The objective of this study was to provide morphometric analysis of an accessory spine that was found within the lumen of the foramen ovale, as well as to find out whether this structure could mechanically irritate the mandibular nerve. A bifid spine was perceived in the macerated skull of an adult individual. It was located in the anterior part of the left foramen ovale. The overall length...

OBJECTIVE To report a specific pathophysiology of hemidiaphragmatic paralysis that may result in severe hypoxemia. DESIGN Case series. SETTING Intensive care unit in a cardiology hospital. PATIENTS The series included three patients with refractory hypoxemia in whom a diagnosis of right-to-left-shunt through a patent foramen ovale was made by contrast echocardiography. The three patients ...

We describe the case of a woman who presented to the intensive care unit with acute respiratory failure that required mechanical ventilation. She had severe pulmonary hypertension secondary to interstitial lung disease, and her history included sarcoidosis and tuberculosis. She was dependent on inhaled nitric oxide (INO) to maintain safe arterial oxygen saturation and could not be weaned from ...

A36-year-old woman with a 3-week history of shortness of breath was admitted to the hospital after having suffered syncope. She also complained of left-sided leg pain. Duplex ultrasound revealed a right-sided proximal deep venous thrombosis and an occluded left popliteal artery. Echocardiography demonstrated a dilated right ventricle and tricuspid regurgitation with an estimated pulmonary systo...

Air embolism is a rare complication of percutaneous nephrolithotomy. Patent foramen ovale, which is necessary in fetal circulation, is a potential route for emboli arising from the venous system to enter the systemic arterial circulation, resulting in paradoxical air embolism syndrome. A case of paradoxical air embolism during percutaneous nephrolithotomy is presented. To our knowledge, this is...

This manuscript will focus on a rare complication: shunting through a patent foramen ovale (PFO) as a long term complication of right sided pneumonectomy or bilobectomy. Three patients who were diagnosed with shunting through a patent foramen ovale following lung resection are described. In these patients right ventricular compression by the elevated right hemidiaphragm was the cause of shuntin...

= Abstract =An autopsy case is described of a premature closure of the foramen ovale with a marked dilatation of the left atrium and an intact ventricular septum with aortic atresia but without left ventricular hypoplasia. This 28-week-old male baby was a stillborn to a 34-year-old multiparous mother. An intrauterine sonogram revealed marked ascites with anasarca, an enlarged left atrium and ve...

Dyspnea and hypoxemia are among the most common symptoms and signs that need to be assessed in clinical practice. This case illustrates how simple steps in history taking and physical examination can be crucial for diagnosis. We present a patient with intermittent hypoxemia, initially attributed to a pulmonary infection. However, the hypoxemia persisted even after successful treatment of the in...

Previous randomized trials on patent foramen ovale (PFO) Background: closure versus medical therapy for stroke prevention were inconclusive. Recently, two new randomized trials and new findings from an extended follow-up of a previous trial have been published on this topic. We conducted a systematic review and meta-analysis of randomized trials comparing PFO closure with medical therapy for st...

Isolated hand paresis is a rare presentation of stroke, which mostly results from a lesion in the cortical hand motor area, a knob-like area within the precentral gyrus. I report the case of a patient who experienced recurrent ischemic stroke alternately involving bilateral hand knob areas, causing isolated hand paresis. There was no abnormal finding on brain and neck magnetic resonance angiogr...