Patent Foramen Ovale Size and Embolic Brain Imaging Findings Among Patients With Ischemic Stroke
- 1 May 1998
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 29 (5), 944-948
- https://doi.org/10.1161/01.str.29.5.944
Abstract
Background and Purpose —Although the cause of stroke among patients with patent foramen ovale (PFO) may be due to paradoxical cerebral embolism (PCE), this mechanism is often difficult to prove. The aim of our study was to evaluate the association between brain imaging findings suggestive of embolism and PFO among ischemic stroke patients. Methods —As part of the Northern Manhattan Stroke Study, 95 patients with first ischemic stroke over age 39 underwent transesophageal echocardiography (TEE) for evaluation of a cardiac source of embolism. The stroke subtype was determined by modified NINDS Stroke Data Bank criteria. Stroke subtype and MRI/CT imaging data were evaluated blind to the presence of a PFO. These findings were compared between two groups: patients with medium to large PFO (≥2 mm) and small (Results —Of the 95 patients who underwent TEE, 31 (33%) had a PFO. The frequency of PFO was significantly greater among patients with cryptogenic infarcts (19 of 42; 45%) compared with patients with determined cause of stroke (12 of 53, 23%; P =0.02). Medium to large PFOs were found more often among cryptogenic strokes than among infarcts of determined cause (26% versus 6%; P =0.04). Superficial infarcts occurred more often in the group with larger PFOs than in the group with small or no PFOs (50% versus 21%; P =0.02). Patients with medium or large PFOs more frequently had occipital and infratentorial strokes (57% versus 27%; P =0.02). Conclusions —Stroke patients with larger PFOs show more brain imaging features of embolic infarcts than those with small PFOs. Larger PFOs may be more likely to cause paradoxical embolization and may help explain the stroke mechanism among patients with no other definite cause.Keywords
This publication has 14 references indexed in Scilit:
- Stroke recurrence in patients with patent foramen ovaleNeurology, 1996
- Vascular distribution of paradoxical emboli by transcranial DopplerNeurology, 1993
- Brain embolism, revisitedNeurology, 1993
- Risk of patent foramen ovale for thromboembolic events in all age groupsThe American Journal of Cardiology, 1992
- Cardiogenic embolism to the brainThe Lancet, 1992
- Intraoperative Detection of Patent Foramen Ovale by Transesophageal EchocardiographyAnesthesiology, 1991
- Cerebellar infarction in the territory of the superior cerebellar arteryNeurology, 1990
- PATENT FORAMEN OVALE IN YOUNG STROKE PATIENTSThe Lancet, 1988
- Prevalence of Patent Foramen Ovale in Patients with StrokeNew England Journal of Medicine, 1988
- Paradoxical embolism: Diagnosis during lifeAmerican Journal Of Medicine, 1972