nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2021-5-123-129nnp-1676Research ArticleCLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯParadoxial embolism as a cause of ischemic stroke in patient with sinus venosus atrial septal defectИшемический инсульт по механизму парадоксальной эмболии на фоне дефекта межпредсердной перегородки типа sinus venosusКулешА. А.KuleshA. A.

Алексей Александрович Кулеш

614990, Пермь, ул. Петропавловская, 26

Aleksey Aleksandrovich Kulesh

26, Petropavlovskaya St., Perm 614990

aleksey.kulesh@gmail.comМехряковС. А.MekhryakovS. A.

614107, Пермь, ул. КИМ, 2

2, KIM St., Perm 614107

СыромятниковаЛ. И.SyromyatnikovaL. I.

614990, Пермь, ул. Петропавловская, 26614107, Пермь, ул. КИМ, 2

26, Petropavlovskaya St., Perm 6149902, KIM St., Perm 614107

ГорстН. Х.GorstN. H.

614990, Пермь, ул. Петропавловская, 26

26, Petropavlovskaya St., Perm 614990

ДробахаС. О.DrobakhaS. O.

614107, Пермь, ул. КИМ, 2

2, KIM St., Perm 614107

НиколаеваЕ. В.NikolaevaE. V.

357538, Пятигорск, ул. Адмиральского, 6

6, Admiralskogo St., Pyatigorsk 357538

ФГБОУ ВО «Пермский государственный медицинский университет им. акад. Е.А. Вагнера» Минздрава РоссииРоссияAcad. E.A. Vagner Perm State Medical University, Ministry of Health of RussiaRussian FederationГАУЗ Пермского края «Городская клиническая больница №4»РоссияCity Clinical Hospital FourRussian FederationФГБОУ ВО «Пермский государственный медицинский университет им. акад. Е.А. Вагнера» Минздрава России; ГАУЗ Пермского края «Городская клиническая больница №4»РоссияAcad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia; City Clinical Hospital FourRussian FederationГБУ Ставропольского края «Пятигорская городская клиническая больница №2»РоссияPyatigorsk City Clinical Hospital №2Russian Federation202116102021135123129Copyright © Kulesh A.A., Mekhryakov S.A., Syromyatnikova L.I., Gorst N.H., Drobakha S.O., Nikolaeva E.V., 20212021Кулеш А.А., Мехряков С.А., Сыромятникова Л.И., Горст Н.Х., Дробаха С.О., Николаева Е.В.Kulesh A.A., Mekhryakov S.A., Syromyatnikova L.I., Gorst N.H., Drobakha S.O., Nikolaeva E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1676

We present a case report of a middle-aged patient with a rare sinus venosus atrial septal defect (ASD) and ischemic stroke that developed due to paradoxical embolism. Occlusion of the anterior cerebral artery led to a stroke with cognitive impairment, acalculia, and apraxia. Diagnostic ultrasound features of this anomaly in suspected cases are discussed. In the presented case, verification of the stroke cause became possible due to the contrast-enhanced computed tomography of the heart. ASD detection made it possible to refer the patient to the surgical treatment necessary to prevent both recurrent cerebral accidents and the progression of pulmonary hypertension, and the prevention of the development of right ventricular heart failure.

Представлено описание клинического случая ишемического инсульта, который развился у пациента среднего возраста по механизму парадоксальной эмболии на фоне редкого варианта дефекта межпредсердной перегородки (ДМПП) типа sinus venosus. Окклюзия передней мозговой артерии привела к своеобразной клинической картине инсульта с возникновением когнитивных нарушений, акалькулии и апраксии. Обсуждаются особенности ультразвуковой диагностики при подозрении на данную аномалию. В представленном случае верификация причины инсульта стала возможна благодаря проведению компьютерной томографии сердца с контрастированием. Выявление ДМПП позволило направить пациента на хирургическое лечение, необходимое для профилактики как повторных мозговых катастроф, так и прогрессирования легочной гипертензии, предотвращения развития правожелудочковой сердечной недостаточности.

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The authors declare that there are no conflicts of interest present.