Stroke in Young Adults: The Role of Paradoxical Embolism

2001 ◽  
Vol 85 (01) ◽  
pp. 22-29 ◽  
Author(s):  
Harvey Chant ◽  
Charles McCollum
Keyword(s):  
Young Adults ◽  
Young People ◽  
Cryptogenic Stroke ◽  
Rare Event ◽  
Paradoxical Embolism ◽  
Foramen Ovale ◽  
Arterial Circulation ◽  
Stroke In Young Adults ◽  
Stroke In Young

SummaryStroke 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 that it is an important or even dominant cause of stroke in young people and that a transcranial Doppler (TCD) technique may be the investigation of choice to identify v-aCS.Appendix I, II on pp. 26-7

scholarly journals The management of cryptogenic stroke in pregnancy

2011 ◽  
Vol 4 (1) ◽  
pp. 2-6 ◽  
Author(s):  
E A Orchard ◽  
N Wilson ◽  
O J M Ormerod
Keyword(s):  
Cryptogenic Stroke ◽  
Postpartum Women ◽  
Foramen Ovale ◽  
Cerebrovascular Accidents ◽  
Stroke In Young Adults ◽  
Paradoxical Emboli ◽  
Pregnant State ◽  
In Pregnancy ◽  
Stroke In Young

Cerebrovascular accidents (CVAs) during pregnancy are uncommon but can have devastating consequences. The causes of CVA in both the pregnant and the non-pregnant state are diverse and require thorough investigation. Recent studies have indicated that embolic stroke in young adults may be caused by paradoxical emboli through a patent foramen ovale (PFO), suggesting that the presence of a PFO should be specifically sought in pregnant or postpartum women presenting with CVA. This review will outline the causes of CVAs in pregnancy and the role of paradoxical emboli, with a focus on PFO.

Patent Foramen Ovale, the Role of Antiplatelet Therapy Alone or Anticoagulant Therapy Alone Versus Device Closure for Cryptogenic Stroke: A Review of the Literature and Current Recommendations

2020 ◽  
Vol 18 (2) ◽  
pp. 135-150
Author(s):  
Harsha S. Nagarajarao ◽  
Chandra P. Ojha ◽  
Archana Kedar ◽  
Debabrata Mukherjee
Keyword(s):  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Narrow Channel ◽  
Paradoxical Embolism ◽  
Current Evidence ◽  
Foramen Ovale ◽  
The Right ◽  
The Relationship ◽  
Current Guidelines

: Cryptogenic stroke and its relation to the Patent Foramen Ovale (PFO) is a long-debated topic. Recent clinical trials have unequivocally established the relationship between cryptogenic strokes and paradoxical embolism across the PFO. This slit-like communication exists in everyone before birth, but most often closes shortly after birth. PFO may persist as a narrow channel of communication between the right and left atria in approximately 25-27% of adults. : In this review, we examine the clinical relevance of the PFO with analysis of the latest trials evaluating catheter-based closure of PFO’s for cryptogenic stroke. We also review the current evidence examining the use of antiplatelet medications versus anticoagulants for stroke prevention in those patients with PFO who do not qualify for closure per current guidelines.

scholarly journals Patent Foramen Ovale and Cryptogenic Stroke: Challenges in Diagnosis and Management

2021 ◽  
Vol 42 (3) ◽  
Author(s):  
Dhanang Ali Yafi ◽  
Azmi Azmi
Keyword(s):  
Patent Foramen Ovale ◽  
Adult Population ◽  
Management Strategies ◽  
Cryptogenic Stroke ◽  
Paradoxical Embolism ◽  
Foramen Ovale ◽  
Arterial Circulation ◽  
Systemic Embolization ◽  
The Relationship ◽  
Pfo Closure

A patent foramen ovale (PFO) is a common disorder that affects between 20-34% of the adult population. This condition is a benign finding for most people. However, In some the PFO can open widely and enabling paradoxical embolism to transit from venous to arterial circulation, which is associated with stroke and systemic embolization. There are still unclear to date regarding the effectiveness of pharmacological anticoagulant therapy, defined as antithrombin or antiplatelet therapy, which has proven to be more beneficial for patients with PFO and cryptogenic stroke. In addition, surgical and transcutaneous PFO closure has been proposed for secondary prevention of stroke in patients with cryptogenic stroke with PFO. Both catheter-based and surgical modes of closure have been shown to reduce the incidence of subsequent embolism substantially. This review will discuss the evidence regarding the relationship between PFO and cryptogenic stroke and decision making for management strategies.

scholarly journals Stroke in young adults

2018 ◽  
Vol 8 (6) ◽  
pp. 501-506 ◽  
Author(s):  
Nirav Bhatt ◽  
Amer M. Malik ◽  
Seemant Chaturvedi
Keyword(s):  
Young Adults ◽  
Ischemic Stroke ◽  
Management Strategies ◽  
Cryptogenic Stroke ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Stroke In Young Adults ◽  
New Information ◽  
Traditional Risk Factors ◽  
Stroke In Young

Purpose of reviewThe incidence of stroke in young adults is increasing, mainly driven by an increasing incidence of ischemic stroke in this population. We provide new information that has been recently presented regarding the risk factor prevalence, some specific etiologic causes, and management strategies in ischemic stroke in this population.Recent findingsRecent studies indicate a rapid increase in traditional risk factors in young adults. New information regarding the management of patent foramen ovale in cryptogenic stroke and cervical artery dissection is available.SummaryStroke in young adults is a rapidly growing problem with deep public health implications. There are many areas in this field, which require further research.

scholarly journals Interaction between proatherosclerotic factors and right-to-left shunt on the risk of cryptogenic stroke: the Italian Project on Stroke in Young Adults

Heart ◽  
2012 ◽  
Vol 98 (6) ◽  
pp. 485-489 ◽  
Author(s):  
Alessandro Pezzini ◽  
Mario Grassi ◽  
Corrado Lodigiani ◽  
Rosalba Patella ◽  
Carlo Gandolfo ◽  
...  
Keyword(s):  
Young Adults ◽  
Cryptogenic Stroke ◽  
Stroke In Young Adults ◽  
Stroke In Young

Blood Pressure, Smoking and Oral Contraceptive Control after Cryptogenic Stroke in Young Adults in the PFO-ASA Study

2005 ◽  
Vol 20 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Caroline Arquizan ◽  
Emmanuel Touzé ◽  
Thierry Moulin ◽  
France Woimant ◽  
Xavier Ducrocq ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Oral Contraceptive ◽  
Cryptogenic Stroke ◽  
Stroke In Young Adults ◽  
Stroke In Young

Tobacco Use and Cryptogenic Stroke in Young Adults

2015 ◽  
Vol 24 (12) ◽  
pp. 2694-2700 ◽  
Author(s):  
Aude Jaffre ◽  
Jean Bernard Ruidavets ◽  
Nathalie Nasr ◽  
Brigitte Guidolin ◽  
Jean Ferrieres ◽  
...  
Keyword(s):  
Young Adults ◽  
Tobacco Use ◽  
Cryptogenic Stroke ◽  
Stroke In Young Adults ◽  
Stroke In Young
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