Patent foramen ovale and stroke
Patent Foramen Ovale Microchapters
Patent foramen ovale and stroke On the Web
American Roentgen Ray Society Images of Patent foramen ovale and stroke
There is a lack of consensus on the association of patent foramen ovale and cryptogenic stroke. While some studies have demonstrated an increased incidence of patent foramen ovale in younger patients with cryptogenic stroke. Factors that might increase the occurrence of recurrent stroke in patients with patent foramen ovale are atrial septal aneurysm, bigger shunts and longer tunnels. Some systematic reviews done to compare medical versus percutaneous closure, found the rate of recurrent strokes with medical treatment to be greater than that with percutaneous closure. However, the results of these systematic reviews should be carefully interpreted, as the individual studies included in the review were very heterogeneous.
Patent Foramen Ovale and Stroke
Association of Cryptogenic Stroke/Transient Ischemic Attacks with Patent Foramen Ovale
- A cryptogenic stroke is one with undetermined pathogenesis.
- Patent foramen ovale can serve as a route for platelet aggregates, gas bubbles, thrombi, and other particulate matter to travel through from the systemic venous circulation to the brain.
- One in every four cases of ischemic stroke does not have an identifiable cause other than cryptogenic stroke which is a diagnosis of exclusion
- The association between the presence of a patent foramen ovale and cryptogenic stroke is controversial and inconsistent. While some studies have demonstrated an increased incidence of patent foramen ovale in younger patients with cryptogenic stroke, others failed to show an association 
Patent Foramen Ovale and First Stroke
- Although, two prospective cohort studies namely, ‘ The Northern Manhattan Study’ (NOMAS) and 'Stroke Prevention: Assessment of Risk in a Community' (SPARC), found an increased incidence of first stroke in patients with patent foramen ovale, both these studies did not reach a statistical significance.
Patent Foramen Ovale and Recurrent Stroke
- There exists a discrepancy on the influence of patent foramen ovale (PFO) on recurrent stroke (after first episode of cryptogenic stroke).
- Several factors have been found to be associated with a patent foramen ovale (PFO) that may increase the incidence of recurrent strokes namely, atrial septal aneurysm, (ASA) in association with PFO, bigger shunts and longer tunnels 
- Nevertheless, some studies have found no association between patent foramen ovale or abnormal septal morphology with recurrent strokes .
- Studies have failed to show that patent foramen ovale increases the risk of recurrent stroke in cryptogenic stroke patients with a patent foramen ovale when compared with those without a patent foramen ovale.
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