Clinical Characteristics Of Patent Foramen Ovale With Ischemic Stroke

Objective To analyze the clinical characteristics of patent foramen ovale-related stroke and atrial fibrillation-related stroke,and summarize the DWI pathological pattern of patent foramen ovale-related stroke and the characteristics of corresponding vascular embolism,so as to give early clinical treatment.Methods A total of 11471 patients with ischemic stroke admitted to the Depart ment of Neurology and Stroke in General Hospital of Ningxia Medical University fro m January 2015 to April 2018.According to the concept of TOSAT classification and unexplained embolic stroke,whether or not patent foramen ovale was combined with a trial fibrillation,the patients were divided into patent foramen ovale related stroke(85cases in total)and atrial fibrillation related stroke(85 cases in total).Stroke(referred to as atrial fibrillation group,a total of 98 cases),comparing the general clinical cha racteristics(demographic data,risk factors,NIHSS score,laboratory test indicators,et c.),imaging characteristics(classification of lesion types according to lesion location,s ize and number)and the corresponding arterial occlusion,so as to draw the characteri stics of PFO-related stroke,so as to give secondary prevention of cerebral infarction a s early as possible.Results 1.Analysis of general clinical data between the two groups:the age rang e of patients with patent foramen ovale was 17-80 years old(49.34±12.76),and that o f patients with atrial fibrillation group was 44-98 years old(67.67±10.62).The age dif ference between the two groups was statistically significant.Significance(t=-10.61,P<0.001);the proportion of males in the patent foramen ovale group(n=66,77.6%)w as higher than that in the atrial fibrillation group(n=59,60.2%),and the difference was statistically significant(?~2=6.397,P=0.011)。2.Comparisons of neurological deficit scores between the two groups:the neurological deficits in the patent foramen ovale group were lower than those in the atrial fibrillati on group in admission(median 2,upper and lower quartile 0,4.5)and discharge(me dian 1,upper and lower quartile 0,2)and discharge(median 4,upper and lower quar tile 2,10)and discharge(median 2,upper and lower quartile 0,7).There were statist ical differences between the two groups.Academic significance(Z=-4.647,P<0.001),(Z=-3.261,P=0.001).3.Analysis of imaging results between the two groups:Patent foramen ovale group w as mainly characterized by single cortical infarction(n=27,32%)and higher than atrial fibrillation group(n=6,6%).The difference was statistically significant(?~2=20.249,P<0.001).Infarction focus in atrial fibrillation group was mainly cortico-subcortical in farction(n=40,41%)and higher than that in patent foramen ovale group(n=6,7%).T he difference was statistically significant(?~2=27.565,P<0.001).There was no signifi cant occlusion in nearly two-thirds of patients with patent foramen ovale(n=64,75%)than in patients with atrial fibrillation(n=58,59%).There was significant difference b etween the two groups(?~2=36.328,P<0.001).The occlusive vessels in patent forame n ovale group were mainly distributed in the vertebral-basilar circulation system(n=12,57%),higher than those in patients with atrial fibrillation(n=6,15%).Learning signi ficance(?~2=11.758,P=0.001).Conclusion 1.The age of the patent foramen ovale-related stroke is relatively y ounger than that of atrial fibrillation-related stroke,and is more common in male patie nts.2.Patent foramen ovale-related stroke usually manifests as a single cortical infarction of the vertebrobasilar circulation system,with a low occlusion rate of the correspondin g vessels.