Patent foramen ovale, stroke

Apart from atrial fibrillation, there are many other causes of cardioembolic stroke including prosthetic heart valves and patent foramen ovale (see Ch. 6). 

Diener HC, Weimar C, Katsarava Z (2005). Patent foramen ovale paradoxical connection to migraine and stroke. Current Opinion in Neurology 18 299-304... 

Gan R, Sacco RL, Kargman DE et al. (1997). Testing the vaUdity of the lacunar hypothesis the Northern Manhattan Stroke Study experience. Neurology 48 1204-1211 Gautier )G, Durr A, Koussa S et al. (1991). Paradoxical cerebral embohsm with a patent foramen ovale. A report of 29 patients. Cerebrovascular Diseases 1 193-202... 

Jeanrenaud X, Kappenberger L (1991). Patent foramen ovale and stroke of unknown origin. Cerebrovascular Diseases 1 184-192... 

Kizer JR, Devereux RB (2005). Clinical practice. Patent foramen ovale in young adults with unexplained stroke. New England Journal of Medicine 353 2361-2372 Koennecke H, Mast H, Trocio SH et al (1998). Frequency and determinants of microembolic signals on transcranial Doppler in unselected patients with acute carotid territory ischemia. A prospective study. Cerebrovascular Diseases 8 107-112... 

Lamy C, Giarmesini C, Zuber M et al. (2002). Clinical and imaging findings in cryptogenic stroke patients with and without patent foramen ovale the PFO-ASA Study (Atrial Septal Aneurysm). Stroke 33 706-711 Leung SY, Ng THK, Yuen ST et al. (1993). Pattern of cerebral atherosclerosis in Hong Kong Chinese severity in intracranial and extracranial vessels. Stroke 24 779-786 Leys D, Moulin Th, Stojkovic T et al. (1995). Follow-up of patients with history of cervical artery dissection. Cerebrovascular Diseases 5 43-49... 

Advances in Neurology 92 197-202 Mas JL, Arquizan C, Lamy C et al. (2001). Patent Foramen Ovale and Atrial Septal Aneurysm Study Group. Recurrent cerebrovascular events associated with patent foramen ovale atrial septal aneurysm or both. New England Journal of Medicine 345 1740-1746 Masuda J, Yutani C, Wald R et al. (1992). Histopathological analysis of the mechanisms of intracranial haemorrhage complicating infective endocarditis. Stroke 23 843-850 Matijevic N, Wu K (2006). Hypercoagulable states and strokes. Current Atherosclerosis Reports 8 324-329... 

Cardioembolic stroke—An ischemic stroke thought to be caused by an embolism arising from the heart. Cardioembolic stroke can be assumed in patients with significant cardiovascular disease including atrial fibrillation, dilated cardiomyopathy, prosthetic valves, recent MI and patent foramen ovale. 

Mas JL, Zuber M Recurrent cerebrovascular events in patients with patent foramen ovale, atrial septal aneurysm, or both and cryptogenic stroke or transient ischemic attack, french study group on patent foramen ovale and atrial septal aneurysm. Am Heart J 1995 130 pp. 1083-1088. 

Homma S, Sacco RL, Di TuUio MR, Sciacca RR, Mohr JP Effect of medical treatment in stroke patients with patent foramen ovale patent foramen ovale in cryptogenic stroke study. Circulation 2002 105 pp. 2625-2631. 

Cardiac resynchronization therapy has clearly demonstrated hemodynamic benefit in patients with advanced CHF (124-130). Successful stimulation of the Left ventricular (LV) is critical to this new therapeutic pacing modaUty. This can be accomplished by either an epicardial or endocardial approach. The endocardial approach involves access to the LV endocardium transatrially through a patent foramen ovale or a direct tiansseptal puncture. This approach is considered potentially dangerous because of the risk of thromboembolism and stroke (131). The epicardium of the LV can be accesses by direct placement... 

A 52-year-old woman with von Willebrand s disease was admitted for a surgical procedure. Preoperatively she received intravenous desmopressin 0.3 micrograms/kg and on the day after surgery she developed bilateral pulmonary emboli and an acute ischemic stroke. Echocardiography showed a small patent foramen ovale. She was anticoagulated and recovered without clinical sequelae. 

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