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I had a stroke 9 days ago when I sneezed.

I am 46, thin (145 pounds) and active. I eat very healthy and go to the gym 4 days a week. I do cardio and mild weight lifting.

My BP is excellent (averages 105/60). Cholesterol is 170 total, 52 HDL. Also good.

Doc doesn't know why I had a stroke, but thinks it's because I have a PFO.  So the doctor now has essentially said the stroke was because I had a blood clot that went through the PFO and got into my brain.

I don't buy it. The math just does not add up. They examined me for clots. I had none. I am also not in a high risk category for clots.  I have no diabetes, no family history of stroke and no lifestyle vices that may lead to stroke (heavy drinking, smoking, cocaine use, etc.).

The chance of me developing a clot is minuscule.
If I had a clot, the chance of it actually nearing the PFO at the exact moment I sneezed, and then pushing its way through -- is also minuscule.

These two unlikely events just do not make sens to me.

But, the doctors are going with it because they have nothing better.  Any ideas? They want me to get a patch for my PFO.

I fear the stroke must have been caused by something else.

I am at a loss here.  Any ideas?

[Dr Rajgopal]

Hi,
Without other associated defects, there are usually no complications associated with a PFO that may lead to stroke . Older patients with PFOs have a higher rate of a thromboembolic stroke because they develop blood clots in the veins in their legs.

The stroke in your case could  be  an Ischemic stroke caused by a  Cervical artery dissection. Two major arteries in the neck, called the carotid artery and the vertebral artery, carry blood to the brain. Together these are called the cervical arteries. In cervical artery dissection, the lining of one of the cervical arteries becomes torn. Tears happen more often in the carotid artery (carotid artery dissection) .The tear in the artery wall causes the blood around the tear to clot, blocking off the artery or weakening the artery wall. A disruption of the blood flow can starve parts of the brain of oxygen and nutrients. This damages brain cells and they begin to die.

Cervical artery dissection  can be caused by any kind of injury to the neck, including high-impact injury, eg from a car crash ,sports – like yoga and gymnastics ,straining of  neck, eg from coughing or sneezing .


A number of different tests are required to confirm whether you have a cervical artery dissection  . The most important  test is  -Magnetic resonance (MR) angiogram, which uses magnets and radiowaves to produce images of the blood vessels in your neck. Other imaging tests you may have to include are : a standard angiogram ( this uses an injection of a special dye (contrast medium) into the blood vessels, which makes them clearly .visible on X-ray ),CT scan and an ultrasound . Please consult a neurologist cardiologist for diagnosis and treatment . Hope this helps you . Take care and regards !