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Percutaneous atrial shunt closure and the risk of recurrent ischemic stroke: A register-based, nationwide cohort study
Patent foramen ovale may cause paradoxical emboli1. Cryptogenic ischemic cerebrovascular events (stroke or transient ischemic attack) (CVE) accounts for about 25% of ischemic strokes.2,3 Transcatheter closure of atrial shunts, including atrial septal defects (ASD) and patent foramen ovale (PFO), was introduced in 1996.4-6 Initially,randomized studies failed7-9 but more recent randomized studies have shown superiority of interventional treatment, with 68 % reduction of recurrent stroke after transcatheter closure of PFO compared with medical treatment in patients with cryptogenic CVE.
Source: Journal of Stroke and Cerebrovascular Diseases - March 23, 2023 Category: Neurology Authors: Alexia Karagianni, Zacharias Mandalenakis, Savvas Papadopoulos, Mikael Dellborg, Peter Eriksson Source Type: research

Letter to the Editor regarding “Cardiac-Neurovascular Adverse Effects Responsible to Contrast Transcranial Doppler: A case report”
We read with interest a case report by Mo et al. A 44 years-old woman experienced a hemodynamic abnormality due to massive air embolism from a large right-to-left shunt associated with ventricular septal defect (VSD). After saline-bubble contrast injection, the curtain pattern of air embolisms for over 100 seconds in the middle cerebral artery was detected by the transcranial Doppler (TCD).1
Source: Journal of Stroke and Cerebrovascular Diseases - July 29, 2020 Category: Neurology Authors: Sombat Muengtaweepongsa, Sirinat Puengcharoen Tags: Letter to the Editor Source Type: research

Paradoxical Brain Embolism in Elderly Subjects with Small Atrial Septal Defects
Atrial septal defects have a low prevalence in the general population, and are recognized as a rare cause of paradoxical brain embolism.
Source: Journal of Stroke and Cerebrovascular Diseases - March 20, 2018 Category: Neurology Authors: Taisuke Kitamura, Shuji Arakawa, Kei Murao, Takanari Kitazono, Tetsuro Ago Source Type: research

Paradoxical Embolism in a Girl with Atrial Septal Defect After Paroxysmal Supraventricular Tachycardia Ablation
Paradoxical embolism is a kind of important pathogenesis of cardiocerebrovascular diseases. In our case, radiofrequency current catheter ablation was accomplished successfully in a 15-year-old girl who had been experiencing supraventricular tachycardia for 6 months. She presented with abrupt onset of left hemiplegia and loss of consciousness on the first postoperative day. An urgent cerebral computed tomography showed a hyperdense right middle cerebral artery. Transthoracic echocardiogram examination revealed an atrial septal defect (ASD), with the diameter measuring 39  mm.
Source: Journal of Stroke and Cerebrovascular Diseases - July 19, 2017 Category: Neurology Authors: Xiang Chen, Zhijun Zhu, Danning Wu Tags: Case Report Source Type: research

Recent Nationwide Trends in Transcranial Doppler Utilization During Acute Ischemic Stroke Hospitalizations (P4.296)
Conclusions:Over the last decade there has been a slight but steady decrease in the use of TCD during AIS hospitalizations in the US. Future studies should examine the cost-utility of TCD, especially with the advent of endovascular stroke treatment systems.Disclosure: Dr. Liu has nothing to disclose. Dr. Lunagariya has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Feng has nothing to disclose. Dr. Ovbiagele has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Liu, Y., Lunagariya, A., Patel, U., Patel, A., Feng, W., Ovbiagele, B. Tags: In-Hospital Stroke Care Source Type: research

Orthodeoxia–platypnea syndrome and stroke: Overlapping pathophysiology
Orthodeoxia–platypnea syndrome (OPS) is a rare cause of dyspnea and hypoxemia induced by upright positioning due to orthostatic conditions [1]. Right-to-left interatrial shunt due to an atrial septal defect or patent foramen ovale (PFO) is the most common cause of this syndrome [2]. Although PFO has been implicated as a potential cause of paradoxical embolism and cerebral embolism in cryptogenic stroke [3], OPS due to PFO has rarely been described presenting as stroke [2,4,5].
Source: Journal of the Neurological Sciences - June 24, 2015 Category: Neurology Authors: Célia Machado, Ricardo Pereira, José Amorim, Carlos Galvão, João Pinho, Carla Ferreira, João Rocha Tags: Letter to the Editor Source Type: research

