Problems in identifying paradoxical cerebral embolism: Case report with discussion.
We report a case of paradoxical cerebral embolism in a 63-year-old man with newly diagnosed rectal cancer. The onset was heralded by nearly simultaneous pulmonary embolism and left hemiplegia. He was subsequently found to have deep venous thrombosis. Despite placement of a vena caval filter, a second cerebral infarction occurred in the opposite hemisphere. Air contrast transthoracic echocardiography was negative, but autopsy revealed a patent foramen ovale. Problems in the identification of paradoxical embolism are discussed.
From the Department of Neurology, University of Mississipi Medical Center, Jackson, MS, U.S.A.
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