Abstract
We present a case of stroke in a young girl, preceded by a deep vein thrombosis and pulmonary embolism, both clinically asymptomatic, and accompanied by upper limb acute ischemia. Diagnosis of paradoxical embolism through a patent foramen ovale was made on clinical grounds and with contrast echocardiography. We discuss the main points leading to diagnosis, stressing the importance of contrast echocardiography. We also suggest that paradoxical embolism could be a more frequent cause of stroke than usually suspected.
Sommario
Presentiamo il caso di un ictus in una ragazza, preceduto da trombosi venosa profonda ed embolia polmonare, entrambi clinicamente asintomatici, ed accompagnato da ischemia acuta di un braccio. Abbiamo diagnosticato un'embolia paradossa attraverso un forame ovale pervio, sulla scorta dei dati clinici e dell'ecocardiogramma con mezzo di contrasto.
Discutiamo poi le basi diagnostiche dell'embolia paradossa, sottolineando l'importanza dell'ecocardiografia con contrasto.
Suggeriamo inoltre che l'embolia paradossa possa essere causa di ictus più frequentemente di quanto solitamente si sospetti.
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References
Adams RD, Victor M:Principles of neurology; 3rd edition, McGraw-Hill, New York, pp. 605–609, 1985.
Biller J., Adams HP Jr, Johnson MR et al.Paradoxical cerebral embolism: eight cases. Neurology 36:1356–1360, 1986.
Biller, J., Johnson MR, Adams HP Jr et al.,:Further observations on cerebral or retinal ischemia in patients with right-left intracardiac shunts. Arch Neurol 44:740–743, 1987.
Bogousslavski J., Van Melle G., Regli F.:The Lausanne stroke registry: analysis of 1.000 consecutive patients with first stroke. Stroke 19:1083–1092, 1988.
Dubourg O., Bourdarias J-P, Farcot J-C, et al:Contrast echocardiographic visualization of cough-induced right to left shunt through a patent foramen ovale. J Am Coll Cardiol 4:587–594, 1984.
Hagen PT, Scholz DG, Edwards WD:Incidence and size of patent foramen ovale during the first ten decades of life: an autopsy study of 965 normal hearts. Mayo Clin Proc 59: 17–20, 1984.
Lachat PH, Mas JL, Lescault G et al:Prevalence of patent foramen ovale in patients with stroke. N. Engl J Med 318: 1148–1152, 1988.
Rosenow EC III, Osmundson PJ, Brown ML:Pulmonary embolism. Mayo Clin Proc 56: 161–178, 1981.
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Frisoni, G.B., Di Monda, V. & Bariselli, M. Stroke due to paradoxical embolism. Ital J Neuro Sci 11, 61–64 (1990). https://doi.org/10.1007/BF02334907
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DOI: https://doi.org/10.1007/BF02334907