An unusual case of paradoxical embolism in a young patient affected by stroke

The majority of ischemic strokes are due to atherothrombosis, cardioembolism, systemic hypoperfusion (general decrease in blood supply, e.g., in shock), or small vessel occlusive disease. However, many ischemic strokes occur without a well-defined etiology and are labeled as cryptogenic, and they constitute 30–40 % of all ischemic strokes. By the TOAST classification, which is the most commonly used in clinical practice, cryptogenic stroke (or stroke of undetermined origin in TOAST terminology) is defined as brain infarction that is not attributable to a source of definite cardioembolism, large artery atherosclerosis, or small artery disease despite extensive vascular, cardiac, and serologic evaluation. This means that in a large part of our patients we are unable to identify stroke etiology. In our report we described an unusual cause of stroke discovered by non-routinary investigations.