PFO Tied to Quadruple Stroke Risk in Pulmonary Embolism PFO Tied to Quadruple Stroke Risk in Pulmonary Embolism

Screening PE patients for patent foramen ovale with the aim of identifying those at risk for ischemic stroke who may be eligible for indefinite anticoagulation could be justified, a new study suggests.Medscape Medical News
Source: Medscape Critical Care Headlines - Category: Intensive Care Tags: Neurology & Neurosurgery News Source Type: news

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AbstractHigh-risk PE can be complicated by the presence of a patent foramen ovale (PFO), which can lead to paradoxical systemic embolization, including cerebral embolism ultimately leading to acute ischemic stroke (AIS). Acute management is challenging given the competing benefits and risks of systemic thrombolysis. Herein, we aim to provide a review of clinical presentations, diagnostic findings, and treatment and outcome from the available literature, with the hopes of providing insight into treatment options. We followed the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (P...
Source: Emergency Radiology - Category: Emergency Medicine Source Type: research
Ka U Lio, Maruti Kumaran, Parth RaliLung India 2019 36(6):564-566
Source: Lung India - Category: Respiratory Medicine Authors: Source Type: research
PMID: 31569246 [PubMed - in process]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
WEDNESDAY, May 8, 2019 -- For patients with symptomatic pulmonary embolism (PE), the frequency of recent ischemic stroke is higher in those with patent foramen ovale (PFO), according to a study published online May 7 in the Annals of Internal...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
Conclusion: Frequency of recent ischemic stroke in patients with symptomatic PE was higher in patients with PFO than in those without PFO. This finding supports the hypothesis that paradoxical embolism is an important mechanism of ischemic stroke in patients with PFO. Primary Funding Source: French Ministry of Health. PMID: 31060047 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
We report a rare case of large-cell, high-grade neuroendocrine lung cancer embolus occluding the basilar artery, which likely detached into the bloodstream from the lung after intruding into a pulmonary vein. The embolus was treated with endovascular aspiration, and achieved modified Thrombolysis In Cerebral Infarction 2c revascularization. After initial neurological recovery, the patient suffered respiratory arrest and support was withdrawn 48 h later. We discuss the tumor characteristics and implications for treatment of acute ischemic stroke in patients with cancer diagnoses. PMID: 30786802 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - Category: Radiology Tags: Interv Neuroradiol Source Type: research
ConclusionsHigh blood troponin T, NT-proBNP, RV dilatation/systolic dysfunction and pulmonary hypertension predicted in-hospital mortality. PFO/RLS presence and ST were predictors of clinically apparent/silent brain infarction.
Source: Cor et Vasa - Category: Cardiology Source Type: research
Patent foramen ovale is frequently observed in the general population. In case of massive pulmonary embolism, the sudden increase in the right heart cavity's pressure may cause a right-to-left shunting across this foramen, which could be associated with conflicting outcomes. Herein, we report a case of reversible cardiac arrest preceded by seizures, and followed by hemodynamic stability without any vasopressor. A brain CT-scan showed a limited ischemic stroke. Initial echocardiographic assessment revealed an acute cor pulmonale and a right-to-left intracardiac shunt across a large patent foramen ovale, suggesting the diagn...
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
Conclusions—In patients with cryptogenic stroke who have migraine, there is a high prevalence (79%) of PFO with right-to-left shunt. The timing of the stroke in migraineurs is usually not related to a migraine attack. These observations are consistent with the hypothesis that the mechanism of stroke in migraineurs is most likely because of a paradoxical embolus. Future cryptogenic stroke classification schemes should consider including PFO as a separate etiologic category.
Source: Stroke - Category: Neurology Authors: Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke, Embolism Original Contributions Source Type: research
Abstract Silent pulmonary embolism (PE) may be associated with acute ischemic stroke (AIS). We identified 10 patients from 3,132 unique patients (3,431 CT scans). We retrospectively examined CT angiogram of patients with AIS to determine the frequency of concurrent PE in AIS. The period prevalence of PE was 0.32. Seven patients had concurrent PE, whereas three had PE diagnosed 2 days after their AIS presentation. We suspected paradoxical embolism via patent foramen ovale as the cause of stroke in three patients and thrombophilia in four patients. Seven patients had poor outcome including four deaths. CT angiogram ...
Source: The Canadian Journal of Neurological Sciences - Category: Neurology Authors: Tags: Can J Neurol Sci Source Type: research
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