{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:31:51Z","timestamp":1790008311555,"version":"4.0.1"},"reference-count":37,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,12,19]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>We report the case of a woman in her late 20s, with no significant medical history, who was found unresponsive at home. Her mother revealed a \u2018selfie\u2019 sent to her by the patient 30\u2009min prior to collapse which revealed bilateral ptoses. Initial brain imaging with non-contrast CT of the brain revealed nil of note. A multiphase CT angiogram revealed an acute basilar artery thrombosis. She underwent timely thrombolysis and was transferred for endovascular thrombectomy. Further evaluation with an aim to define the aetiology revealed the diagnosis of patent foramen ovale with a resultant paradoxical embolism. The differential diagnoses of unexplained rapidly evolving neurology with reduced Glasgow coma scale, and relevant appropriate investigations are discussed in this case report.<\/jats:p>","DOI":"10.1136\/bcr-2023-256223","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:43:05Z","timestamp":1704847385000},"page":"e256223","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Presentation of basilar artery stroke secondary to patent foramen ovale: a diagnosis made with a \u2018selfie\u2019"],"prefix":"10.1136","volume":"17","author":[{"given":"Aoife","family":"Casey","sequence":"first","affiliation":[{"name":"Medicine, Wexford General Hospital, Newtown Road, Carricklawn, Wexford, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arveen","family":"Jeyaseelan","sequence":"additional","affiliation":[{"name":"Medicine, Wexford General Hospital, Newtown Road, Carricklawn, Wexford, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Byrne","sequence":"additional","affiliation":[{"name":"Medicine, Wexford General Hospital, Newtown Road, Carricklawn, Wexford, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Francis","family":"Reardon","sequence":"additional","affiliation":[{"name":"Medicine, Wexford General Hospital, Newtown Road, Carricklawn, Wexford, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,5]]},"reference":[{"key":"2025082701284275000_17.1.e256223.1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.669929"},{"key":"2025082701284275000_17.1.e256223.2","first-page":"105","article-title":"Stroke of the posterior cerebral circulation","volume":"30","author":"Labropoulos","year":"2011","journal-title":"Int Angiol"},{"key":"2025082701284275000_17.1.e256223.3","doi-asserted-by":"crossref","unstructured":"Marini C , Russo T , Felzani G . Incidence of stroke in young adults: a review. Stroke Res Treat 2010;2011. doi:10.4061\/2011\/535672","DOI":"10.4061\/2011\/535672"},{"key":"2025082701284275000_17.1.e256223.4","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.020783"},{"key":"2025082701284275000_17.1.e256223.5","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1177\/17474930211046758","article-title":"Patterns of ischemic posterior circulation strokes: a clinical, anatomical, and radiological review","volume":"17","author":"Salerno","year":"2022","journal-title":"Int J Stroke"},{"key":"2025082701284275000_17.1.e256223.6","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/69.2.73"},{"key":"2025082701284275000_17.1.e256223.7","first-page":"545","article-title":"Occlusion of the basilar artery. a review with 17 personal cases (author\u2019s Transl","volume":"137","author":"Labauge","year":"1981","journal-title":"Rev Neurol (Paris)"},{"key":"2025082701284275000_17.1.e256223.8","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.21.8.1135"},{"key":"2025082701284275000_17.1.e256223.9","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70229-0"},{"key":"2025082701284275000_17.1.e256223.10","doi-asserted-by":"publisher","DOI":"10.1053\/j.sult.2013.01.004"},{"key":"2025082701284275000_17.1.e256223.11","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.12.6.1439013"},{"key":"2025082701284275000_17.1.e256223.12","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.2214\/AJR.21.25846","article-title":"Controversies in imaging of patients with acute ischemic stroke: AJR expert panel narrative review","volume":"217","author":"de Oliveira","year":"2021","journal-title":"AJR Am J Roentgenol"},{"key":"2025082701284275000_17.1.e256223.13","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.37.11.1742"},{"key":"2025082701284275000_17.1.e256223.14","unstructured":"R Caplan, MD L . Posterior circulation cerebrovascular syndromes. In: Ted Post (Editor-in-Chief ), ed. UpToDate. Wolters Kluwer,"},{"key":"2025082701284275000_17.1.e256223.15","doi-asserted-by":"crossref","unstructured":"Caplan LR . Vertebrobasilar ischemia and hemorrhage: clinical findings, diagnosis and management of posterior circulation disease; 2015. doi:10.1017\/CBO9781139019453","DOI":"10.1017\/CBO9781139019453"},{"key":"2025082701284275000_17.1.e256223.16","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.8.2011"},{"key":"2025082701284275000_17.1.e256223.17","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2011.2083"},{"key":"2025082701284275000_17.1.e256223.18","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/69.2.73"},{"key":"2025082701284275000_17.1.e256223.19","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.4.496"},{"key":"2025082701284275000_17.1.e256223.20","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.30.1.72"},{"key":"2025082701284275000_17.1.e256223.21","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1988.00520330044009"},{"key":"2025082701284275000_17.1.e256223.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2007.00583.x"},{"key":"2025082701284275000_17.1.e256223.23","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)91228-V"},{"key":"2025082701284275000_17.1.e256223.24","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.8.1172"},{"key":"2025082701284275000_17.1.e256223.25","doi-asserted-by":"crossref","first-page":"335","DOI":"10.7326\/M17-2679","article-title":"Device closure versus medical therapy alone for patent foramen ovale in patients with cryptogenic stroke: a systematic review and meta-analysis","volume":"168","author":"Shah","year":"2018","journal-title":"Ann Intern Med"},{"key":"2025082701284275000_17.1.e256223.26","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1001\/jama.2021.20956","article-title":"Heterogeneity of treatment effects in an analysis of pooled individual patient data from randomized trials of device closure of patent foramen ovale after stroke","volume":"326","author":"Kent","year":"2021","journal-title":"JAMA"},{"key":"2025082701284275000_17.1.e256223.27","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.529883"},{"key":"2025082701284275000_17.1.e256223.28","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1001\/jamaneurol.2013.575","article-title":"Ischemic stroke and transient ischemic attack in young adults: risk factors, diagnostic yield, neuroimaging, and thrombolysis","volume":"70","author":"Ji","year":"2013","journal-title":"JAMA Neurol"},{"key":"2025082701284275000_17.1.e256223.29","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31828ab2ed"},{"key":"2025082701284275000_17.1.e256223.30","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1161\/STROKEAHA.119.028343","article-title":"Focal cerebral arteriopathy in young adult patients with stroke","volume":"51","author":"McKenna","year":"2020","journal-title":"Stroke"},{"key":"2025082701284275000_17.1.e256223.31","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199609123351102"},{"key":"2025082701284275000_17.1.e256223.32","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205663"},{"key":"2025082701284275000_17.1.e256223.33","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.581256"},{"key":"2025082701284275000_17.1.e256223.34","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.667808"},{"key":"2025082701284275000_17.1.e256223.35","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.016599"},{"key":"2025082701284275000_17.1.e256223.36","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1161\/STROKEAHA.120.033595","article-title":"Body mass index in 1.9 million adolescents and stroke in young adulthood","volume":"52","author":"Bardugo","year":"2021","journal-title":"Stroke"},{"key":"2025082701284275000_17.1.e256223.37","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2006.01159.x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-256223","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:28:56Z","timestamp":1756283336000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-256223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,5]]},"published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1136\/bcr-2023-256223"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-256223","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}