Clinical Presentation and Frequency of Potential Sources of Embolism in Acute Ischemic Stroke Patients: The Experience of the Rome Acute Stroke Registry

Using data extracted from the Registry of the Stroke Unit located in the Department of Neurological Sciences of the University of Rome, we evaluated whether a sudden clinical onset was significantly associated with the embolic origin of stroke. For this purpose, territorial infarcts associated with a congruous intracranial arterial occlusion detected by acute angiography were defined as embolic. Cardiac or arterial sources of emboli were classified as absent, low risk or high risk according to established criteria. Out of 80 studied patients, 53 (66%) were classified as having an embolic stroke, whereas 27 (34%) did not satisfy the criteria for intracranial embolism. Sudden clinical onset was as prevalent in patients with embolic stroke as in their counterpart (68% vs. 70%). There was a statistically significant trend for an increasing frequency of embolic strokes in the three groups with no source of emboli, low-risk and high-risk source of emboli (respectively 35, 50 and 85 %). Mode of onset does not appear to be accurate enough to identify patients with or without embolic stroke at the bedside in the very early phase of acute stroke. Ancillary investigations might be needed for the correct therapeutic choice in stroke patients.