Abstract
A 40-year-old female patient without clinical risk factors for stroke experienced a short episode of hemiparesis. CT and MR imaging revealed multiple small ischemic lesions of both cerebral hemispheres. Neurological testing showed decreased short-term memory and attention. Coagulopathy screen and cardiac rhythm monitoring were negative. A persistent foramen ovale (PFO) was evident on transesophageal echocardiography and a spontaneous right-to-left shunting was demonstrated using agitated saline contrast. The atrial septum was found to be aneurysmal with a maximum excursion of 12 mm. No other structural abnormalities were noted. Paradoxical embolism was considered a probable cause for the multiple cerebral lesions. The patient was offered device closure of the PFO, which she accepted.
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Olsen, N.T., Sondergaard, L. (2017). Difficult Cases and Complications from the Catheterization Laboratory: PFO Device Embolization and Settling in the Distal Aorta. In: Reimers, B., Moussa, I., Pacchioni, A. (eds) Percutaneous Interventions for Structural Heart Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-43757-6_22
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