脑损伤
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Figure 1｜AHEAD mnemonic for ESUS75.
Therefore, to promote widespread use of these key, stricter ESUS criteria, we created the mnemonic AHEAD (Figure 1): A for Age ≥ 75 years; Head imaging confirming nonlacunar stroke; Echocardiography (including trans-thoracic and trans-esophageal echocardiography) and EKG (including longer-term arrhythmia monitoring like insertable cardiac monitor) to look for cardioembolic source; Arterial studies excluding atherosclerotic stenosis, unfavorable plaque morphology, dissection, vasculitis, or web; and Differential diagnosis including hypercoagulable labs, malignancy screening, and other less common etiologies. The accompanying paper seems well aligned with this approach, along with further studies underway to determine the importance of some of the grayer areas, such as atrial cardiopathy, moderate left ventricular dysfunction, < 50% arterial stenosis, and other potential contributors to ESUS (Siegler et al., 2019).