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Can neuroimaging differentiate PFO and AF-related cardioembolic stroke from the other embolic sources? Clinical-radiological correlation on a retrospective study

  • CARDIAC RADIOLOGY
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Abstract

Purpose

The aim of this retrospective study was to map the specific ischemic lesion patterns of distribution in patent foramen ovale-related stroke (PFO-stroke) and atrial fibrillation-related stroke (AF-stroke) in patients with idiopatic ischemic stroke.

Materials and methods

750 ischaemic strokes were screened on basis of diagnostic imaging and tests: patients with known causes were excluded. 171 patients with unknown cause were selected and divided in two groups: AF-stroke (43 patients) and PFO-stroke (128 patients). Vascular territories of ischemic involvement were divided into four classes in each group: the anterior cerebral artery, the middle cerebral artery, the vertebro-cerebral artery (including the posterior cerebral artery) and multisite (MS) involvement.

Results

Infarcts in vertebro-basilar territory and multisite represented each one about 32% of infarcts in PFO-stroke group and their involvement are more frequent than AF-stroke group (p = 0.03). Ischemic lesions in PFO-group were predominantly cortical (34.3%), and in AF-group cortical-subcortical (60.4%). Multisite pattern of ischemic lesion was more frequent in patients with severe degree of right to left shunts (37.5%).

Conclusion

In clinical practice, PFO may be considered a cause of cortical stroke on the basis of radiological findings, when VB vascular territory or MS brain involvement is present in younger patients (<50 age).

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Authors and Affiliations

  1. Neuroradiology Unit, Radiology Department, “Maggiore della Carità” Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy

    Alessandro Stecco

  2. Radiology Department, “Maggiore della Carità” Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy

    Martina Quagliozzi, Eleonora Soligo, Alessia Cassarà, Paola Amatuzzo, Francesco Buemi, Elena Guenzi & Alessandro Carriero

  3. Neurology Department, “Maggiore della Carità” Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy

    Andrea Naldi & Lorenzo Coppo

  4. Cardiology Department, “Maggiore della Carità” Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy

    Roberta Rosso & Angelo Sante Bongo

Authors
  1. Alessandro Stecco
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  2. Martina Quagliozzi
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  3. Eleonora Soligo
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  5. Alessia Cassarà
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  7. Roberta Rosso
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  10. Francesco Buemi
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Correspondence to Alessandro Stecco.

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Ethical statement

This type of work does not require approval by Ethics Committee, because of the retrospective nature of the study, but before all diagnostic exams patients received and signed informed consent.

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Stecco, A., Quagliozzi, M., Soligo, E. et al. Can neuroimaging differentiate PFO and AF-related cardioembolic stroke from the other embolic sources? Clinical-radiological correlation on a retrospective study. Radiol med 122, 412–418 (2017). https://doi.org/10.1007/s11547-017-0738-6

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  • DOI: https://doi.org/10.1007/s11547-017-0738-6

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