Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Dec;30(12):106115.
doi: 10.1016/j.jstrokecerebrovasdis.2021.106115. Epub 2021 Sep 14.

Patent Foramen Ovale Related Cryptogenic Stroke during COVID-19 Disease in Three Patients: A Case Series

Daniela Palleri  1 , Marta Guidarini  1 , Elisabetta Mariucci  2 , Anna Balducci  1 , Gabriele Egidy Assenza  1 , Susanna Esposito  3 , Andrea Donti  1
Affiliations
Case Reports

Patent Foramen Ovale Related Cryptogenic Stroke during COVID-19 Disease in Three Patients: A Case Series

Daniela Palleri et al. J Stroke Cerebrovasc Dis. 2021 Dec.
No abstract available

Keywords: COVID-19; Cryptogenic stroke; Patent foramen ovale; SARS-CoV-2 disease.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors received no funding for this study. The authors have no conflicts of interest to declare.

Figures

Fig. 1:
Fig. 1
TOP LEFT: contrast transcranial Doppler (TCD) for the detection of right‐to‐left shunt. With patient in a supine position, the contrast agent is prepared using 9 ml of isotonic saline solution, 1 ml of air and 1 ml of patient's blood mixed with a three-way stopcock and injected as a bolus in the antecubital vein through an 18-gauge catheter. High intensity transient signals (HITS), defined as visible and audible short-duration, high-intensity signals within the Doppler flow spectrum, are recorded. The magnitude of right‐to‐left shunt is determined by counting the number of HITS in the middle cerebral artery in the first 40 s after bolus infusion and by applying the four-level visual categorization of the International Consensus Criteria. In this case grade III: curtain pattern (Adams et al., 1993) or grade ≥ III: >30 signals (Spencer et al., 200417). TOP RIGHT: Transoesophageal echocardiography (TOE) short axis view (53°) showing the right atrium (RA) down, the left atrium (LA) up, and the aorta on the right. The patent foramen ovale (PFO) is a huge tunnel measuring 9 mm in the right side and 5.8 mm in the left side. Bottom Left: TOE long axis view (84°) showing the right atrium (RA) down, the left atrium (LA) up, and the superior caval vein on the right. The color Doppler demonstrates a left-to-right shunt throught the PFO in basal condition. Bottom Right: TOE short axis view (61°) with contrast injection showing the RA on the left, the LA up and right and the aorta down and right. After the RA is completely filled with contrast bubbles there is a severe shunt of contrast into the LA across the PFO.
See this image and copyright information in PMC

References

    1. EpiCentro. COVID-19 integrated surveillance data in Italy. Available from: https://www.epicentro.iss.it/en/coronavirus/sars-cov-2-dashboard. Date of update: 31 July 2021
    1. Lodigiani C, Iapichino G, Carenzo L, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020;191:9–14. - PMC - PubMed
    1. Oxley TJ, Mocco J, Majidi S, et al. Large-vessel stroke as a presenting feature of COVID-19 in the young. N Engl J Med. 2020;382(20):e60. - PMC - PubMed
    1. Klok FA, Kruip MJHA, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191:145–147. - PMC - PubMed
    1. Nopp S, Moik F, Jilma B, et al. Risk of venous thromboembolism in patients with COVID-19: a systematic review and meta-analysis. Res Pract Thromb Haemost. 2020;4(7):1178–1191. - PMC - PubMed

Publication types