卵圆孔未闭
医学
经颅多普勒
反常栓塞
瓦萨尔瓦机动
心脏病学
分流(医疗)
右向左分流
内科学
放射科
调车
冲程(发动机)
栓塞
对比度(视觉)
血压
偏头痛
人工智能
工程类
机械工程
计算机科学
作者
Christof Klötzsch,G.W.T. Janssen,Peter Berlit
出处
期刊:Neurology
[Ovid Technologies (Wolters Kluwer)]
日期:1994-09-01
卷期号:44 (9): 1603-1603
被引量:185
标识
DOI:10.1212/wnl.44.9.1603
摘要
Patent foramen ovale (PFO) is increasingly recognized in association with cryptogenic stroke. Using transesophageal echocardiography (TEE) and transcranial Doppler sonography with ultrasonic contrast medium (contrast-TCD), we evaluated the frequency of a PFO as the fundamental condition of paradoxical embolism in 111 patients after cerebral ischemia. There was a right-left shunt in 50 patients (45%) with TEE. In 31 of 40 patients with stroke of unknown etiology, a PFO was the only detectable finding associated with cerebral ischemia. Using TEE as the "gold standard," the sensitivity of contrast-TCD was 91.3%, specificity 93.8%, and the overall accuracy 92.8%. Contrast-TCD failed to detect a right-left shunt in four patients, but there were four other patients with negative TEE and positive contrast-TCD. We conclude that contrast-TCD is a highly sensitive method for detecting a right-left shunt. Its advantages are low cost, its ability to detect single contrast-medium embolism, and control of the Valsalva maneuver by observing the decrease of cerebral blood flow. Evidence of PFO in cryptogenic stroke should prompt a search for a subclinical venous thrombosis as the embolic source.
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