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Increased Blood Residence Time as Markers of High-Risk Patent Foramen Ovale
AbstractPrevious investigations have suggested that patients with patent foramen ovale (PFO) often have an atrial dysfunction, like to that observed in patients with atrial fibrillation (AF) which may concur to an increased risk of cryptogenic stroke. The aim of the study is to compare the atrial resident time (Rt) of PFO patients to those with sinus rhythm (SR) and AF using patient-specific 3D computational fluid dynamics (CFD) analysis. Models of left atrium (LA) hemodynamics were obtained from time-resolved CT scans and transthoracic echocardiography (TTE). Enrolled patients were divided into three groups: 30 healthy su...
Source: Translational Stroke Research - June 11, 2022 Category: Neurology Source Type: research

Carotid Artery Free-Floating Thrombus Caused by Paradoxical Embolization From Greater Saphenous Vein Ascending Thrombophlebitis
We report a case of a young woman without cardiovascular risk factors who was admitted to our emergency department with listlessness and altered mental status. The clinical examination revealed right lower limb swelling. Magnetic resonance imaging and contrast-enhanced computed tomographic scans revealed a free floating thrombus of the left internal carotid artery (ICA) with a large bilateral frontal ischemic lesion. The diagnosis of a medium-sized PFO with moderate right-to-left contrast shunting was made after transesophageal echocardiography. No other cardiac sources for embolization were detected, while an ascending th...
Source: Annals of Vascular Surgery - April 28, 2013 Category: Surgery Authors: Luigi Irace, Roberto Gabrielli, Maria Sofia Rosati, Maria Fabrizia Giannoni, Anna Castiglione, Antonella Laurito, Bruno Gossetti Tags: Case Report Abstracts Source Type: research

Thromboembolic infarction caused by an unknown patent foramen ovale 30  years after VA shunt insertion: a case report and review of the literature
ConclusionsThromboembolic events due to a PFO are rare but possible life-threatening complication after VA shunt insertion. Therefore, preoperative cardiac diagnostic might be clinically relevant prior to a VA shunt implantation to avoid such complications.
Source: Acta Neurochirurgica - June 18, 2019 Category: Neurosurgery Source Type: research

Decompressive craniectomy for malignant middle cerebral artery infarction in a 16-year old boy: a case report
ConclusionsThis case highlights the preponderance of cryptogenic stroke in younger patients and its etiological elusiveness. It further demonstrates that age is predictive in terms of survival and functional outcome in the context of malignant middle cerebral artery infarction.
Source: Journal of Medical Case Reports - December 19, 2016 Category: Journals (General) Source Type: research

Paradoxical Embolism in the Setting of Inferior Vena Cava Filter Removal (P1.283)
Conclusions:Although clinically relevant events secondary to IVC filter migration and fracture are rare, they can be life-threatening. Care should be taken when choosing to place these devices, and alternative therapies should be considered when possible. They should be removed when no longer needed, as fracture rates are increased with longer dwell times. Up to half of complications can be avoided with retrieval within 3 months.Disclosure: Dr. Yost has nothing to disclose. Dr. Klaas has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Yost, M., Klaas, J. Tags: Cerebrovascular Disease Case Reports I Source Type: research

Cerebral Infarction in an HIV-Infected Patient with Combined Protein S and C Deficiency and a Patent Foramen Ovale
A 41-year-old male with a history of human immunodeficiency virus (HIV) infection developed motor aphasia, dysarthria, and right hemiparesis. A magnetic resonance imaging scan of the brain revealed a cerebral infarction in the territory of the left middle cerebral artery. The laboratory data showed decreased levels of protein S and protein C. Transesophageal contrast-enhanced echocardiography revealed a patent foramen ovale (PFO). Prothrombotic states, such as protein S and C deficiency, have been reported in HIV-infected patients. In addition, previous studies have reported prothrombotic states to be risk factors for PFO-...
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2013 Category: Neurology Authors: Ran Tomomasa, Kazuo Yamashiro, Ryota Tanaka, Nobutaka Hattori Tags: Case Reports Source Type: research

Artery of percheron occlusion: a rare cause of coma
Conclusions AOP occlusion is a rare cause of coma and should be suspected in patients who present with acute loss of consciousness, once other common aetiologies are excluded. This case raises pertinent questions regarding the indications and benefits of thrombolysis and/or clot retrieval in such patients.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: El-Wahsh, S., Weerasinghe, D., McDougall, A. Tags: Abstracts Source Type: research

Paradoxical brain embolism shadowing massive pulmonary embolism
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 - May 15, 2018 Category: Emergency Medicine Authors: Fran çois Bagate, Alexandre Bedet, Armand Mekontso Dessap, Guillaume Carteaux Source Type: research

Paradoxical arterial gas embolism following a direct incisive injury to the skull.
CONCLUSION: This case reflects the simultaneous presence of air in the arterial and venous circulation of the brain, as well as the peripheral communication through a patent foramen ovale. This production mechanism is poorly documented in the literature. PMID: 31310000 [PubMed - in process]
Source: Revista de Neurologia - July 18, 2019 Category: Neurology Authors: Rodenas-Lozano R, Molina-Nuevo JD, Collado-Jimenez RM, Ayo-Martin O, Pedrosa-Jimenez MJ, Lopez-Martinez L, Hernandez-Fernandez F Tags: Rev Neurol Source Type: research

Thrombotic Thrombocytopenic Purpura Without Schistocytes: Beware of Misdiagnosis
A 43-year-old woman was admitted for acute unusual headache, vertigo, and left upper limb weakness. She had been complaining of asthenia for the past few weeks. Her medical history included uterine cervix cancer treated with conisation and 2 pregnancies without serious complications. No allergy or recent drug introduction was noted. After ruling out current pregnancy, magnetic resonance imaging (MRI) was immediately performed and showed recent ischemic strokes in multiple territories. Doppler ultrasound imaging showed no carotid or vertebral arteries lesion. Electrocardiogram showed no ST elevation or atrial fibrillation, ...
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Decker, P., Moulinet, T., Revuz, S., Perez, P., Jaussaud, R. Tags: Autoimmune diseases, Hematologic, All Cerebrovascular disease/Stroke Case Source Type: research

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