Yang-Yang Huang1, Bei Shao2, Xian-Da Ni3, Jian-Ce Li4. 1. Department of Neurology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. 2. Department of Neurology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. Electronic address: shaobei56@126.com. 3. Department of Ultrasonography, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. 4. Department of Radiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Abstract
BACKGROUND: The present study aimed to determine lesion patterns and the stroke mechanisms in cryptogenic ischemic stroke patients with patent foramen ovale (PFO) on T2-weighted magnetic resonance imaging (T2WI) and fluid-attenuated inversion recovery (FLAIR) sequences combined. METHODS: In this retrospective study, 38 patients with cryptogenic stroke and an isolated PFO compared with 51 cryptogenic stroke patients without PFO were evaluated and their characteristics of lesion patterns on T2WI and FLAIR sequences combined were investigated. The number, distribution of small ischemic lesions, and the frequency of multiple small ischemic lesions were analyzed between the 2 groups. RESULTS: Thirty-two of 38 patients had a total of 341 small ischemic lesions in cryptogenic stroke patients with PFO versus 24 of 51 patients with 156 small ischemic lesions in patients without PFO, and, 8.97±7.91 and 3.19±4.82 ischemic lesions per person, respectively. Multiple small ischemic lesions occurred more frequently in cryptogenic stroke patients with PFO (25 of 38 patients, 66%) than in patients without PFO (16 of 51 patients, 31%; P=.001). Subcortical frontal and parietal small lesions were more frequent in cryptogenic stroke patients with PFO (28 of 38 patients, 74%) than in patients without PFO (18 of 51 patients, 35%; P<.0001). CONCLUSIONS: Multiple small ischemic lesions and subcortical frontal and parietal small lesions were significantly associated with cryptogenic stroke patients with PFO, suggesting that paradoxical embolism may be the mechanism of PFO-associated cryptogenic stroke patients.
BACKGROUND: The present study aimed to determine lesion patterns and the stroke mechanisms in cryptogenic ischemic strokepatients with patent foramen ovale (PFO) on T2-weighted magnetic resonance imaging (T2WI) and fluid-attenuated inversion recovery (FLAIR) sequences combined. METHODS: In this retrospective study, 38 patients with cryptogenic stroke and an isolated PFO compared with 51 cryptogenic strokepatients without PFO were evaluated and their characteristics of lesion patterns on T2WI and FLAIR sequences combined were investigated. The number, distribution of small ischemic lesions, and the frequency of multiple small ischemic lesions were analyzed between the 2 groups. RESULTS: Thirty-two of 38 patients had a total of 341 small ischemic lesions in cryptogenic strokepatients with PFO versus 24 of 51 patients with 156 small ischemic lesions in patients without PFO, and, 8.97±7.91 and 3.19±4.82 ischemic lesions per person, respectively. Multiple small ischemic lesions occurred more frequently in cryptogenic strokepatients with PFO (25 of 38 patients, 66%) than in patients without PFO (16 of 51 patients, 31%; P=.001). Subcortical frontal and parietal small lesions were more frequent in cryptogenic strokepatients with PFO (28 of 38 patients, 74%) than in patients without PFO (18 of 51 patients, 35%; P<.0001). CONCLUSIONS: Multiple small ischemic lesions and subcortical frontal and parietal small lesions were significantly associated with cryptogenic strokepatients with PFO, suggesting that paradoxical embolism may be the mechanism of PFO-associated cryptogenic strokepatients.