Embolischer Schlaganfall mit ungeklärter Emboliequelle (ESUS) – Klassifikation einer neuen Schlaganfallentität

Zusammenfassung

Als embolischer Schlaganfall mit ungeklärter Emboliequelle (ESUS) wird eine Subgruppe kryptogener Schlaganfälle bezeichnet, welche durch ein embolisches Infarktmuster definiert werden, wenn gleichzeitig trotz einer sorgfältig durchgeführten Diagnostik keine eindeutige und spezifische Emboliequelle identifiziert werden kann. In diesem Übersichtsartikel werden die Grundlagen des ESUS-Konzepts analysiert und ein Überblick über die Evidenz jüngster Kohortenstudien gegeben. Es werden die Definition, Ätiologie und die Diagnostik eines ESUS neu bewertet. Durch eine gezielte Diagnostik bei ESUS-Patienten kann die Anzahl kryptogener Schlaganfälle durch Stellen einer spezifischen Diagnose reduziert werden.

Abstract

Embolic stroke of undetermined source (ESUS) represents a subpopulation of cryptogenic strokes defined by its embolic stroke pattern on imaging and if after a carefully performed diagnostic evaluation, a specific, well recognized cause of stroke has not been identified. This review article analyses the basics of the ESUS concept and provides an overview of the evidence from recent cohort studies. The definition, aetiology and diagnosis of ESUS are reassessed. Targeted diagnostics in ESUS patients can reduce the number of cryptogenic strokes by making a specific diagnosis.

Schlüsselwörter

embolischer Schlaganfall ungeklärter Ursache - ESUS - Schlaganfallätiologie - Diagnose

Key words

embolic stroke of undetermined source - stroke etiology - diagnosis

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