"This has since been revised and expanded by other groups, including a proposed revision in 2025, the Ischaemic Stroke Phenotyping System (ISPS25), which aims to help identify aetiological mechanisms through a comprehensive work-up 2. These aetiologies include cardioembolism, large artery atherosclerosis, small vessel disease, or other determined causes, with “ESUS 2.0” only being classified should that diagnostic work-up return negative 2."
"blood tests: CBC (FBC), BMP (UEC), coagulation labs, D-dimer, lipid panel, HbA1C, drug screen, and consideration of HIV and syphilis"
"blood tests: CBC (FBC), BMP (UEC), coagulation labs, D-dimer, lipid panel, HbA1C, drug screen, and consideration of HIV and syphilis"
"blood tests: CBC (FBC), BMP (UEC), coagulation labs, D-dimer, lipid panel, HbA1C, drug screen, and consideration of HIV and syphilis"
"blood tests: troponin, BNP, CRP, ESR, vasculitis screen (e.g. ANA, RF, ANCA), tumour markers, haemoglobin electrophoresis"
"blood tests: troponin, BNP, CRP, ESR, vasculitis screen (e.g. ANA, RF, ANCA), tumour markers, haemoglobin electrophoresis"
"blood tests: troponin, BNP, CRP, ESR, vasculitis screen (e.g. ANA, RF, ANCA), tumour markers, haemoglobin electrophoresis"
"blood tests: troponin, BNP, CRP, ESR, vasculitis screen (e.g. ANA, RF, ANCA), tumour markers, haemoglobin electrophoresis"
"blood tests: troponin, BNP, CRP, ESR, vasculitis screen (e.g. ANA, RF, ANCA), tumour markers, haemoglobin electrophoresis"
"CT or MR angiogram (arch to vertex): interrogation of blood vessels proximal to ischaemic stroke (e.g. carotid artery stenosis (50-99%), carotid artery dissection, vertebral artery dissection, carotid web, vertebral web, fibromuscular dysplasia, intracranial atherosclerotic disease, moyamoya disease, CNS vasculitis, RCVS, ascending aortic arch atheroma (>4 mm), etc.) 1-3"
"MR vessel wall imaging: may give further insights into vascular pathology (e.g. CNS vasculitis, intracranial atherosclerotic disease, RCVS) 2,3"
"neuroimaging: MR angiogram with fat suppression (if concern for dissection)"
"no major cardioembolic source (e.g. atrial fibrillation, mechanical heart valve, intracardiac thrombus)"
"no other specific cause (e.g. arteritis, dissection, drug use)"
"cardiac rhythm testing: prolonged outpatient cardiac rhythm monitoring (e.g. implantable loop recorder)"
"blood tests: CBC (FBC), BMP (UEC), coagulation labs, D-dimer, lipid panel, HbA1C, drug screen, and consideration of HIV and syphilis"
"blood tests: troponin, BNP, CRP, ESR, vasculitis screen (e.g. ANA, RF, ANCA), tumour markers, haemoglobin electrophoresis"
"CT or MRI brain: confirm presence of ischaemic stroke and ascertain its pattern (e.g. one vascular territory vs multiple (e.g. three-territory sign), not conforming to vascular territories (e.g. watershed, patterns in MELAS), evidence of an explanatory cerebral small vessel disease (e.g. cerebral amyloid angiopathy, hypertensive microangiopathy, monogenic cerebral small vessel diseases), etc.) 1-3"
"CT or MR angiogram (arch to vertex): interrogation of blood vessels proximal to ischaemic stroke (e.g. carotid artery stenosis (50-99%), carotid artery dissection, vertebral artery dissection, carotid web, vertebral web, fibromuscular dysplasia, intracranial atherosclerotic disease, moyamoya disease, CNS vasculitis, RCVS, ascending aortic arch atheroma (>4 mm), etc.) 1-3"
"transthoracic echocardiogram with bubble study: structural evaluation of the heart (e.g. patent foramen ovale, interatrial septal aneurysm, heart failure with reduced ejection fraction, valvulopathies, features of atrial cardiopathy (e.g. left atrial enlargement), infective and non-bacterial thrombotic endocarditis, regional wall motion abnormalities, intracardiac tumours (e.g. myxoma, fibroelastoma), intracardiac thrombus, left ventricular aneurysm, other shunts, etc.) 2"
"neuroimaging: CT or MRI brain, CT or MR angiogram (arch to vertex)"