[A 49-year-old woman with deep vein thrombosis, pulmonary embolism, and left-sided paralysis].
We report the case of a 49-year-old female patient who was admitted stationary because of a left-sided paralysis which had appeared some hours before. An embolic occlusion of the right A. cerebri media turned out to be the cause. A paradoxical embolism could be assumed because of an existing deep vein thrombosis and an increased right-ventricular pressure within a hemodynamically relevant fulminant pulmonary embolism as well as the additional existence of a patent foramen ovale (PFO). Systemic lysis as treatment of the pulmonary embolism was contraindicated because slight bleeding had occurred in the area of the right basal ganglia after treatment of the embolic occlusion of the right A. cerebri media by a local lysis. Subsequently and in the acuteness, a catheter interventional PFO-closure via a double-umbrella device was placed and the pulmonary embolism was effectively treated by a local lysis through the insertion of a pigtail-catheter into the right pulmonary artery.
Jurisch
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D
Einheit für multidisziplinäre Intensivmedizin, Universitätsklinikum Leipzig, Liebigstrasse 20, 04103, Leipzig, Deutschland. daniel.jurisch@medizin.uni-leipzig.de
Szokodi
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D
Pfeiffer
D
D
Kahn
T
T
Engelmann
L
L
D000483:Alleles; D006328:Cardiac Catheterization; D004252:DNA Mutational Analysis; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D004452:Echocardiography; D017128:Embolectomy; D019320:Embolism, Paradoxical / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics / Q000628:therapy; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D006580:Genetic Carrier Screening; D006429:Hemiplegia / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics / Q000628:therapy; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics / Q000628:therapy; D008875:Middle Aged; D019919:Prosthesis Implantation; D011516:Prothrombin / Q000235:genetics*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics / Q000628:therapy; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000235:genetics / Q000628:therapy
D011516:Prothrombin