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Paradoxical brain embolism from thrombus associated with vena caval filter in a patient with cancer

  • Catalina Ionita
  • , Pierre Giglio
  • , Eugene Isayev
  • , Ronald Alberico
  • , Patrick Pullicino

Research output: Contribution to journalArticlepeer-review

Abstract

A 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.

Original languageEnglish
Pages (from-to)69-71
Number of pages3
JournalJournal of Neuroimaging
Volume12
Issue number1
DOIs
StatePublished - 2002

Keywords

  • Bubble study
  • Cancer
  • Intracaval filter
  • Paradoxical emboli
  • Right-to-left shunt
  • Transcranial Doppler

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