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Paradoxical brain embolism in a young man: Is it only a patent foramen ovale?
Affiliations- Department of Pediatric Cardiology and Congenital Hear t Diseases, Medical University of Gdansk, Poland
- Department of Cardiology, Medical University of Gdansk, Poland
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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.
Keywords
Patent foramen ovale (PFO), Pulmonary arteriovenous fistula (PAVF), Paradoxical embolism, Right-to-left shunting (RLS)
About this articleTitle
Paradoxical brain embolism in a young man: Is it only a patent foramen ovale?
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
61-64
Page views
511
Article views/downloads
607
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
