Abstract
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Highlights
To the Editor: Paradoxical embolism via a patent foramen ovale (PFO) has been suggested as a mechanism of otherwise unexplained, cryptogenic stroke.[1]
Paradoxical embolism, can be diagnosed only if there is evidence of a venous thrombosis coexisting with arterial embolism and right-to-left shunting via a PFO
Diagnosing venous thrombosis in patients with suspected paradoxical embolism is sometimes difficult since the thrombosis (1) may be confined to the calf veins and only detectable by venography; (2) may be localized in places other than in the leg veins and not detectable by leg venography; (3) may be not the cause but the consequence of arterial embolism; or (4) may spontaneously dissolve, re-embolize, or recanalize.[3]
Summary
To the Editor: Paradoxical embolism via a patent foramen ovale (PFO) has been suggested as a mechanism of otherwise unexplained, cryptogenic stroke.[1]. The first strategy is by improving noninvasive methods to visualize venous thrombosis in different locations, like magnetic resonance venography.[4] Another strategy is by search for a clotting diathesis in patients with suspected paradoxical embolism. 5. In how many patients were investigations of the lower limbs performed and how were the results related with the prevalence of thrombophilic mutations in the PFOϩ and PFOϪ groups?. Three of the patients in the PFOϩ group had deep-vein thrombosis at the time of stroke Did these 3 patients have thrombophilic mutations?. Response We appreciate Drs Stöllberger and Finsterer’s critical comments on our article concerning the role of inherited thrombophilic disorders in PFO-related cerebral infarcts
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