It can be difficult to differentiate a MS lesion, and a stroke. However, PFO's result in embolic stroke (a clot going from the heart to the brain), and these are typically located in the periphery of the brain, while MS lesions are typically deep. If there is any confusion, then the diagnosis of MS can be established by performing a spinal fluid analysis.
A PFO causes stroke by allowing a clot to pass from the body into the outgoing cirulation (i.e. to the brain) without being filtered in the lung. Therefore, in order to have a stroke an individual has to have a clot somewhere in there body that breaks free, then the clot travels to the right side of the heart and has to travel through the PFO to the left side of the heart, and then be pumped to the brain. Therefore, any condition which predisposes women to have clots, such as smoking, birth control pills, or clotting disorders, should be avoided or treated. However, if your sister has an event it may be difficult to differentiate between MS and Stroke.
What I would recommend is for your sister to be seen by a Stroke Neurologist. He/she will evaluate your sister and determine what her risk for future stroke is. If the PFO is small, and she has no clotting risk factors, then the stroke risk is small. However, if her risk is high they may recommend medical treatment or possibly closure of the PFO. Good luck.
I have had several MRI's with the differential of chronic small vessel ischemic change or MS. It seems every neuro thinks it is MS and that is why I keep getting sent for MRI's. However, after 5 yrs I still have just one lesion. I didn't develop symptoms until 2 1/2 yrs ago.
Anyway, I have been told my symptoms are MS symptoms and yet haven't rec'd the diagnosis of MS (I know it calls for 2 lesions). My current neuro gave me the diag and then back peddled. She won't say it is a stroke, though. She says the lesion isn't typical or the location for a stroke. At one point said it was def. a MS lesion.
Well, I could go on. I guess my question to you is, how are to quote you, "Stroke signs are easily recognized and are different from MS"?
I would appreciate any info.