{"title":"Patent Foramen Ovale And Stroke In Adolescents - To Close Or Not To Close?","authors":"Sónia Silva","doi":"10.24966/ncp-878x/100041","DOIUrl":null,"url":null,"abstract":"Stroke is a rare condition in childhood and about half of the cases are due to an arterial ischemic event. Although the long list of known causes, many cases remain undetermined, so-called cryptogenic strokes. However, increasing evidence indicates that some of these cryptogenic cases can be a result of a paradoxical embolism via a Patent Foramen Ovale (PFO) with a right-to-left intracardiac shunt, but the exact contribution of PFO to stroke or stroke recurrence in childhood remains unclear. Considering this, as a second line of study, a transthoracic and transoesophageal echocardiogram should be done in all cases to rule out a possible right-to-left shunt, such as PFO. Optimal treatment for acute ischemic strokes in children is con-troversial, with lacking studies. Closure of PFO should be considered as a preventive measure depending on individual risk factors and anatomic features. We present two cases of a 16-year-old boy and a 17-year-old girl who had an event of cerebral ischemia documented on MRI, and in whom was found a PFO with a shunt, with the remaining exhaustive etiologic investigation all negative. Both of them underwent percutaneous closure of the PFO.","PeriodicalId":73255,"journal":{"name":"HSOA journal neonatology & clinical pediatrics","volume":"1 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2019-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HSOA journal neonatology & clinical pediatrics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.24966/ncp-878x/100041","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Stroke is a rare condition in childhood and about half of the cases are due to an arterial ischemic event. Although the long list of known causes, many cases remain undetermined, so-called cryptogenic strokes. However, increasing evidence indicates that some of these cryptogenic cases can be a result of a paradoxical embolism via a Patent Foramen Ovale (PFO) with a right-to-left intracardiac shunt, but the exact contribution of PFO to stroke or stroke recurrence in childhood remains unclear. Considering this, as a second line of study, a transthoracic and transoesophageal echocardiogram should be done in all cases to rule out a possible right-to-left shunt, such as PFO. Optimal treatment for acute ischemic strokes in children is con-troversial, with lacking studies. Closure of PFO should be considered as a preventive measure depending on individual risk factors and anatomic features. We present two cases of a 16-year-old boy and a 17-year-old girl who had an event of cerebral ischemia documented on MRI, and in whom was found a PFO with a shunt, with the remaining exhaustive etiologic investigation all negative. Both of them underwent percutaneous closure of the PFO.