title: The relationship of patent foramen ovale location with severity of stroke: A new risk factor for paradoxical embolism.
abstract: OBJECTIVE
  Patent foramen ovale (PFO) is a common developmental anomaly and is well associated with paradoxical embolism and cryptogenic stroke. The aim of this study was to investigate the relationship of PFO location with severity of cryptogenic stroke.
  
  
  METHODS
  Fifty patients with cryptogenic stroke and echocardiographically proven PFO were classified according to the severity of stroke. In order to define the location of PFOs, an imaginary line dividing the length of interatrial septum vertically into two equal parts was drawn manually at axial plane on cardiac multidetector computed tomography. PFOs located at superior part of this imaginary line was defined as superiorly located PFO, while PFOs located at inferior part of this imaginary line was defined as inferiorly located PFO.
  
  
  RESULTS
  Fourteen patients (28%) revealed mild, 20 patients (40%) revealed moderate and 16 patients (32%) had severe stroke. Based on PFO location, there were 34 patients (68%) with superiorly (group 1), and 16 patients (32%) with inferiorly (group 2) located PFO. It was found that patients of group 1 had significantly higher frequency of moderate or severe stroke compared to those of group 2 (p < 0.005) CONCLUSION: In conclusion, the patients with superiorly located PFO had higher frequency of severe stroke compared to the patients with inferiorly located PFO. Since this is a preliminary study, clinical application and importance of this finding necessitates further large-scale interventional studies.
authors.affiliation: a Department of Radiology , School of Medicine, Bozok University , Yozgat , Turkey.
authors.forename: Mustafa Fatih
authors.initials: MF
authors.lastname: Erkoç
authors.affiliation: b Department of Radiology , School of Medicine, Cumhuriyet University , Sivas , Turkey.
authors.forename: Bilge
authors.initials: B
authors.lastname: Öztoprak
authors.affiliation: a Department of Radiology , School of Medicine, Bozok University , Yozgat , Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Okur
authors.affiliation: c Department of Cardiology , School of Medicine, Bozok University , Yozgat , Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ede
authors.affiliation: d Department of Cardiology , State Hospital of Sivas , Sivas , Turkey.
authors.forename: Özcan
authors.initials: Ö
authors.lastname: Örsçelik
authors.affiliation: e Department of Radiology , School of Medicine, Atatürk University , Erzurum , Turkey.
authors.forename: Mecit
authors.initials: M
authors.lastname: Kantarcı
authors.affiliation: e Department of Radiology , School of Medicine, Atatürk University , Erzurum , Turkey.
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Kızrak
mesh_terms: D000328:Adult; D019320:Embolism, Paradoxical / Q000150:complications / Q000453:epidemiology*; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000453:epidemiology* / Q000473:pathology
keywords: Cardiac computed tomography; Patent foramen ovale; Stroke