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The importance of paradoxical embolism through a patent foramen ovale (PFO) as a cause of stroke remains unclear, especially in older patients. In this prospective German study of 503 adults with stroke, researchers examined the association between PFO and cryptogenic stroke (i.e., stroke of unknown cause). All patients underwent brain imaging, transesophageal echocardiography, duplex sonography of extracranial and intracranial arteries, and other tests if indicated.
Nearly half the strokes were considered cryptogenic, including 39% in patients aged 55 and older, and 63% in patients younger than 55. The prevalence of PFO was significantly higher among patients with cryptogenic stroke than among those with stroke of known cause (34% vs. 12%).…