Arquivos de Neuro-Psiquiatria (Dec 2005)

Alterações do septo interatrial e acidente vascular cerebral isquêmico em adultos jovens Abnormalities of interatrial septum and ischemic stroke in young people

  • Edson M. Negrão,
  • Ivar V. Brandi,
  • Simone V. Nunes,
  • Paulo S.S. Beraldo

DOI
https://doi.org/10.1590/S0004-282X2005000600025
Journal volume & issue
Vol. 63, no. 4
pp. 1047 – 1053

Abstract

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OBJETIVO: Avaliar a freqüência de forame oval patente (FOP) em pacientes com acidente cerebrovascular isquêmico (AVCI) criptogênico ou de causa definida, investigados com doppler transcraniano (DTC) e ecocardiograma transesofágico. Paralelamente, examinar a validade diagnóstica do primeiro, comparado ao segundo método. MÉTODO: Retrospectivamente, foram estudados 124 pacientes (OBJECTIVE: To verify the frequency of patent foramen ovale (PFO) among patients with ischemic stroke (cryptogenic or with a known cause) investigated by transcranial doppler (TCD) and transesophageal echocardiography. Secondarily, to determine the diagnostic validity of the former, compared with the later method. METHOD: Retrospectively, 124 patients (<51 years old) with ischemic stroke were submitted to TCD and or transesophageal echocardiography. The patients were classified as cryptogenic stroke or not. RESULTS: We could found an important association between cryptogenic ischemic stroke and PFO (odds ratio 4.3 - CI 95% 1.7 - 10.7). Only five cases of interatrial septal aneurysm were diagnosed among patients with PFO. Sensitivity, specificity and positive and negative predictive values exhibited values upper of 85%, equivalents, at least based on confidence intervals. CONCLUSION: We could determine, for the first time in our country, a strong association between cryptogenic ischemic stroke and PFO. The TCD is a valuable diagnostic resource in this context since its validity was considered excellent. A detailed investigation in these cases should always be done due to the possibility of FOP closure.

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