Left Upper Lung Lobectomy Is an Embolic Risk Factor for Cerebral Infarction

Area of Science:

• Cardiology
• Thoracic Surgery
• Neurology

Background:

• Cerebral embolism typically originates from cardiac sources or patent foramen ovale.
• Idiopathic strokes, termed embolic stroke of undetermined source (ESUS), present a diagnostic challenge.
• Lung lobectomy is an emerging, yet overlooked, risk factor for cerebral embolism.

Observation:

• A 66-year-old male experienced cerebral infarction two days post-left upper lobectomy.
• Pulmonary vein stump thrombus formation is a known complication after lung lobectomy.
• This risk persists for several years, often remaining undetected.

Findings:

• The study highlights pulmonary vein stump thrombus as a potential cause of cerebral embolism following lung lobectomy.
• Three-dimensional computed tomography revealed specific structural features of the pulmonary vein stump in the affected patient.
• This case underscores the importance of considering the pulmonary vein stump in patients with stroke after lung lobectomy.

Implications:

• Pulmonary vein stump evaluation should be considered in patients presenting with cerebral infarction post-lung lobectomy.
• Further research is needed to establish early detection, prevention, and treatment strategies for this condition.
• This finding may lead to revised clinical guidelines for stroke risk assessment in post-lobectomy patients.