Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular Thrombectomy

An unusual case of ischemic stroke due to calcified cerebral embolus occurring in a pregnant patient during the peripartum period is reported. The source of the embolus was suspected to be a pelvic phlebolith in origin which paradoxically embolized via a patent foramen ovale to the supraclinoid righ...

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Main Authors: Sherwin Azad, John Anson, Tamara Majic, Raisa Lev, Varoujan Kostanian
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Case Reports in Radiology
Online Access:http://dx.doi.org/10.1155/2023/1653631
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author Sherwin Azad
John Anson
Tamara Majic
Raisa Lev
Varoujan Kostanian
author_facet Sherwin Azad
John Anson
Tamara Majic
Raisa Lev
Varoujan Kostanian
author_sort Sherwin Azad
collection DOAJ
description An unusual case of ischemic stroke due to calcified cerebral embolus occurring in a pregnant patient during the peripartum period is reported. The source of the embolus was suspected to be a pelvic phlebolith in origin which paradoxically embolized via a patent foramen ovale to the supraclinoid right internal carotid artery. To our knowledge, this is the first reported case of calcified cerebral embolus attributed to paradoxical embolism of a pelvic phlebolith, and we theorize that introduction of the phlebolith into the venous system may have occurred as a consequence of vascular remodeling due to pregnancy-related hemodynamic changes. Clinicians should be aware of this potential source of calcified cerebral emboli in patients with a patent foramen ovale during pregnancy. Our patient ultimately achieved an excellent outcome with surgical endarterectomy and embolectomy following an unsuccessful attempt at mechanical thrombectomy.
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issn 2090-6870
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publisher Wiley
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spelling doaj-art-e647df160d04486397112e80f4feba002025-08-20T02:21:03ZengWileyCase Reports in Radiology2090-68702023-01-01202310.1155/2023/1653631Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular ThrombectomySherwin Azad0John Anson1Tamara Majic2Raisa Lev3Varoujan Kostanian4HCA Mountainview Hospital Sunrise Health GME ConsortiumSunrise Hospital and Medical CenterSunrise Hospital and Medical CenterHCA Mountainview Hospital Sunrise Health GME ConsortiumHCA Mountainview Hospital Sunrise Health GME ConsortiumAn unusual case of ischemic stroke due to calcified cerebral embolus occurring in a pregnant patient during the peripartum period is reported. The source of the embolus was suspected to be a pelvic phlebolith in origin which paradoxically embolized via a patent foramen ovale to the supraclinoid right internal carotid artery. To our knowledge, this is the first reported case of calcified cerebral embolus attributed to paradoxical embolism of a pelvic phlebolith, and we theorize that introduction of the phlebolith into the venous system may have occurred as a consequence of vascular remodeling due to pregnancy-related hemodynamic changes. Clinicians should be aware of this potential source of calcified cerebral emboli in patients with a patent foramen ovale during pregnancy. Our patient ultimately achieved an excellent outcome with surgical endarterectomy and embolectomy following an unsuccessful attempt at mechanical thrombectomy.http://dx.doi.org/10.1155/2023/1653631
spellingShingle Sherwin Azad
John Anson
Tamara Majic
Raisa Lev
Varoujan Kostanian
Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular Thrombectomy
Case Reports in Radiology
title Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular Thrombectomy
title_full Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular Thrombectomy
title_fullStr Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular Thrombectomy
title_full_unstemmed Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular Thrombectomy
title_short Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular Thrombectomy
title_sort ischemic stroke due to intracranial embolization of a pelvic phlebolith in a pregnant patient successfully treated by surgical embolectomy following attempted endovascular thrombectomy
url http://dx.doi.org/10.1155/2023/1653631
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AT tamaramajic ischemicstrokeduetointracranialembolizationofapelvicphlebolithinapregnantpatientsuccessfullytreatedbysurgicalembolectomyfollowingattemptedendovascularthrombectomy
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