Orthodeoxia-platypnea syndrome and stroke: Overlapping pathophysiology
Orthodeoxia-platypnea syndrome (OPS) is a rare cause of dyspnea and hypoxemia induced by upright positioning due to orthostatic conditions [1]. Right-to-left interatrial shunt due to an atrial septal defect or patent foramen ovale (PFO) is the most common cause of this syndrome [2]. Although PFO has been implicated as a potential cause of paradoxical embolism and cerebral embolism in cryptogenic stroke [3], OPS due to PFO has rarely been described presenting as stroke [2,4,5].
Source: Journal of the Neurological Sciences - June 24, 2015 Category: Neurology Authors: Célia Machado, Ricardo Pereira, José Amorim, Carlos Galvão, João Pinho, Carla Ferreira, João Rocha Tags: Letter to the Editor Source Type: research

Early Wallerian degeneration in a neonate with MCA stroke
A 23-day-old female with history of transposition of great arteries, ventricular septal defect, pulmonary stenosis and placement of right modified Blalock-Taussig shunt complicated by thrombosis at age 9 days of life presented with episodes of upper extremity extension and gasping respirations concerning for seizure. Brain MRI demonstrated an extensive, acute right middle carotid artery (MCA) territory stroke with occlusion of the right proximal MCA. There was also a small left frontal stroke. Diffusion restriction abnormalities with simultaneous presence of hyperintensity on T2 sequences in the cotricospinal tract consist...
Source: Pediatric Neurology - October 31, 2014 Category: Neurology Authors: Olga D. Taraschenko, Charles Nichter, John Pugh Tags: Visual Diagnosis Source Type: research

Early Wallerian Degeneration in a Neonate With Middle Carotid Artery Stroke
A 23-day-old girl with a history of transposition of the great arteries, ventricular septal defect, pulmonary stenosis, and placement of right modified Blalock-Taussig shunt complicated by thrombosis at age 9 days of life presented with episodes of upper extremity extension and gasping respirations concerning for seizure. Brain magnetic resonance imaging demonstrated an extensive, acute right middle carotid artery territory stroke with occlusion of the right proximal middle carotid artery. There was also a small left frontal stroke.
Source: Pediatric Neurology - October 31, 2014 Category: Neurology Authors: Olga D. Taraschenko, Charles Nichter, John A. Pugh Tags: Visual Diagnosis Source Type: research

Toward a better understanding of PFO and stroke risk
A patent foramen ovale (PFO) is a remnant of the fetal circulation and may be found in approximately 25% of adults.1 Multiple case-control studies have demonstrated an association between PFO and cryptogenic ischemic stroke, particularly in younger patients.2 The mechanism for the association is presumed to be venous thromboembolism through the PFO and into the cerebral circulation (i.e., paradoxical embolization).3 Randomized studies of percutaneous PFO closure devices for secondary stroke prevention have been in progress for years with slow enrollment because of off-label use of atrial septal defect closure devices.4,5 T...
Source: Neurology - August 12, 2013 Category: Neurology Authors: Messe, S. R., Kernan, W. N. Tags: Stroke in young adults, Stroke prevention, Prognosis, Embolism EDITORIALS Source Type: research

Correlation of Atrial Septal Defect Size as Measured by Intracardiac Echocardiography and Transcranial Doppler Ultrasound in Children and Young Adults (P02.102)
CONCLUSIONS: Curtain result on TCD bubble studies is associated with significantly larger ASDs and other cardiac abnormalities in children and young adults.Disclosure: Dr. Doan has nothing to disclose. Dr. Barreto has nothing to disclose. Dr. Fulep has nothing to disclose. Dr. Bui has nothing to disclose. Dr. Butler has nothing to disclose.
Source: Neurology - February 14, 2013 Category: Neurology Authors: Doan, D., Barreto, A., Fulep, E., Bui, T.-T., Butler, I. Tags: P02 Child Neurology I Source Type: research