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AJNR - American Journal of Neuroradiology

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Risks of Tumor Embolization in the Presence of an Unrecognized Patent Foramen Ovale: Case Report

Michael Bruce Horowitz^a,b, Ricardo Carrau^a, Donald Crammond^a and Emanuel Kanal^a

^a Department of Neurosurgery, University of Pittsburgh Medical Center, Presbyterian University Hospital, PA
^b Department of Radiology, University of Pittsburgh Medical Center, Presbyterian University Hospital, PA
^c Department of Otolaryngology, University of Pittsburgh Medical Center, Presbyterian University Hospital, PA

View larger version (100K): [in a new window]   FIG 1. SSEP tracing demonstrates changes in recordings during the embolization. Upper extremity (UE) SSEP were obtained from stimulating the left (MS) and right (MD) median nerves at the wrists and by recording evoked potentials from the scalp. The arrow on the far right indicates the time at which the SSEP waveforms began to deviate. The arrowheads indicate the wave change with a 60% loss of amplitude in the P30 response in each hemisphere.

View larger version (39K): [in a new window]   FIG 2. Diffusion-weighted MR image shows multiple infarctions secondary to paradoxical emboli.