title: Can neuroimaging differentiate PFO and AF-related cardioembolic stroke from the other embolic sources? Clinical-radiological correlation on a retrospective study.
abstract: OBJECTIVE
  The aim of this retrospective study was to map the specific ischemic lesion patterns of distribution in patent foramen ovale-related stroke (PFO-stroke) and atrial fibrillation-related stroke (AF-stroke) in patients with idiopatic ischemic stroke.
  
  
  METHODS
  750 ischaemic strokes were screened on basis of diagnostic imaging and tests: patients with known causes were excluded. 171 patients with unknown cause were selected and divided in two groups: AF-stroke (43 patients) and PFO-stroke (128 patients). Vascular territories of ischemic involvement were divided into four classes in each group: the anterior cerebral artery, the middle cerebral artery, the vertebro-cerebral artery (including the posterior cerebral artery) and multisite (MS) involvement.
  
  
  RESULTS
  Infarcts in vertebro-basilar territory and multisite represented each one about 32% of infarcts in PFO-stroke group and their involvement are more frequent than AF-stroke group (p = 0.03). Ischemic lesions in PFO-group were predominantly cortical (34.3%), and in AF-group cortical-subcortical (60.4%). Multisite pattern of ischemic lesion was more frequent in patients with severe degree of right to left shunts (37.5%).
  
  
  CONCLUSIONS
  In clinical practice, PFO may be considered a cause of cortical stroke on the basis of radiological findings, when VB vascular territory or MS brain involvement is present in younger patients (<50 age).
authors.affiliation: Neuroradiology Unit, Radiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy. a.stecco@libero.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Stecco
authors.affiliation: Radiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Quagliozzi
authors.affiliation: Radiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Soligo
authors.affiliation: Neurology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Naldi
authors.affiliation: Radiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Cassarà
authors.affiliation: Neurology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Coppo
authors.affiliation: Cardiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Rosso
authors.affiliation: Cardiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Angelo Sante
authors.initials: AS
authors.lastname: Bongo
authors.affiliation: Radiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Amatuzzo
authors.affiliation: Radiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Buemi
authors.affiliation: Radiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Guenzi
authors.affiliation: Radiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Carriero
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology*
keywords: Atrial fibrillation; Computed tomography; Magnetic resonance imaging; Patent foramen ovale; Stroke; Vascular territories