title: Paradoxical brain embolism in a young man: is it only a patent foramen ovale?
abstract: Paradoxical embolism is considered the major cause of cerebral ischemic events in young patients. The most common cause of paradoxical embolism, which has been widely described, is right-to-left shunting (RLS) at cardiac level through a patent foramen ovale (PFO). Rarely paradoxical embolism can also be caused by RLS at pulmonary level due to pulmonary arteriovenous fistula (PAVF). Herein, we present a case of a young man, who experienced transient ischemic attack (TIA) due to paradoxical embolism, in whom both abovementioned abnormalities coexisted. This coincidence is very rare (noted in only 1% of patients with cryptogenic stroke or TIA), but it highlights the importance of searching for extracardiac RLS in patients with cryptogenic stroke, even if a PFO has been detected.
authors: Department of Pediatric Cardiology and Congenital Heart Diseases, Medical University, Gdansk, Poland. Electronic address: lidiawozniak@yahoo.com.
authors: Lidia
authors: L
authors: Wozniak
authors: 1st Department of Cardiology, Medical University, Gdansk, Poland.
authors: Maksymilian
authors: M
authors: Mielczarek
authors: Department of Pediatric Cardiology and Congenital Heart Diseases, Medical University, Gdansk, Poland.
authors: Robert
authors: R
authors: Sabiniewicz
mesh_terms: D000293:Adolescent; D001164:Arteriovenous Fistula / Q000150:complications*; D019320:Embolism, Paradoxical / Q000150:complications* / Q000209:etiology; D054092:Foramen Ovale, Patent / Q000150:complications*; D006801:Humans; D020766:Intracranial Embolism / Q000150:complications* / Q000209:etiology; D002546:Ischemic Attack, Transient / Q000209:etiology*; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities*; D011667:Pulmonary Veins / Q000002:abnormalities*
keywords: Paradoxical embolism; Patent foramen ovale (PFO); Pulmonary arteriovenous fistula (PAVF); Right-to-left shunting (RLS)