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Avatar universal

patent foramen ovale and stroke

I had an aphasic stroke at 40. No cause or health problem was found. I recovered with insignificant damge. After 5 1/2 years (last December) I developed some bizzare symptoms that were similar to the stroke: short, repetitive (multiple times a day) episodes of speech and balance problems. I returned to the neurologist. I had a new MRI which shoed only the original stroke. After a few weeks, I was diagnosed as having a seizure disorder caused by scar tissue from the stroke, thus the symptoms were like the stroke given that thesame area of the brain was involved. Anti-seizure medication stopped the symptoms cold (first Depakote which I didn't tolrate and now Neurontin which is great). After the seizure disorder was diagnosed, my neuroligist (who was not the same one I saw with the stroke) started to run and re-run tests (Arteriogram, TEE, echo, etc.) to see why I had the stroke in the first place. The TEE indicated a small patent foramen ovale which had not shown up on the echo. My doctor and another neurolgist now think the PFO was the cause of the stroke. I have been told to take an aspirin each day as  blood thinner to reduce the risk of future strokes. My question: what is my risk of futue strokes given my history? Is aspirin the best prevention? Should I consider repairing the PFO (my doctors are not in favor of this)? Thanks for any adivse on this.
13 Responses
238671 tn?1189759432
This is a tough question and there really is not a "right" answer to this question yet. The issue is being studied, but as of now, there are only lots of opinions as far as the correct approach to your situation. One approach is your doctors' approach of trying aspirin, and as long as you do not have a recurrence of stroke or mini-stroke, to just leave you on the aspirin. If you do have a recurrence, the next step would be to add another blood thinner in addition to aspirin. This is a sensible, common sense approach that has been used for many years. The only problem with this is that if the next stroke is a large one, it could leave you with significant disability, or worse. Closing the PFO would eliminate any stroke risk that his may be posing (this makes sense, but is actually unproven), but the downside is that it is an invasive approach associated with real risks right now. I know smart doctors who feel very strongly about each of those approaches. If you would like another opinion, you could call and make an appointment with one of our pediatric interventional cardiologists (they do this procedure on adult patients too).
Avatar universal
I read in USA Weekend that men and women who have migraines preceded by auras also have a small heart defect called PFO.  Is this true in all cases?  I have had auras before migraines for over 40 years.  I also have an occasional extra heartbeat and sometimes a short pause in my heartbeat.  Am I at risk?
Avatar universal
I had head ache on my right side for a week followed by numbness of my left hand fingers.Doctors confirmed it to be stroke(Hypodense area was revealed in ct scan).
I was on
FAXIPARIN
NOOTROPIL
for a week followed which I recovered except for headache

They called it complicated migraine.My Echo cardioghram showed normal while my ECG showed WPW syndrome(assymptomatic).TEE revealed PFO.Doctors didnot suggest cardiac surgery as the passage is very small.
I was on:
ECOSPIRIN 325(1 0 0)
TRENTAL (1 0 1)
CIPLACTIN 10 (1 0 1)
FLUNARIN 10   (1 0 1)

After this treatment my brain has become dull and inactive.Is it because of the medicines or the stroke.I require your suggestions


Avatar universal
HELLO
Avatar universal
I have read that skin rashes were associated with PFO...if so, what kind?  I have small patches on the inside of my elbows which appeared after scuba diving.  It goes away with use of a cream called Ultravate...but it comes back regularly. I have read that divers may face special problems if they have PFO.  If that rash is my only symptom, should I get tested to see if I have PFO?
Avatar universal
One man's experience for those considering surgical ASD/PFO closure.

I was an otherwise healthy, moderately fit 52 year old when I had the surprise of a lifetime...a small stroke.   During the course of a one week hospital stay it was revealed that I had a PFO and atrial septal aneurism which possibley allowed a clot to find its way to the right middle cerebral artery.  I was discharged with the typical pharmaceutical course of warfarin plus asparin.  I encountered some difficulty in keeping therapeutic on the medication and was troubld by "drifts" ...my own definition of  unexpected bouts of imbalance and transient dizzy spells (possibly blood shunting across the ASD, PVC'S, PAC'S, who knows ?). My research into the matter revealed what has already been articulated. There is no unanimous support for surgical closure. However, the preponderance of the evidence plus my own consultations with the medical profession seemed to point in that direction in my case. I elected surgery.  No doubt about it, the surgery is not pleasant and the recovery is as variable as the number of individual patients.  However, even in spite of an allergic reaction to the antibiotic while on the heart-lung  machine (which I will inquire about later) and post-surgical bout with pericarditis, I remain grateful that I had the operation and that we live in a nation which at least offers us choices.  Life is certainly fragile and maybe tomorrow I'll get hit by a car, but at least I can say that I made a decision which eliminated possibility of another more debilitating stroke from the ASD.  Which brings me to the point that in such cases where the biomedical community is not decisive, we ourselves, have to take the initiative to get the best information we can and take responsibility for our own health care decisions.  For those of you who are saying "Oh yeah, easy for him to say," believe me it's not and I have the 8 inch scar on my chest to prove it.

Always independent and strong willed, I never thought of myself as the type to seek a support group or chat line with which to share my story.  Well, just goes to show you how circumstances can change things. I would drive a hundred+ miles to just sit with a few people who have had similar experiences just to share and hopefully help another person.

I would appreciate any replies/responses.

Dan



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