Jacobs Journal of Clinical Case Reports

Embolic Stroke with Visualization of “Paradoxical” Thrombus

*Brigid Dwyer
Department Of Neurology, Boston University, United States

*Corresponding Author:
Brigid Dwyer
Department Of Neurology, Boston University, United States

Published on: 2017-03-06


In cases of embolic stroke, paradoxical thromboembolic events are a frequent consideration and are thought to represent a significant proportion of strokes in patients under 55, especially those at risk for deep venous thrombosis (DVT) [1,2]. Nevertheless, it is extremely difficult to demonstrate clinically the presumed interatrial transport that underlies this particular stroke mechanism.


Embolism; Infarction; Stroke in young adults;CT; Ultrasound


As a notable exception to this pattern, we submit the case of a 52 year old man diagnosed with invasive squamous cell carcinoma of the tongue and admitted for glossectomy, mandibulotomy, and neck dissection. His post-op course complicated by bilateral DVTs and a pulmonary embolism detected on hospital day eight. He subsequently relayed a complaint of at least several days of abnormal vision to his primary surgical team, with apparent onset approximately one day prior to detection of the DVTs and pulmonary embolism. Therapeutic anticoagulation had begun on hospital day eight.