Paradoxical embolism of cerebral arteries with an open oval window of the interatrial septum
Authors:   Department of Neurology and Manual Therapy, Faculty of Professional Education, Pavlov First St. Petersburg State Medical University, Skoromets A.P. , Skoromets A.T. ,   Pavlov First St. Petersburg State Medical University; Research Pediatric Institute, First Children's City Hospital of St. Petersburg, Northwestern Federal District of the Russian Federation, St. Petersburg, Russia, Skoromets A.A. ,   Russian Academy of Sciences, head of the Department of Neurology, Pavlov First St. Petersburg State Medical University, director of the Research Institute of Neurology, Pavlov First St. Petersburg State Medical University, Skoromets Jr., A.A. ,   Pavlov First St. Petersburg State Medical University; Research Pediatric Institute, First Children's City Hospital of St. Petersburg, Northwestern Federal District of the Russian Federation, St. Petersburg, Russia, Bondarenko E.V. ,   Pavlov First St. Petersburg State Medical University; Research Pediatric Institute, First Children's City Hospital of St. Petersburg, Northwestern Federal District of the Russian Federation, St. Petersburg, Russia, Gasanova M.B. ,   Pavlov First St. Petersburg State Medical University; Research Pediatric Institute, First Children's City Hospital of St. Petersburg, Northwestern Federal District of the Russian Federation, St. Petersburg, Russia, Makarova O.T. ,   Pavlov First St. Petersburg State Medical University; Research Pediatric Institute, First Children's City Hospital of St. Petersburg, Northwestern Federal District of the Russian Federation, St. Petersburg, Russia, Skoromets T.A. ,   Pavlov First St. Petersburg State Medical University; Research Pediatric Institute, First Children's City Hospital of St. Petersburg, Northwestern Federal District of the Russian Federation, St. Petersburg, Russia, Shumilina M.V. ,   Department of Neurology, Pavlov First St. Petersburg State Medical University, Adnan Jalkhi ,   Pavlov First St. Petersburg State Medical University; Research Pediatric Institute, First Children's City Hospital of St. Petersburg, Northwestern Federal District of the Russian Federation, St. Petersburg, Russia
Published: October 2024

significant proportion of cerebral ischemic strokes in childhood and adolescence is caused by a patent foramen ovale of the interatrial septum. This pathology requires special strategy and tactics of diagnosis, treatment, and rehabilitation. Over the past 5 years, we have been able to identify 75 patients with such cardio-neurological pathology in children's hospitals and clinics. Purpose of the study. To determine the frequency of occurrence of acute cerebral circulatory disorders in childhood and adolescence and examine their clinical variability and modern treatment and rehabilitation tactics. Material and methods. In the process of treatment and advisory work in children's neurological hospitals and clinics in St. Petersburg and the Leningrad Region, out of more than 5 thousand patients with various neurological pathologies studied, 75 patients with cardio-neurological pathology were selected for a thorough clinical study and dynamic follow-up for at least 2 years. The pathology was manifested by acute disorders of cerebral circulation against the background of non-closure of the foramen ovale of the interventricular septum (patent foramen ovale). The diagnosis was confirmed by echocardiography, ultrasound examination of newborns, color Doppler sonography, MRI, and CT scan of the brain. In addition, all patients underwent general clinical tests of blood, cerebrospinal fluid, and urine. The age of the patients ranged from neonatal to juvenile. There were 44 boys (58.7%) and 31 (41.3%) girls. Comorbid conditions included traumatic brain injury, neuro-infections, migraines, cerebral vascular abnormalities in the form of hypoplasia, aplasia of the vertebral arteries, epileptic seizures, and CADASIL syndrome.