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. 2011 Mar 22;3(3):e170-e172.
doi: 10.1016/j.jccase.2011.02.005. eCollection 2011 Jun.

Suspicious seizures: Uncommon complication of PFO/ASA

George Syros  1 , Alexandros Briasoulis  1 , George Psevdos  2
Affiliations

Suspicious seizures: Uncommon complication of PFO/ASA

George Syros et al. J Cardiol Cases. .

Abstract

Brain abscesses have cardiac etiology in 5% of cases with valvular heart disease and endocarditis being the most common. Congenital heart disease with the risk of right to left shunt and paradoxical embolization is also a culprit. Our case describes a young patient with a prior undiagnosed patent foramen ovale (PFO), who presented with solitary brain abscess without any underlying primary source of infection. Since there was no evidence of contiguous spread of infection by computed tomography or magnetic resonance imaging scans, hematogenous spread of the streptococcal species was the most likely etiology. Transesophageal echocardiography (TEE) revealed no evidence of valvular endocarditis but did show intracardiac right-to-left shunting via a PFO. We suggest that all patients with a brain abscess of an unclear etiology caused be screened for a PFO with a TEE and bubble study.

Keywords: Brain abscess; PFO; Streptococcus intermedius.

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Figures

Figure 1
Figure 1
Ring enhancing lesion noted within the posterior left frontal lobe. Non-enhancing central portion of the lesion is bright on the diffusion series.
Figure 2
Figure 2
Patent foramen ovale as shown in transesophageal echocardiogram.
Figure 3
Figure 3
Computed tomography of the brain with intravenous contrast. There is no abnormal intracranial enhancement.
See this image and copyright information in PMC

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