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CRITICAL CARE AND TRAUMA

Paradoxical Embolus After Multiple Trauma Resulting in a Cerebrovascular Accident

Mark D. Price^*, Pranay Kanake, MD, and Daniel Talmor, MD, MPH

*Division of Health Sciences and Technology and Department of Anaesthesia and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

Address correspondence and reprint requests to Daniel Talmor, MD, Department of Anesthesia and Critical Care, CC-470, Beth Israel Deaconess Medical Center, 1 Deaconess Rd., Boston, MA 02215. Address e-mail to dtalmor{at}bidmc.harvard.edu

We present the case of a 57-yr-old patient who suffered an unexplained cerebrovascular event 3 days after being struck by a motor vehicle. Workup demonstrated a previously unknown patient foramen ovale. The etiologies of paradoxical embolism in trauma are discussed.

IMPLICATIONS: Paradoxical embolism after multiple traumas is described. Delay in diagnosis may occur given the need for near continuous sedation in the patient with injuries undergoing multiple surgeries and diagnostic tests.