© 2005 by BMJ Publishing Group & British Cardiac Society
MINI-SYMPOSIUM
Patent foramen ovale and the risk of stroke: smoking gun guilty by association?
Correspondence to:
Correspondence to:
Dr Pierre Amarenco
Department of Neurology and Stroke Centre, Bichat University Hospital and Medical School, Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, France; pierre.amarenco@bch.ap-hop-paris.fr
Abbreviations: ASA, atrial septal aneurysm; TIA, transient ischaemic attack; TOE, transoesophageal echocardiography; TTE, transthoracic echocardiography
Keywords: patent foramen ovale; stroke
| The first 150 words of the full text of this article appear below. |
Between 15–20% of cases of brain infarction involve patients under the age of 55 years—that is, 150 000 to 200 000 patients each year in Europe. The main causes include cardiac valve disease and dissections of extracranial arteries (accounting for up to 20% of cases). In this age range, rare causes of arteriopathies may be found more frequently than in older stroke patients. Their mechanism is either inflammatory disease, infectious, metabolic, or toxic. Atherosclerosis accounts for 10% of cases. Over 150 causes of stroke have been listed. However, despite a thorough evaluation, the cause of the stroke remains unknown in up to 50–60% of cases in patients younger than 55 years.
In this group, transoesophageal echocardiography (TOE) shows inter-atrial septal abnormalities in 55–60% of cases. The same abnormal septum is observed in 20% of the normal population. However, when present in a patient with a stroke of unknown cause, is
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