{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:02:59Z","timestamp":1791925379936,"version":"4.3.4"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1998,5]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            \u2014Although the cause of stroke among patients with patent foramen ovale (PFO) may be due to paradoxical cerebral embolism (PCE), this mechanism is often difficult to prove. The aim of our study was to evaluate the association between brain imaging findings suggestive of embolism and PFO among ischemic stroke patients.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            \u2014As part of the Northern Manhattan Stroke Study, 95 patients with first ischemic stroke over age 39 underwent transesophageal echocardiography (TEE) for evaluation of a cardiac source of embolism. The stroke subtype was determined by modified NINDS Stroke Data Bank criteria. Stroke subtype and MRI\/CT imaging data were evaluated blind to the presence of a PFO. These findings were compared between two groups: patients with medium to large PFO (\u22652 mm) and small (&lt;2 mm) or no PFO.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            \u2014Of the 95 patients who underwent TEE, 31 (33%) had a PFO. The frequency of PFO was significantly greater among patients with cryptogenic infarcts (19 of 42; 45%) compared with patients with determined cause of stroke (12 of 53, 23%;\n            <jats:italic>P<\/jats:italic>\n            =0.02). Medium to large PFOs were found more often among cryptogenic strokes than among infarcts of determined cause (26% versus 6%;\n            <jats:italic>P<\/jats:italic>\n            =0.04). Superficial infarcts occurred more often in the group with larger PFOs than in the group with small or no PFOs (50% versus 21%;\n            <jats:italic>P<\/jats:italic>\n            =0.02). Patients with medium or large PFOs more frequently had occipital and infratentorial strokes (57% versus 27%;\n            <jats:italic>P<\/jats:italic>\n            =0.02).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Stroke patients with larger PFOs show more brain imaging features of embolic infarcts than those with small PFOs. Larger PFOs may be more likely to cause paradoxical embolization and may help explain the stroke mechanism among patients with no other definite cause.\n          <\/jats:p>","DOI":"10.1161\/01.str.29.5.944","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"944-948","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":253,"title":["Patent Foramen Ovale Size and Embolic Brain Imaging Findings Among Patients With Ischemic Stroke"],"prefix":"10.1161","volume":"29","author":[{"given":"Michaela M.","family":"Steiner","sequence":"first","affiliation":[{"name":"From the Neurological Institute (M.M.S., T.R., R.G., X.C., R.L.S.) and the Division of Cardiology, Department of Medicine (M.R. Di T., C.L., S.H.), Columbia-Presbyterian Medical Center, New York, NY; Division of Biostatistics (X.C.) and Division of Epidemiology and Gertrude H. Sergievsky Center (R.L.S.), School of Public Health, Columbia University, New York, NY; and Center for Postgraduate Studies in Neuroscience, Danube University, Landesnervenklinik Gugging (M.M.S., M.B.), Gugging, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco R.","family":"Di Tullio","sequence":"additional","affiliation":[{"name":"From the Neurological Institute (M.M.S., T.R., R.G., X.C., R.L.S.) and the Division of Cardiology, Department of Medicine (M.R. Di T., C.L., S.H.), Columbia-Presbyterian Medical Center, New York, NY; Division of Biostatistics (X.C.) and Division of Epidemiology and Gertrude H. Sergievsky Center (R.L.S.), School of Public Health, Columbia University, New York, NY; and Center for Postgraduate Studies in Neuroscience, Danube University, Landesnervenklinik Gugging (M.M.S., M.B.), Gugging, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Rundek","sequence":"additional","affiliation":[{"name":"From the Neurological Institute (M.M.S., T.R., R.G., X.C., R.L.S.) and the Division of Cardiology, Department of Medicine (M.R. Di T., C.L., S.H.), Columbia-Presbyterian Medical Center, New York, NY; Division of Biostatistics (X.C.) and Division of Epidemiology and Gertrude H. Sergievsky Center (R.L.S.), School of Public Health, Columbia University, New York, NY; and Center for Postgraduate Studies in Neuroscience, Danube University, Landesnervenklinik Gugging (M.M.S., M.B.), Gugging, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Gan","sequence":"additional","affiliation":[{"name":"From the Neurological Institute (M.M.S., T.R., R.G., X.C., R.L.S.) and the Division of Cardiology, Department of Medicine (M.R. Di T., C.L., S.H.), Columbia-Presbyterian Medical Center, New York, NY; Division of Biostatistics (X.C.) and Division of Epidemiology and Gertrude H. Sergievsky Center (R.L.S.), School of Public Health, Columbia University, New York, NY; and Center for Postgraduate Studies in Neuroscience, Danube University, Landesnervenklinik Gugging (M.M.S., M.B.), Gugging, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Chen","sequence":"additional","affiliation":[{"name":"From the Neurological Institute (M.M.S., T.R., R.G., X.C., R.L.S.) and the Division of Cardiology, Department of Medicine (M.R. Di T., C.L., S.H.), Columbia-Presbyterian Medical Center, New York, NY; Division of Biostatistics (X.C.) and Division of Epidemiology and Gertrude H. Sergievsky Center (R.L.S.), School of