Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Recurrent embolic strokes associated with persistent left superior vena cava draining into the left atrium

Keita Kondo, M.D.1), Kouichi Noda, M.D.2), Kazuhide Ochi, M.D.1)2), Eiichi Nomura, M.D.1)3), Toshiho Ohtsuki, M.D.1) and Masayasu Matsumoto, M.D.1)

1)Department of Clinical Neuroscience and Therapeutics, Hiroshima University
2)Department of Neurology, National Hospital Organization Higashi-Hiroshima Medical Center
3)Department of Neurology, Suiseikai Kajikawa Hospital

We report a 36-year-old man who admitted due to brain infarctions of the pons and cerebellum. He had a history of brain infarction 4 years ago. Chest radiograph and enhanced CT showed an abnormal shadow in the superior mediastinum. Chest enhanced CT showed dilated right and persistent left superior vena cava (PLSVC), and venous thrombus was detected in the thorax. The PLSVC connected directly to the left atrium. Abdominal CT showed surface irregularity of the bilateral kidney, suggesting that renal infarctions had occurred. There was no risk factor of systemic embolism except for PLSVC thrombosis. We thought that retention of blood flow caused the formation of thrombus in the PLSVC, and the thrombus flowed into directly the systemic circulation through the left atrium and caused multiple embolisms.
Full Text of this Article in Japanese PDF (776K)

(CLINICA NEUROL, 48: 492|496, 2008)
key words: juvenile-onset, cerebral infarction, paradoxical embolism, persistent left superior vena cava (PLSVC)

(Received: 14-Dec-07)