Paradoxical Emboli Secondary to Hepatic Pathology: Common or Coincidental?

Paradoxical cerebral emboli from cardiac and pulmonary sources are well described in the peer-reviewed literature. We outline a case with a hepatic etiology and describe diagnostic and management options. Though this paper represents the first documentation of such, we believe that transpulmonary sh...

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Bibliographic Details
Main Authors: Patrik Gabikian, Melanie Walker, Abhineet M. Chowdhary, Arthur M. Lam, Gavin W. Britz
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2009/184192
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Summary:Paradoxical cerebral emboli from cardiac and pulmonary sources are well described in the peer-reviewed literature. We outline a case with a hepatic etiology and describe diagnostic and management options. Though this paper represents the first documentation of such, we believe that transpulmonary shunting with concurrent paradoxical cerebral microemboli is more prevalent than recognized. We introduce this case report to compel practitioners to consider paradoxical emboli in selected cirrhotic patients since it can often be difficult to elicit subtle neurologic changes on clinical examination of patients with end stage liver disease.
ISSN:1687-9627
1687-9635