{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:02:01Z","timestamp":1789052521561,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Transcranial Doppler (TCD) detects microembolic signals (MES), reflecting ongoing cerebral embolization. MES have been studied across stroke subtypes and may clarify etiology, monitor treatment, and predict recurrence. We aimed to determine the prevalence of MES in acute ischemic stroke (AIS), explore clinical and laboratory associations, and assess their role in etiological workup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective single\u2010center study over 3\u2009years including anterior circulation AIS patients within 24\u2009h of onset. Stroke subtype was classified by TOAST criteria. Bilateral middle cerebral artery TCD monitoring was performed for 30\u2009min to detect and quantify MES.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 136 patients (mean age 60.1\u2009\u00b1\u200912.4\u2009years), MES were detected in 22 (16.2%; 95% CI: 10.4%\u201323.5%). MES(+) patients had more often multiple\u2010territory infarcts (36.4% vs. 10.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), newly detected atrial fibrillation (13.6% vs. 0.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), and cancer\u2010associated stroke (18.2% vs. 0.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), whereas cryptogenic etiology was less common (18.2% vs. 41.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041). MES were absent in lacunar stroke. MES positivity correlated with higher D\u2010dimer levels (median 932 vs. 456\u2009ng\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and MES counts correlated strongly with D\u2010dimer values (Spearman coefficient: 0.393,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MES were detected in one\u2010sixth of anterior circulation AIS patients, but were absent in lacunar stroke. Their presence was associated with multiple\u2010territory infarcts, newly detected atrial fibrillation, and cancer\u2010related stroke. MES counts correlated with D\u2010dimer levels, supporting their role as markers of ongoing cerebral embolization and underlying prothrombotic state, with potential utility in revealing occult embolic mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70550","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:36:37Z","timestamp":1772966197000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Significance of Microembolic Signal Detection in Acute Ischemic Stroke: Insights Into Ongoing Cerebral Embolization and Occult Etiologies"],"prefix":"10.1111","volume":"33","author":[{"given":"Eleni","family":"Bakola","sequence":"first","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National &amp; Kapodistrian University of Athens  Athens 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Medicine, National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Papagiannopoulou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Keramida","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Fanouraki","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angeliki\u2010Erato","family":"Sterpi","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apostolos","family":"Safouris","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National &amp; Kapodistrian University of Athens  Athens Greece"},{"name":"Stroke Unit Metropolitan Hospital  Piraeus Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Karapanayiotides","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki  Thessaloniki 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