You are here

  • Home
  • Online First
  • Idiopathic pulmonary vein thrombosis: an under-recognised source of embolic stroke

Article Text

Article menu
Download PDFPDF
Neurological rarities
Idiopathic pulmonary vein thrombosis: an under-recognised source of embolic stroke
  1. Y Muralidhar Reddy1,
  2. Subhendu Parida2,
  3. Manvitha Reddy3,
  4. Johann Christopher4,
  5. Lalitha Pidaparthi1,
  6. Abhinay Kumar Gattu1,
  7. J M K Murthy1
  1. 1Neurology, Renova Institute of Neurological Sciences (RINS), Renova Century Hospital, Hyderabad, Telangana, India
  2. 2Neuroradiology, Renova Institute of Neurological Sciences (RINS), Renova Century Hospital, Hyderabad, Telangana, India
  3. 3Neurology, CARE Hospital Banjara Hills, Hyderabad, Telangana, India
  4. 4Cardiology, CARE Hospital Banjara Hills, Hyderabad, Telangana, India
  1. Correspondence to Dr Y Muralidhar Reddy, Neurology, Renova Institute of Neurological Sciences (RINS); Renova Century Hospital, Hyderabad, Telangana, India; muralidharnims{at}gmail.com

Abstract

Embolic stroke due to pulmonary vein thrombosis is rare but may be associated with lung and left atrial tumours, pulmonary surgery, atrial fibrillation and radiofrequency ablation. It is very rarely idiopathic. A 23-year-old man developed acute onset of a left partial third nerve palsy and left ataxic hemiparesis. His MR scan of the brain showed an acute infarct in the left midbrain and left thalamus. CT angiogram found no steno-occlusive disease and transthoracic echocardiogram was normal. However, a transoesophageal echocardiogram showed a hyperechoic mass projecting from the right inferior pulmonary vein, confirmed on cardiac MR scan to be a right inferior pulmonary vein thrombus. A cardiac loop recorder did not capture an atrial arrhythmia. CT scan of the chest found no significant abnormality in the pulmonary parenchyma. Investigations for hypercoagulable state were negative. He took dabigatran for 6 months with complete resolution of thrombus.

  • STROKE

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

https://doi.org/10.1136/pn-2024-004244

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information.

    View Full Text

    Footnotes

    • X @Murali_Doctor

    • Contributors YMR is the corresponding author and acts as the guarantor. YMR identified and managed the case, conceptualised the case report and wrote the manuscript. SP and JC aided in the radiological and echocardiographic identification of the thrombus. MR collected all the information and had done the literature search. LP and AKG were involved in the management of the case. JMKM performed the final revision of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed by David Werring, London, UK.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

    Other content recommended for you