What is a Cryptogenic Stroke and Why Can't Doctors Find the Cause?

Hearing the word stroke can feel very frightening and overwhelming. A stroke happens when blood flow to your brain gets blocked or a blood vessel bursts, causing serious damage. Sometimes, even after many tests, doctors cannot find the exact cause of the stroke. When doctors cannot find a clear reason, it is called a cryptogenic stroke.

Living with a diagnosis of unknown origin can leave you with many questions and worries. Knowing what to expect can help you feel more in control of your health and recovery. Let us walk through what a cryptogenic stroke is, how to spot the signs, and how to take care of yourself moving forward.

What Is a Cryptogenic Stroke?

Simply put, a cryptogenic stroke is a stroke with no clear or known cause. It falls under the wider category of ischemic strokes. An ischemic stroke happens when a blood clot blocks an artery that carries blood and oxygen to your brain.

When you have a typical ischemic stroke, doctors can usually find an underlying health condition. Common causes include high blood pressure, diabetes, or high cholesterol. With a cryptogenic stroke, finding that specific reason is very difficult. The medical term cryptogenic literally means of hidden or unknown origin.

Just like any other stroke, a cryptogenic stroke is a life-threatening medical emergency. If you or someone near you shows signs of a stroke, call 911 in the US or 999 in the UK right away. Getting a fast diagnosis and starting treatment quickly can save lives. Every single second counts.

What Are the Symptoms of a Cryptogenic Stroke?

The symptoms of a cryptogenic stroke are the same as the symptoms of any other ischemic stroke. Review this list to see if these sudden changes sound familiar:

• Weakness or numbness on one side of your face or body, such as a sudden inability to move an arm or leg.
• Difficulty speaking or trouble finding the right words, known as aphasia.
• Slurred speech or trouble pronouncing words clearly, known as dysarthria.
• Loss of muscle control on one side of your face, causing your mouth to droop.
• Sudden loss of function in any of your senses, such as vision, hearing, smell, taste, or touch.
• Blurry vision or seeing double, known as diplopia.
• Loss of balance, trouble walking, or clumsy movements, known as ataxia.
• Dizziness or a spinning sensation, known as vertigo.
• Nausea and vomiting.
• Stiffness in your neck.
• Sudden shifts in your mood, temper, or personality.
• Feeling confused or disoriented.
• Sudden seizures or fits.
• Loss of memory, known as amnesia.
• A severe, sudden headache that comes on without warning.
• Fainting or losing consciousness.
• Falling into a coma in severe cases.

Stroke Warning Signs: Remember BE FAST!

Strokes can show many different signs and symptoms. To help you quickly recognize if you or a loved one is having a stroke, remember the acronym BE FAST. Here is what each letter stands for:

• B - Balance: Check for a sudden loss of balance. Watch if someone is suddenly unsteady on their feet or unable to walk straight.
• E - Eyes: Check for sudden vision loss or changes in one or both eyes. Look for blurry vision or double vision.
• F - Face: Ask the person to smile. Check if one side of the face droops or if saliva drips from the corner of the mouth.
• A - Arms: Ask the person to raise both arms. If one arm drifts downward or they cannot keep it up, it is a warning sign.
• S - Speech: Listen to their speech. Check if their words are slurred, hard to understand, or if they struggle to form sentences.
• T - Time: Time is more precious than anything else! If you notice any of these signs, call emergency services right away. If possible, note the exact time the symptoms started. Telling the doctor this time helps them choose the best treatment for you.

What Causes a Cryptogenic Stroke?

To be honest, doctors still cannot say for sure what causes a cryptogenic stroke. This uncertainty is the hardest part of this diagnosis for many patients and families.

Most people who have an ischemic stroke have a clear underlying condition. Common risk factors include:

• Blood clotting disorders.
• Narrowing and hardening of the arteries, known as atherosclerosis.
• An irregular heartbeat, known as atrial fibrillation.
• Congenital heart defects, such as holes between the heart chambers like atrial septal defects or ventricular septal defects.

These conditions might cause a cryptogenic stroke, but doctors cannot confirm them as the definite cause. Sometimes, you can have a cryptogenic stroke even if you have none of these risk factors.

Transient Ischemic Attack Or TIA.

You might have heard of a transient ischemic attack, often called a mini-stroke or TIA. This acts just like a stroke, but the effects are temporary. The symptoms go away within a few minutes or a few hours. However, a TIA is a very serious warning sign! Having a TIA means you have a much higher risk of having a full stroke in the near future. If you suspect a TIA, seek medical care right away.

How Do Doctors Diagnose a Cryptogenic Stroke?

A doctor diagnoses a cryptogenic stroke using neurological exams and several other medical tests. If you arrive at an emergency department, the medical team will run these tests right away.

