personality changes
• Mood and emotion changes
• Urinary incontinence (lack of control over bladder)
• Lack of control over the bowels
• Sleepiness,stuporous, lethary
• Loss of consciousness
• Coma

Signs and tests

A physical exam may reveal the following:

• Changes in vision or visual fields
• Clots in the retina of the eye
• Changes in reflexes including abnormal reflexes or abnormal extent of "normal" reflexes
• Abnormal eye movements
• Muscle weakness
• Decreased sensation

The pulse may be irregular. Abnormal sounds may be heard when listening to the heart with a stethoscope. There may be signs of splinter hemorrhages.

Tests include:

• Head CT scan
• MRI of head, MRA of the head
• ECG showing arrhythmia, such as atria

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