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Echocardiographic evaluation of young adults with nonhemorrhagic cerebral infarction
Journal article   Open access   Peer reviewed

Echocardiographic evaluation of young adults with nonhemorrhagic cerebral infarction

Jose Biller, Maryl R Johnson, Harold P Adams Jr, Richard E Kerber, Gilbert J Toffol and Michael J Butler
Stroke (1970), Vol.17(4), pp.608-612
1986
DOI: 10.1161/01.STR.17.4.608
PMID: 3738939
url
https://doi.org/10.1161/01.STR.17.4.608View
Published (Version of record) Open Access

Abstract

We reviewed echocardiographic findings in patients aged 15 to 45 years with acute nonhemorrhagic cerebral infarction (NHCI). Among 132 patients with NHCI, 96 (72.7%) had M-mode and two-dimensional echocardiography, including contrast echocardiography with intravenous saline injection when clinically indicated. Echocardiograms were abnormal in 33 patients. Of these, 7 had other conditions that could cause NHCI. Echocardiography corroborated the clinical diagnosis of a cardiogenic source for cerebral infarction in 17 others. The other 9 had no other clues for cardiovascular disease. Potential etiologies of NHCI diagnosed by echocardiography in these 9 cases included: paradoxical embolism, 5 patients; right atrial myxoma, 1; rheumatic mitral valve vegetation, 1; myxomatous mitral valve (marantic endocarditis at postmortem), 1; and left atrial enlargement associated with decreased left ventricular function, 1. Routine echocardiography frequently conveys useful information in patients under age 45 with NHCI. In young patients with cerebral embolism of unknown etiology if routine M-mode and two dimensional echocardiographic studies are normal, contrast echocardiographic studies should be performed to rule out intracardiac shunts and the possibility of paradoxical cerebral embolism.
 Neurology Biological and medical sciences Vascular diseases and vascular malformations of the nervous system Medical sciences

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