title: Brain abscess associated with patent foramen ovale.
abstract: BACKGROUND
  Brain abscesses can develop with Tetralogy of Fallot and pulmonary anterior venous fistula with large right-to-left shunt. However, some patients exhibit cryptogenic brain abscess (CBA) in the absence of any such congenital disease or other infections. Patent foramen ovale (PFO) is a very common disease that exhibits right-to-left shunt. This study reports the potential for concern between CBA and PFO.
  
  
  METHODS
  We enrolled patients with CBA in our hospital between January 2003 and January 2013. Patients underwent transesophageal echocardiography (TEE) with contrast medium to investigate the presence of PFO.
  
  
  RESULTS
  Seven patients were included. Four were females, and the mean age was 67.7 ± 9.2 years. In all patients, TEE failed to reveal any new findings, however, six patients had PFO, and another patient had pulmonary arteriovenous shunt. Four patients had odontopathy.
  
  
  CONCLUSIONS
  In this study, all CBA patients exhibited right-to-left shunt. CBA might be caused by paradoxical embolization of a bacterial mass via PFO. Thus, more patients with CBA need to undergo TEE to detect PFO.
authors: Department of Neurosurgery and Clinical Neuroscience, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, Japan, sadapiro@yamaguchi-u.ac.jp.
authors: Hirokazu
authors: H
authors: Sadahiro
authors: Sadahiro
authors: S
authors: Nomura
authors: Akinori
authors: A
authors: Inamura
authors: Akiko
authors: A
authors: Yamane
authors: Kazutaka
authors: K
authors: Sugimoto
authors: Yuichi
authors: Y
authors: Fujiyama
authors: Michiyasu
authors: M
authors: Suzuki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001922:Brain Abscess / Q000150:complications / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged