School of Medicine, Jianghan University, Wuhan, China.
Department of Cardiology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2024 Oct 4;103(40):e39986. doi: 10.1097/MD.0000000000039986.
Arterial ischemic stroke is a general term for necrosis of brain tissue due to insufficient blood supply to the brain from various causes. About 30% of these cases are of unknown origin and are known as cryptogenic strokes (CS).
We report 2 female patients, one 5 years and 5 months old and the other 6 years old. Both children had clinical manifestations of CS, and after ruling out other possible etiologies, we finally suspected that CS was associated with patent foramen ovale (PFO).
Case 1 was diagnosed with PFO, paradoxical embolism, and third-degree atrioventricular block, and case 2 was diagnosed with PFO, paradoxical embolism, and refractory mycoplasma pneumonia.
Case 1 underwent permanent pacemaker placement at the same time as PFO closure. Case 2 underwent conservative anticoagulation with poor therapeutic results and subsequently underwent PFO closure.
Patient 1 underwent PFO closure, which resulted in relief of neurologic symptoms and no recurrence of neurologic symptoms after 10 months of follow-up. In case 2, the child's neurologic symptoms improved after PFO closure.
Although most children with PFO do not require targeted interventions, a few cases involving PFO and CS may benefit from closure of the foramen ovale.
动脉缺血性脑卒中是由于各种原因导致脑血液供应不足引起的脑组织坏死的统称。这些病例中约有 30%来源不明，被称为隐源性脑卒中（CS）。
我们报告了 2 例女性患者，年龄分别为 5 岁 5 个月和 6 岁。这 2 名儿童均有 CS 的临床表现，在排除其他可能病因后，我们最终怀疑 CS 与卵圆孔未闭（PFO）有关。
例 1 被诊断为 PFO、反常栓塞和三度房室传导阻滞，例 2 被诊断为 PFO、反常栓塞和难治性支原体肺炎。
例 1 在 PFO 关闭的同时进行了永久性起搏器安置。例 2 进行了保守抗凝治疗，但效果不佳，随后进行了 PFO 关闭。
患者 1 接受了 PFO 关闭，神经症状得到缓解，随访 10 个月后未再出现神经症状复发。在例 2 中，孩子的神经症状在 PFO 关闭后得到改善。
尽管大多数 PFO 患儿不需要针对性干预，但少数涉及 PFO 和 CS 的病例可能受益于卵圆孔关闭。
