• Jie Gong, Huayong Zhang, Changjian Li, and Yong Zhang.
• School of Medicine, Jianghan University, Wuhan, China.
• Medicine (Baltimore). 2024 Oct 4; 103 (40): e39986e39986.

RationaleArterial ischemic stroke is a general term for necrosis of brain tissue due to insufficient blood supply to the brain from various causes. About 30% of these cases are of unknown origin and are known as cryptogenic strokes (CS).Patient ConcernsWe report 2 female patients, one 5 years and 5 months old and the other 6 years old. Both children had clinical manifestations of CS, and after ruling out other possible etiologies, we finally suspected that CS was associated with patent foramen ovale (PFO).DiagnosesCase 1 was diagnosed with PFO, paradoxical embolism, and third-degree atrioventricular block, and case 2 was diagnosed with PFO, paradoxical embolism, and refractory mycoplasma pneumonia.InterventionsCase 1 underwent permanent pacemaker placement at the same time as PFO closure. Case 2 underwent conservative anticoagulation with poor therapeutic results and subsequently underwent PFO closure.OutcomesPatient 1 underwent PFO closure, which resulted in relief of neurologic symptoms and no recurrence of neurologic symptoms after 10 months of follow-up. In case 2, the child's neurologic symptoms improved after PFO closure.LessonsAlthough most children with PFO do not require targeted interventions, a few cases involving PFO and CS may benefit from closure of the foramen ovale.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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