Cryptogenic Stroke Care

Diagnosing and treating the underlying causes of cryptogenic stroke

Diagnosing and treating the underlying causes of cryptogenic stroke

If you or a loved one has had a cryptogenic stroke, Scripps Health in San Diego has the expertise required to reduce the chances of having another one.


Our interventional cardiologists and neurologists work together to diagnose and treat underlying conditions that can trigger a cryptogenic stroke. Many of these treatments can be performed on an outpatient basis.

What is a cryptogenic stroke?

A stroke happens when the flow of blood to an area of the brain is blocked. This can result in loss of speech, movement, memory or, in the most serious of cases, death. 


A cryptogenic stroke is defined as a stroke that has occurred without a known cause. It tends to occur more often in younger people — generally under the age of 60.

Treating conditions underlying cryptogenic stroke

Even though cryptogenic stroke causes may not be known initially, after careful evaluation, contributing factors may be identified and proactively addressed to prevent recurrence. 


Underlying conditions that can be traced to a cryptogenic stroke include:

Patent foramen ovale (PFO)

PFO is a hole in the heart that never closes after birth. This common abnormality is found in more than 30 million people in the United States. In people with a PFO and a cryptogenic stroke confirmed by special brain imaging, PFO closure (an outpatient, minimally-invasive procedure) can reduce the risk of stroke recurrence.

Atrial fibrillation (A-Fib)

A-Fib is an irregular heart rhythm that affects about 2.7 million people in the US. A-Fib can lead to blood clots in the heart, which can be prevented with blood thinners or the WATCHMAN, an implantable device that prevents blood clots from forming.

Thrombophilia

Thrombophilia is a medical condition — inherited or developed — in which someone’s blood has an increased chance of clotting. Thrombophilia can be treated with blood thinners.

Aortic arch atheroma

Aortic arch atheroma is the development of fatty plaque (cholesterol) in the aorta, the body’s main artery. This problem can be treated with medicines.

Other conditions

Other underlying conditions include migraines, vascular tearing or an unstable rupture of a mildly stenotic plaque in a vessel.

Diagnosing cryptogenic strokes

Different tests and exams can be used to help identify what happened to trigger a cryptogenic stroke. These tests and exams help doctors see structural elements of the heart, brain and vascular system, as well as measure heart behavior and blood composition.


Tests to diagnose cryptogenic stroke include:


  • Magnetic resonance imaging (MRI) to take pictures of organs and structures inside the body
  • Brain computed tomography (CT) to take an X-ray of the brain
  • Different blood tests to measure sugar, platelet, blood clotting and oxygen levels
  • Electrocardiogram (ECG) that records the hearts electrical activity and can pinpoint A-Fib or previous heart attack
  • Remote monitoring devices worn outside the skin or inserted just under the skin above the heart to detect abnormal heart rhythms
  • Venous duplex ultrasound of the legs that can help doctors see possible blood clots
  • Transthoracic echocardiogram (TTE) and transesophageal echocardiogram (TEE), types of heart exams using ultrasound

Cryptogenic stroke and heart care expertise

Scripps cardiologists see patients from across San Diego, Southern California and the Western US. The conditions they treat include the most complex heart cases requiring multi-disciplinary teams of physicians. 


Scripps was the first on the West Coast to use an FDA-approved device to close a PFO in the heart to reduce the risk of stroke. Scripps was also the first in the U.S. to implant the world’s smallest cardiac monitoring device.


Matthew Price, MD, Mary Kalafut, MD, and John Rogers, MD, are co-directors of the Scripps Cryptogenic Stroke Program on the campus of Scripps Memorial Hospital La Jolla, which includes the Prebys Cardiovascular Institute and the Scripps Clinic, John R. Anderson V Medical Pavilion.


Prebys Cardiovascular Institute is the most comprehensive place for heart care in San Diego. Built upon a 90-year history of Scripps medical breakthroughs and discoveries, the center is also the largest on the West Coast for cardiovascular medicine, research and training.