Public Health, Columbia University, New York, NY; and Center for Postgraduate Studies in Neuroscience, Danube University, Landesnervenklinik Gugging (M.M.S., M.B.), Gugging, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Liguori","sequence":"additional","affiliation":[{"name":"From the Neurological Institute (M.M.S., T.R., R.G., X.C., R.L.S.) and the Division of Cardiology, Department of Medicine (M.R. Di T., C.L., S.H.), Columbia-Presbyterian Medical Center, New York, NY; Division of Biostatistics (X.C.) and Division of Epidemiology and Gertrude H. Sergievsky Center (R.L.S.), School of Public Health, Columbia University, New York, NY; and Center for Postgraduate Studies in Neuroscience, Danube University, Landesnervenklinik Gugging (M.M.S., M.B.), Gugging, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Brainin","sequence":"additional","affiliation":[{"name":"From the Neurological Institute (M.M.S., T.R., R.G., X.C., R.L.S.) and the Division of Cardiology, Department of Medicine (M.R. Di T., C.L., S.H.), Columbia-Presbyterian Medical Center, New York, NY; Division of Biostatistics (X.C.) and Division of Epidemiology and Gertrude H. Sergievsky Center (R.L.S.), School of Public Health, Columbia University, New York, NY; and Center for Postgraduate Studies in Neuroscience, Danube University, Landesnervenklinik Gugging (M.M.S., M.B.), Gugging, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunichi","family":"Homma","sequence":"additional","affiliation":[{"name":"From the Neurological Institute (M.M.S., T.R., R.G., X.C., R.L.S.) and the Division of Cardiology, Department of Medicine (M.R. Di T., C.L., S.H.), Columbia-Presbyterian Medical Center, New York, NY; Division of Biostatistics (X.C.) and Division of Epidemiology and Gertrude H. Sergievsky Center (R.L.S.), School of Public Health, Columbia University, New York, NY; and Center for Postgraduate Studies in Neuroscience, Danube University, Landesnervenklinik Gugging (M.M.S., M.B.), Gugging, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph L.","family":"Sacco","sequence":"additional","affiliation":[{"name":"From the Neurological Institute (M.M.S., T.R., R.G., X.C., R.L.S.) and the Division of Cardiology, Department of Medicine (M.R. Di T., C.L., S.H.), Columbia-Presbyterian Medical Center, New York, NY; Division of Biostatistics (X.C.) and Division of Epidemiology and Gertrude H. Sergievsky Center (R.L.S.), School of Public Health, Columbia University, New York, NY; and Center for Postgraduate Studies in Neuroscience, Danube University, Landesnervenklinik Gugging (M.M.S., M.B.), Gugging, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"235","volume":"2","year":"1993","unstructured":"Sacco RL, Homma S, Di Tullio MR. Patent foramen ovale: a new risk factor for stroke. Heart Dis Stroke. 1993;2:235\u2013241.","journal-title":"Heart Dis Stroke"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198805053181802"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)92944-3"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)91228-V"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-117-6-461"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.24.7.8322376"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199102000-00003"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(72)90171-4"},{"key":"e_1_3_2_9_2","unstructured":"Cosyns B Schulze D Van Camp G Vandenbossche J-L. Relationship between patent foramen ovale and unexplained stroke: a study by quantitative transesophageal contrast echocardiography. Circulation. 1992;86(suppl I):I-146. Abstract."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.86.6.1451261"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.3.8128511"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)90873-2"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.7.1281"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.5.1301"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.5.1204"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.19.5.3363586"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(14)80395-7"},{"key":"e_1_3_2_18_2","unstructured":"Mohr JP Sacco RL. Classification of ischemic strokes. In: Barnett JM Mohr JP Stein BM Yatsu FM eds. Stroke: Pathophysiology Diagnosis and Management. 2nd ed. New York NY: Churchill Livingstone; 1992:271\u2013283."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1997.00550190013008"},{"key":"e_1_3_2_20_2","first-page":"233","volume":"2","year":"1992","unstructured":"Servan J, Catala M, Rancurel G. Posterior cerebral artery (PCA) infarction: a study of 76 cases. Cerebrovasc Dis. 1992;2:233. Abstract.","journal-title":"Cerebrovasc Dis"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.40.9.1383"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.8.1533"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.29.5.944","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:37:48Z","timestamp":1715553468000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.29.5.944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,5]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1998,5]]}},"alternative-id":["10.1161\/01.STR.29.5.944"],"URL":"https:\/\/doi.org\/10.1161\/01.str.29.5.944","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,5]]},"assertion":[{"value":"1998-01-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-03-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-05-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}