BMC Neurology (Dec 2010)

Decrease in shunt volume in patients with cryptogenic stroke and patent foramen ovale

  • Pabst Wolfgang,
  • Stolz Erwin,
  • Jauss Marek,
  • Kaps Manfred,
  • Tanislav Christian,
  • Nedelmann Max,
  • Grebe Mathias,
  • Reichenberger Frank,
  • Allendoerfer Jens

DOI
https://doi.org/10.1186/1471-2377-10-123
Journal volume & issue
Vol. 10, no. 1
p. 123

Abstract

Read online

Abstract Background In patients with patent foramen ovale (PFO) there is evidence supporting the hypothesis of a change in right-to-left shunt (RLS) over time. Proven, this could have implications for the care of patients with PFO and a history of stroke. The following study addressed this hypothesis in a cohort of patients with stroke and PFO. Methods The RLS volume assessed during hospitalisation for stroke (index event/T0) was compared with the RLS volume on follow-up (T1) (median time between T0 and T1 was 10 months). In 102 patients with a history of stroke and PFO the RLS volume was re-assessed on follow-up using contrast-enhanced transcranial Doppler/duplex (ce-TCD) ultrasound. A change in RLS volume was defined as a difference of ≥20 microembolic signals (MES) or no evidence of RLS during ce-TCD ultrasound on follow-up. Results There was evidence of a marked reduction in RLS volume in 31/102 patients; in 14/31 patients a PFO was no longer detectable. An index event classified as cryptogenic stroke (P Conclusions RLS volume across a PFO decreases over time, especially in patients with cryptogenic stroke. These may determine the development of new strategies for the management in the secondary stroke prevention.