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Pulmonary Embolism in Ischemic Stroke.

Prasanna Venkatesan Eswaradass1, Sadanand Dey1, Dilip Singh1

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Summary

Silent pulmonary embolism (PE) is linked to acute ischemic stroke (AIS). This study found PE in 0.32% of AIS patients, with many experiencing poor outcomes, highlighting the need for vigilance.

Keywords:
Acute ischemic strokeCT angiogramPulmonary embolism

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Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • Acute ischemic stroke (AIS) can be associated with silent pulmonary embolism (PE).
  • The concurrent occurrence and implications of PE in AIS patients require further investigation.

Purpose of the Study:

  • To determine the frequency of concurrent pulmonary embolism (PE) in patients presenting with acute ischemic stroke (AIS).
  • To explore potential causes and outcomes associated with concurrent PE and AIS.

Main Methods:

  • Retrospective analysis of CT angiogram stroke protocol images (aortic arch to vertex) in patients with AIS.
  • Identification of patients with concurrent PE diagnosis.
  • Review of patient history for potential causes like patent foramen ovale and thrombophilia.

Main Results:

  • A period prevalence of 0.32% for PE was observed in the AIS cohort.
  • Seven out of ten identified patients had concurrent PE with AIS; three were diagnosed within 2 days post-AIS.
  • Poor outcomes, including four deaths, were noted in seven patients.

Conclusions:

  • Silent PE is a relevant comorbidity in AIS patients.
  • CT angiogram protocols encompassing the pulmonary arteries aid in detecting PE in AIS.
  • Investigating PE in AIS patients is crucial due to potential links to paradoxical embolism and thrombophilia, and associated poor prognoses.