Clinical practice. Patent foramen ovale in young adults with unexplained stroke.
نویسندگان
چکیده
N Engl J Med 2005;353:2361-72. Copyright © 2005 Massachusetts Medical Society. A 38-year-old man notes abrupt loss of vision in his right visual field while reading. He has no significant medical history and reports that he neither smokes nor uses alcohol or illicit drugs. Physical examination reveals right homonymous hemianopia but no other abnormalities. Magnetic resonance imaging reveals acute left occipital infarction and normal head and neck vessels. Transesophageal echocardiography shows a patent foramen ovale without atrial septal aneurysm. What are the implications of this finding, and what therapy should be recommended?
منابع مشابه
Increased Incidence of Interatrial Block in Younger Adults with Cryptogenic Stroke and Patent Foramen Ovale
BACKGROUND Stroke is often unexplained in younger adults, although it is often associated with a patent foramen ovale (PFO). The reason for the association is not fully explained, and mechanisms other than paradoxical embolism may be involved. Young stroke patients with PFO have more atrial vulnerability than those without PFO. It is plausible that stretching of the interatrial septum may disru...
متن کاملPropensity Score–Based Analysis of Percutaneous Closure Versus Medical Therapy in Patients With Cryptogenic Stroke and Patent Foramen Ovale
Background—We sought to compare the benefit of percutaneous closure to that of medical therapy alone for the secondary prevention of embolism in patients with patent foramen ovale (PFO) and otherwise unexplained ischemic stroke, in a propensity scored study. Methods and Results—Between 2000 and 2012, we selected consecutive first-ever ischemic stroke patients aged 18 to 45 years with PFO and no...
متن کاملDiagnosis of an anatomically and physiologically significant patent foramen ovale.
The presence of an anatomically and physiologically significant patent foramen ovale (PFO) appears to be associated with several different clinical conditions,1 including unexplained neurological decompression sickness (DCS) in divers2–7 and aviators/astronauts,8–9 cryptogenic stroke,10–15 and the platypnea-orthodeoxia syndrome.16–20 Recently, it appears that migraine headache also may be assoc...
متن کاملPatent foramen ovale: is stroke due to paradoxical embolism?
BACKGROUND AND PURPOSE A patent foramen ovale has been reported to be significantly more frequent in young stroke patients than in matched control subjects, and paradoxical embolism has been suggested as the main mechanism of stroke in this situation. The present study was designed to test this hypothesis. METHODS Sixty-eight consecutive patients under 55 years of age presenting with an ische...
متن کاملStroke in young adults: the role of paradoxical embolism.
Stroke in young adults may be devastating and frequently no cause can be found. However, there is ample literature to suggest an association between cryptogenic stroke in young people and paradoxical embolisation via a venous to arterial circulation shunt (v-aCS), commonly due to patent foramen ovale (PFO). Although paradoxical embolisation is assumed to be a rare event, this review suggests th...
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ورودعنوان ژورنال:
- The New England journal of medicine
دوره 353 22 شماره
صفحات -
تاریخ انتشار 2005