Pathogenic heterogenety of ischemic stroke and patent foramen ovale

The comparative analysis of pathogenic mechanisms of ischemic stroke in patients with and without Patent Foramen Ovale (PFO) was performed. 101 patients with cryptogenic stroke and stroke of known etiology were examined. All patients underwent a diagnostic protocol including brain CT/MRI scan, haemostatic system testing, ECG, standard echocardiography, transthoracal echocardiography with bubble test and transcranial Doppler with bubble test; 51 patient underwent transesophageal echocardiography. PFO was found in half of the patients with ischemic stroke. However, the paradoxical cerebral embolism could not be considered as a main stroke risk factor in the studied cases: the mechanism of stroke in PFO was clarified with the same frequency, as in patients without PFO. So, in the presence of other competing risk factors of cerebral lesion, PFO does not play independent pathogenic role in the genesis of brain ischemia.