title: [Functional outcome after one year follow-up in cryptogenetic brain infarction and patent foramen ovale].
abstract: OBJECTIVE
  The presence of patent foramen ovale (PFO) and atrioseptal aneurysm (ASA)has been described as a risk factor in cryptogenetic stroke. Patients with unknown origin stroke and PFO have less severe symptoms compared to the rest of cryptogenetic stroke patients. We evaluated the clinical situation in stroke patients with PFO and describe the factors predictive of a better outcome after a year.
  
  
  METHODS
  1118 patients between 18 and 70 years old were evaluated, and 223 were classified as having cryptogenetic stroke. Our protocol Included transcranial Doppler, a transesophageal echocardiography (TEE) and a cranial RM. We used the NIH Stroke Scale (NIHSS) to evaluate the clinical situation, and the modified Ranking Scale for the functional outcome.
  
  
  RESULTS
  A total of 117 patients had all inclusion criteria. 66 (56.4%) showed a PFO. We observed a younger age, a higher percentage of females (48.4% in PFO vs. 25.5% in no-PFO) and less risk factors in PFO patients, except for migraine (24.6% in PFO vs. 5.9% in no-PFO; p = 0.01). PFO patients had less severe strokes (NIHSS: 3--median--in PFO vs. 5 in no-PFO; p = 0.010) and a lower grade of sequelae (p 0.024). Worse outcome was related to male, initial neurological evaluation (NIHSS) and presence of ASA. After a logistic regression, only the initial clinical situation (NIHSS) and the presence of ASA were associated with sequelae.
  
  
  CONCLUSIONS
  PFO patients showed a less severe stroke and better functional outcome. The initial neurological involvement and the presence of ASA are predictive of the clinical situation after a year.
authors.affiliation: Servicio de Neurología, Hospital Vall d'Hebron, Barcelona, Spain. esantama@vhebron.net
authors.forename: Esteban
authors.initials: E
authors.lastname: Santamarina
authors.forename: Marta
authors.initials: M
authors.lastname: Rubiera
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Molina
authors.forename: M Teresa
authors.initials: MT
authors.lastname: González Alujas
authors.forename: Arturo
authors.initials: A
authors.lastname: Evangelista
authors.forename: Verónica
authors.initials: V
authors.lastname: Muñoz
authors.forename: Alex
authors.initials: A
authors.lastname: Rovira
authors.forename: Manuel
authors.initials: M
authors.lastname: Quintana
authors.forename: José
authors.initials: J
authors.lastname: Alvarez Sabín
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000150:complications / Q000000981:diagnostic imaging; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology*; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging; D006346:Heart Septum; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013997:Time Factors