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Cerebral infarction in conjunction with patent foramen ovale and May-Thurner syndrome

D M Greer1, F S Buonanno

  • 1Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|October 27, 2001
PubMed

Insights

Stroke patients with paradoxical emboli require deep venous thrombosis (DVT) screening. Iliac vein compression, or May-Thurner syndrome, is a potential DVT source, and treating it can be curative.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Cardiology

Background:

  • Paradoxical embolism is a significant cause of stroke.
  • Deep venous thrombosis (DVT) in the lower extremities is a common source of emboli.
  • Iliac vein compression, known as May-Thurner syndrome, is a risk factor for DVT.

Observation:

  • The authors report on three stroke patients.
  • All patients had a patent foramen ovale (PFO).
  • All patients presented with paradoxical cerebral embolism and demonstrated iliac vein compression.

Findings:

  • Iliac vein compression was identified as the presumed source of emboli in these stroke patients.
  • May-Thurner syndrome is a potential, often overlooked, source of DVT leading to paradoxical embolism.
  • The study highlights the link between May-Thurner syndrome, DVT, and paradoxical cerebral embolism.

Implications:

  • May-Thurner syndrome should be considered in the diagnostic workup of stroke patients with paradoxical embolism.
  • Definitive treatment of May-Thurner syndrome can potentially cure the underlying cause of recurrent DVT and embolism.
  • This emphasizes the importance of a comprehensive vascular assessment in cryptogenic stroke cases.

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