OVERVIEW

Cryptogenic stroke remains one of the most challenging entities in vascular neurology, accounting for 20–30% of all ischemic strokes even after a standard diagnostic evaluation. With over 200 known causes of ischemic stroke, clinicians must navigate a complex differential that spans cardioembolic sources, large- and small-vessel disease, hypercoagulable states, dissections, vasculitis, and rare or drug-induced etiologies.

This CME activity provides a structured, clinically grounded approach to the evaluation and management of cryptogenic stroke. Learners will review the contemporary classification of ischemic stroke subtypes, examine the role of advanced vascular imaging, and determine when to escalate to transesophageal echocardiography (TEE) to detect left atrial appendage thrombi, complex aortic plaque, and high-risk PFO/atrial septal aneurysm.

A major focus is on embolic stroke of undetermined source (ESUS)—its criteria, limitations, and the lessons learned from key clinical trials (NAVIGATE ESUS, RESPECT ESUS, ATTICUS, ARCADIA), which collectively demonstrated that empiric anticoagulation with DOACs is not beneficial and may be harmful in this population.

The course also highlights the impact of prolonged rhythm monitoring using loop recorders, which can reclassify a substantial proportion of cryptogenic strokes as cardioembolic by uncovering occult atrial fibrillation and directly altering secondary prevention strategies.

Through case-based discussion (including recurrent “Florida woman” cryptogenic strokes), practical mnemonics, and real-world data comparing comprehensive vs community stroke centers, clinicians will gain a pragmatic framework to reduce the size of the “cryptogenic” category, refine workups, and individualize treatment.

The estimated time to complete this activity is 1 hour.

ACCREDITATION & CREDITS

Physician Accreditation Statement
eMedEd is an approved provider of continuing medical education by the Accreditation Council for Continuing Medical Education (ACCME), Provider #0008305. This activity is approved for 1 AMA PRA Category 1 Credits.

Nursing Accreditation Statement
eMedEd is an approved provider of continuing nursing education by the California Board of Registered Nursing. Provider approved by the California Board of Registered Nursing, Provider #17890, for 1 contact hour.

Release Date: December 19, 2025
Expiration Date: December 18, 2026

1 Contact Hour

1 AMA PRA Category 1 Credit™

FACULTY

David Rose

PhD

TARGET AUDIENCE

PhysicianNursingPhysician Assistant

SPECIALITIES

neurologyInternal MedicineEmergency managementEmergency MedicineNeurocritical CareClinical Cardiac ElectrophysiologyVascular Neurology

TERMS & CONDITIONS

Disclosure Statement
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All faculty, planners, and/or content managers have nothing to disclose, nor do they have any vested interests or affiliations.

Disclaimer Statement
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