{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:12:18Z","timestamp":1788444738601,"version":"build-2803163510"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Neurohospitalist"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>There is a significant percentage of ischemic strokes, particularly in younger people, with etiologies that remain elusive despite standard workup. One dilemma in managing such patients is deciding whether they may have an underlying hypercoagulable condition that would lead to consideration of anticoagulation. Previous guidelines have focused on primary thrombophilia, but acquired conditions exceed genetic causes, and a stepwise approach to exclude such conditions before pursuing primary thrombophilia testing is important to improve diagnostic accuracy. To date, we have not encountered any algorithm in the medical literature that advises exclusion of secondary prothrombotic states prior to considering primary hypercoagulable disorders. This report proposes a methodical approach to screening the basic stroke workup for acquired hypercoagulable states before consideration of primary thromboembolic conditions. These recommendations are informed by the authors\u2019 experience at tertiary stroke centers and the current literature.<\/jats:p>","DOI":"10.1177\/19418744261434353","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:53:17Z","timestamp":1773255197000},"page":"358-361","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypercoagulable Workup in Cryptogenic Stroke: What to Test, and When"],"prefix":"10.1177","volume":"16","author":[{"given":"Saman","family":"Zafar","sequence":"first","affiliation":[{"name":"Department of Neurology, Jefferson Einstein Philadelphia Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushma Helagalli","family":"Paramashivaiah","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jefferson Einstein Philadelphia Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Prabhu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jefferson Einstein Philadelphia Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6155-101X","authenticated-orcid":false,"given":"Muskaan","family":"Uppal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Student at Thomas Jefferson University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Levis-Lahti","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Student at Thomas Jefferson University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sridhara","family":"Yaddanapudi","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Maryland Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000375"},{"key":"e_1_3_4_3_2","volume-title":"Understanding Diagnosis and Treatment of Cryptogenic Stroke","author":"American Heart Association","year":"2014","unstructured":"American Heart Association. Understanding Diagnosis and Treatment of Cryptogenic Stroke. American Stroke Association, 2014."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.040524"},{"issue":"6","key":"e_1_3_4_5_2","first-page":"1136","article-title":"Thrombophilia testing in arterial thrombosis and ischemic stroke","volume":"94","author":"Lim MY","year":"2019","unstructured":"Lim MY, Pruthi RK. Thrombophilia testing in arterial thrombosis and ischemic stroke. Mayo Clin Proc. 2019;94(6):1136-1146.","journal-title":"Mayo Clin Proc"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000129912.56486.2B"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.24.1.35"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1503946"},{"issue":"6","key":"e_1_3_4_9_2","first-page":"2212","article-title":"Thrombophilia testing after ischemic stroke: why, when, and what?","volume":"52","author":"Salehi Omran S","year":"2021","unstructured":"Salehi Omran S, Lerario MP, Navi BB. Thrombophilia testing after ischemic stroke: why, when, and what? Stroke. 2021;52(6):2212-2220.","journal-title":"Stroke"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58081056"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24325"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030431"},{"key":"e_1_3_4_13_2","first-page":"117610","article-title":"Cerebrovascular manifestations in hematological diseases","volume":"429","author":"Ferro JM","year":"2021","unstructured":"Ferro JM, Infante JP. Cerebrovascular manifestations in hematological diseases. J Neurol Sci. 2021;429:117610.","journal-title":"J Neurol Sci"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.032002"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13133667"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.26.1.30"},{"key":"e_1_3_4_17_2","first-page":"9281918","article-title":"Acute arterial occlusion related to cisplatin-based chemotherapy","volume":"2018","author":"Zafar S","year":"2018","unstructured":"Zafar S, Potdar R, Tiu A, Varadi G, Leighton J. Acute arterial occlusion related to cisplatin-based chemotherapy. Case Rep Neurol Med. 2018;2018:9281918.","journal-title":"Case Rep Neurol Med"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.3109\/02841860903524396"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.1.72"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.4.495"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1510993"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2014.05.005"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.17161\/kjm.vol16.19507"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-301345"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.22.1.90"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1705454"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.00686"}],"container-title":["The Neurohospitalist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19418744261434353","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19418744261434353","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19418744261434353","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:14:19Z","timestamp":1788441259000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19418744261434353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/19418744261434353"],"URL":"https:\/\/doi.org\/10.1177\/19418744261434353","relation":{},"ISSN":["1941-8744","1941-8752"],"issn-type":[{"value":"1941-8744","type":"print"},{"value":"1941-8752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]}}}