"The term is typically employed with reference to a 'central' source of embolism as the cause for ischaemic strokes. This is typically in relation to the heart (e.g. atrial fibrillation, infective endocarditis, during/after cardiac surgery), but may also include the aortic arch (e.g. aortic arch atheroma) 1-4. However, a similar pattern of acute ischaemic stroke can also occur due to embolism from more distal arteries or other aetiologies (e.g. hypercoagulable states from malignancy, cerebral fat embolism, hypotension, and COVID-19) 1.6 ."