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Case Reports
Paradoxical brain embolism from thrombus associated with vena caval filter in a patient with cancer.
- Catalina Ionita, Pierre Giglio, Eugene Isayev, Ronald Alberico, and Patrick Pullicino.
- Department of Neurology, Buffalo General Hospital, Buffalo, New York, USA.
- J Neuroimaging. 2002 Jan 1; 12 (1): 69-71.
AbstractA 71-year-old man experienced sudden onset of hemiparesis and aphasia. He had a 4-month history of gallbladder cholangiocarcinoma, complicated with a postoperative deep-vein thrombosis (DVT) that necessitated a vena caval filter placement. Diffusion-weighted magnetic resonance imaging of the brain showed multiple hyperintense foci. Magnetic resonance spectroscopy was compatible with cerebral infarction. Abdominal computed tomography showed a thrombus in the inferior vena cava extending through the filters. A transcranial Doppler bubble study revealed the presence of a right-to-left shunt. Paradoxical cerebral embolism must be considered in patients with DVT who have new onset neurologic deficits even in the presence of a caval filter.
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