neurology

Embolic Stroke of Undetermined Source (ESUS) Criteria

Diagnostic criteria for ESUS -- a subset of cryptogenic stroke characterised by non-lacunar infarct with embolic pattern, used to guide anticoagulation trials and workup.

Non-lacunar ischaemic stroke on CT/MRI (cortical, subcortical > 1.5 cm, or cerebellar infarct)*

Absence of AF on ECG/prolonged monitoring (>= 24-hour cardiac monitoring)*

Absence of significant (>= 50%) stenosis of intra- or extracranial arteries supplying the ischaemic territory*

Absence of major-risk cardioembolic source (intracardiac thrombus, vegetations, mechanical valve, recent MI < 4 weeks, EF < 30%, dilated cardiomyopathy, AF/flutter)*

No other specific cause of stroke identified (vasculitis, dissection, migraine with aura, drug use, coagulopathy, etc.)*

References

Hart RG et al. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol. 2014;13(4):429-438.
NAVIGATE ESUS Investigators. Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source. N Engl J Med. 2018;378(23):2191-2201.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against MDCalc, NICE, or your local guideline before clinical use.

References

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