open access

Vol 49, No 1 (2015)
Case reports
Submitted: 2014-09-30
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Paradoxical brain embolism in a young man: Is it only a patent foramen ovale?

Lidia Wozniak, Maksymilian Mielczarek, Robert Sabiniewicz
DOI: 10.1016/j.pjnns.2014.12.003
·
Neurol Neurochir Pol 2015;49(1):61-64.

open access

Vol 49, No 1 (2015)
Case reports
Submitted: 2014-09-30

Abstract

Paradoxical embolism is considered the major cause of cerebral ischemic events in young patients. The most common cause of paradoxical embolism, which has been widely described, is right-to-left shunting (RLS) at cardiac level through a patent foramen ovale (PFO). Rarely paradoxical embolism can also be caused by RLS at pulmonary level due to pulmonary arteriovenous fistula (PAVF). Herein, we present a case of a young man, who experienced transient ischemic attack (TIA) due to paradoxical embolism, in whom both abovementioned abnormalities coexisted. This coincidence is very rare (noted in only 1% of patients with cryptogenic stroke or TIA), but it highlights the importance of searching for extracardiac RLS in patients with cryptogenic stroke, even if a PFO has been detected.

Abstract

Paradoxical embolism is considered the major cause of cerebral ischemic events in young patients. The most common cause of paradoxical embolism, which has been widely described, is right-to-left shunting (RLS) at cardiac level through a patent foramen ovale (PFO). Rarely paradoxical embolism can also be caused by RLS at pulmonary level due to pulmonary arteriovenous fistula (PAVF). Herein, we present a case of a young man, who experienced transient ischemic attack (TIA) due to paradoxical embolism, in whom both abovementioned abnormalities coexisted. This coincidence is very rare (noted in only 1% of patients with cryptogenic stroke or TIA), but it highlights the importance of searching for extracardiac RLS in patients with cryptogenic stroke, even if a PFO has been detected.

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Keywords

Patent foramen ovale (PFO), Pulmonary arteriovenous fistula (PAVF), Paradoxical embolism, Right-to-left shunting (RLS)

About this article
Title

Paradoxical brain embolism in a young man: Is it only a patent foramen ovale?

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 49, No 1 (2015)

Pages

61-64

DOI

10.1016/j.pjnns.2014.12.003

Bibliographic record

Neurol Neurochir Pol 2015;49(1):61-64.

Keywords

Patent foramen ovale (PFO)
Pulmonary arteriovenous fistula (PAVF)
Paradoxical embolism
Right-to-left shunting (RLS)

Authors

Lidia Wozniak
Maksymilian Mielczarek
Robert Sabiniewicz

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