Mitsui T, Aoki Y, Nagata Y, Kojima Y, Tanaka K
Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8510, Japan.
Gynecol Oncol. 2001 Dec;83(3):608-9. doi: 10.1006/gyno.2001.6455.
Recent investigations of patients with cerebral and peripheral arterial emboli of unknown cause suggest that paradoxical embolism through a patent foramen ovale might be responsible for more arterial embolic events than previously realized.
A 60-year-old woman with advanced ovarian cancer presented with sudden onset of expressive aphasia and right upper hemiplegia postoperatively. A patent foramen ovale diagnosed by echocardiography with contrast combined with the presence of thrombosis in her right femoral vein leads us to speculate that her stroke was secondary to a paradoxical embolism.
Paradoxical embolism should be considered in the differential diagnosis of ovarian cancer patients with embolic stroke and it may be appropriate to include a cardiac echo as part of the diagnostic evaluation.
近期对不明原因脑动脉和外周动脉栓塞患者的调查表明，通过未闭卵圆孔的反常栓塞可能导致比以往认识到的更多的动脉栓塞事件。
一名60岁晚期卵巢癌女性术后突然出现表达性失语和右上半身偏瘫。经超声心动图造影诊断为未闭卵圆孔，同时右股静脉存在血栓，这使我们推测她的中风继发于反常栓塞。
对于患有栓塞性中风的卵巢癌患者，鉴别诊断时应考虑反常栓塞，将心脏超声检查纳入诊断评估可能是合适的。