Doctors use these tests to confirm if you had a stroke:

• Blood tests to check your overall health and clotting factors.
• A CT scan of your head.
• An electrocardiogram, or ECG, to check your heart rhythm.
• An electroencephalogram, or EEG, to check your brain wave activity.
• An MRI scan for detailed pictures of your brain tissue.
• Prolonged cardiac monitoring to check for hidden irregular heartbeats like atrial fibrillation.

These tests can confirm that you suffered an ischemic stroke. However, if doctors cannot find a specific reason for the blood clot, they classify it as a cryptogenic stroke.

What Are the Treatments for a Cryptogenic Stroke?

Doctors usually treat a stroke by targeting its exact cause. Because we do not know what caused a cryptogenic stroke, there is no single targeted treatment for the root cause.

Instead, your doctor will monitor your health closely and focus on prevention. They may prescribe blood-thinning medicines, such as aspirin or other anticoagulants, to lower your risk of future blood clots. You may also need medicine to keep your blood pressure at a safe level.

Why Rehabilitation Matters After a Stroke.

Rehabilitation is a crucial part of recovering after a stroke. You need therapy to help your brain and body adapt to changes. Rehabilitation helps you regain old skills or learn new ways to live with any lasting weakness. You may need one or more of these therapies:

• Physical therapy: Helps you build muscle strength, improve your balance, and regain movement in your arms and legs.
• Occupational therapy: Helps you safely manage everyday tasks, especially tasks that require fine motor skills.
• Speech therapy: Helps you improve speaking and language skills, and strengthens muscles used for swallowing, breathing, and eating.
• Cognitive therapy: Helps you improve memory, focus, and other mental skills.

What Is the Recovery Outlook After a Cryptogenic Stroke?

Because the exact cause of this stroke is unknown, doctors cannot give a precise recovery percentage. Everyone responds differently to a stroke, so you cannot compare your healing journey to anyone else's.

A cryptogenic stroke can be life-threatening and cause permanent disability. Your medical outlook depends on several key factors:

• Which parts of your brain were affected by the stroke.
• How quickly you received medical treatment.
• Your overall health and fitness level before the stroke.

Medical experts note that about one in four people who have a cryptogenic stroke will have another stroke in the future. Your doctor will discuss what you can expect and help you set realistic recovery goals tailored to your health.

Can You Prevent a Cryptogenic Stroke?

Since the exact causes are not always clear, the best way to lower your risk of a cryptogenic stroke is to protect your overall health. Try to follow these healthy habits:

• Keep your blood pressure, cholesterol, and other chronic health conditions well controlled.
• Stop smoking if you smoke. This is one of the most important steps you can take.
• Eat a nutritious diet and maintain a healthy body weight.
• Get regular physical exercise, such as walking for at least 30 minutes a day.
• Schedule an annual checkup with your doctor. Many health conditions that increase stroke risk develop over time. Your doctor can spot warning signs early and help you manage them before they cause a stroke.

How to Take Care of Yourself After a Stroke.

Recovering and going through rehabilitation after a stroke is hard work. Once you and your doctor finish your initial treatment plan, follow it as closely as possible. Generally, you should focus on these steps:

• Take your medicines exactly on schedule. Taking your medicine as your doctor prescribes helps your body heal.
• Attend all of your rehabilitation and therapy appointments. If an exercise feels too painful or unsafe, tell your therapist right away. Rehabilitation is hard work, but you should not have to endure constant severe pain.
• Do not ignore your mental health. Depression and anxiety are very common after a stroke. Feeling sad or anxious does not make you weak or defeated. Your mental health is just as important as your physical health. If you feel overwhelmed, talk to your doctor or a mental health counselor.
• Keep your follow-up appointments. You will need to see your neurologist and primary care doctor regularly. Your doctors will tell you how often you need checkups.

Questions to Ask Your Doctor.

Facing a stroke, especially when doctors cannot find the cause, can leave you feeling scared. You can ask your doctor these helpful questions:

• What is my personal risk of having another stroke?
• Are there any more tests we can run to find the cause of my stroke?
• What warning signs should I watch for at home?
• When should I schedule my next follow-up appointment with you?

Final Thoughts to Keep in Mind.

A stroke is a life-changing event. Dealing with a cryptogenic stroke where the cause remains a mystery can add extra stress. However, you are never alone. Your medical team will help you adapt to any changes in your body. They will guide you as you learn to enjoy your favorite activities and live with any new challenges.

Be sure to celebrate even the smallest progress during your recovery. Healing is a difficult journey, and some days will feel harder than others. Every step you take forward matters. Your therapists are there to help you succeed. Tell them what feels difficult, and they will help you overcome those challenges. Keeping your spirits strong is the most important part of healing!