Stroke in young adults: The role of paradoxical embolism

Stroke in young adults may be devastating and frequently no cause can be fo und. However, there is ample literature to suggest an association between c ryptogenic stroke in young people and paradoxical embolisation via a venous to arterial circulation shunt (v-aCS), commonly due to patent foramen oval e (PFO). Although paradoxical embolisation is assumed to be a rare event, t his review suggests that it is an important or even dominant cause of strok e in young people and that a transcranial Doppler (TCD) technique may be th e investigation of choice to identify v-aCS.