A 42-year-old man presented after multiple episodes of difficulty in speaking. MRI of the brain without contrast suggested an acute infarct in the left frontal supraventricular white matter. Subsequent MRI with contrast indicated a subacute infarct. MRI spectroscopy verified an ischemic infarct. The patient underwent transesophageal echocardiography, seen here, that showed a patent foramen ovale (PFO). The diagnosis was cryptogenic ischemic stroke. Approximately 40% of cryptogenic ischemic strokes are attributed to PFO.
Irina Erlikh, MD; and Vasantha K. Kondamudi, MD.