Cerebral infarction and right ventricular noncompaction.

Area of Science:

• Cardiology
• Neurology
• Radiology

Background:

• Non-compaction cardiomyopathy (NVM) is a rare congenital heart defect characterized by excessive ventricular trabeculations.
• Neurovascular complications, including stroke, are potential but rarely described complications of NVM.

Observation:

• A 26-year-old man presented with acute neurological deficits (dysphasia, headache) suggestive of stroke.
• Echocardiography revealed prominent right ventricular trabeculations with deep intertrabecular recesses.
• Cerebral CT scan showed infarction in the bilateral temporal and frontal lobes.

Findings:

• Thrombus formation within the deep intertrabecular recesses of the extensively trabeculated right ventricle is a proposed mechanism for embolic stroke in NVM.
• This case demonstrates a rare instance of embolic stroke associated with NVM in a young patient without traditional stroke risk factors.

Implications:

• The findings suggest that NVM, particularly with extensive trabeculations and impaired systolic function, may be an underrecognized risk factor for embolic stroke.
• Further research is needed to fully understand the pathophysiology and optimal management strategies for neurovascular complications in NVM.
• Prophylactic anticoagulation may be considered for NVM patients with atrial fibrillation and severe systolic dysfunction to prevent embolic events.