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Stroke due to paradoxical embolism
G B Frisoni1, V Di Monda, M Bariselli
1Clinica Neurologica dell'Università di Brescia.
Italian Journal of Neurological Sciences
|February 1, 1990
Summary
A young girl experienced a stroke due to a paradoxical embolism, a condition where a blood clot travels from the venous to the arterial system. This case highlights the importance of contrast echocardiography in diagnosing such events.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Deep vein thrombosis (DVT) and pulmonary embolism (PE) can lead to paradoxical embolism.
- Patent foramen ovale (PFO) is a potential pathway for paradoxical embolism.
- Cerebrovascular accidents (stroke) in young individuals warrant thorough etiological investigation.
Observation:
- A young female patient presented with acute upper limb ischemia and stroke.
- Clinically asymptomatic DVT and PE were identified as preceding events.
- Diagnosis of paradoxical embolism through a PFO was established using clinical assessment and contrast echocardiography.
Findings:
- Contrast echocardiography proved crucial in diagnosing the PFO-associated paradoxical embolism.
- The patient's presentation underscores the link between venous thromboembolism and arterial stroke.
- Asymptomatic venous thromboembolism can precipitate paradoxical embolism.
Implications:
- This case suggests paradoxical embolism may be an underdiagnosed cause of stroke in young patients.
- Early diagnosis and management of PFO-related paradoxical embolism are critical.
- Enhanced vigilance for paradoxical embolism in patients with unexplained stroke and venous thromboembolism is recommended.