{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:02:11Z","timestamp":1780549331654,"version":"3.54.1"},"reference-count":39,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Faculty of Medicine and Pharmacy \u201cLower Danube\u201d University of Galati, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Beyond the well-known etiologies of ischemic stroke associated with recognized vascular risk factors, the literature describes a spectrum of uncommon causes with low prevalence but significant diagnostic and therapeutic implications. Materials and methods: A case series report of seven rare etiopathogenic mechanisms (in patients aged 25\u201385) who presented within a 3-year interval (2022\u20132025) to our stroke unit at the Neurological Department\u2014\u201cSt. Ap. Andrew\u201d County Emergency Clinical Hospital in Galati, Romania. Results: The seven uncommon embolic stroke cases included three patients with infectious cerebral ischemia (hydatid cyst with double simultaneous embolism, mycotic aneurysm of the carotid artery, syphilis-associated stroke), three cases of rare cardioembolic strokes (patients with Lambl excrescences, cor triatriatum, left ventricular non-compaction), as well as one patient with multiple etiological associations triggering acute stroke. Conclusions: Rare etiologies of ischemic stroke should be actively considered when classical vascular risk factors are absent, particularly in young patients. Comprehensive diagnostic evaluation is mandatory, especially in cases of embolic stroke of undetermined source (ESUS). Such cases represent significant diagnostic and therapeutic challenges and require a multidisciplinary approach to optimize patient outcomes.<\/jats:p>","DOI":"10.3390\/life16060930","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:37:29Z","timestamp":1780544249000},"page":"930","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Embolic Stroke of Uncommon Causes\u2014A Case Series Report from an Acute Stroke Unit"],"prefix":"10.3390","volume":"16","author":[{"given":"Mihaiela","family":"Lungu","sequence":"first","affiliation":[{"name":"Neurological Department, \u201cSt. Ap. Andrew\u201d County Emergency Clinical Hospital in Galati, 800578 Galati, Romania"},{"name":"Clinical Medical Department, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"},{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anamaria","family":"Ionescu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University Ovidius Constanta, 900470 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luminita L\u0103cr\u0103mioara","family":"Apostol","sequence":"additional","affiliation":[{"name":"\u201cSt. Ap. Andrew\u201d County Emergency Clinical Hospital in Galati, 800578 Galati, Romania"},{"name":"Medical Department, Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0986-8056","authenticated-orcid":false,"given":"Andrei Lucian","family":"Zaharia","sequence":"additional","affiliation":[{"name":"Neurological Department, \u201cSt. Ap. Andrew\u201d County Emergency Clinical Hospital in Galati, 800578 Galati, Romania"},{"name":"Clinical Medical Department, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9249-5247","authenticated-orcid":false,"given":"Elena","family":"Niculet","sequence":"additional","affiliation":[{"name":"Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Gala\u021bi, 800008 Galati, Romania"},{"name":"Pathology Department, \u201cSt. Ap. Andrew\u201d County Emergency Clinical Hospital in Galati, 800578 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0871-1339","authenticated-orcid":false,"given":"Violeta Diana","family":"Oprea","sequence":"additional","affiliation":[{"name":"Medical Department, Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Galati, 800008 Galati, Romania"},{"name":"Geriatric Department, Sj\u00e6llands Universitetshospital Nyk\u00f8bing Falster, 4800 Nykobing Falster, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e139","DOI":"10.1161\/CIR.0000000000000757","article-title":"Heart disease and stroke statistics\u20142020 update: A report from the American Heart Association","volume":"141","author":"Virani","year":"2020","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/S0140-6736(10)60834-3","article-title":"Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): A case-control study","volume":"376","author":"Xavier","year":"2010","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1212\/WNL.0000000000003534","article-title":"Relationship between risk factor control and vascular events in the SAMMPRIS trial","volume":"88","author":"Turan","year":"2017","journal-title":"Neurology"},{"key":"ref_4","unstructured":"Ay, H. 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