Thrombus in transit in a patient with ischaemic stroke

Nazar LUQMAN ¹, Ghazala KAFEEL ², Terence CHIN ³

¹ Division of Cardiology, Department of Medicine RIPAS Hospital, ² Department of Pathology RIPAS Hospital, ³ Gleneagles Jerudong Park Medical Centre, Brunei Darussalam

ABSTRACT

Stroke or cerebrovascular accident is common and is most commonly embolic or haemorrhagic. A common source of embolism is the heart and as such echocardiogram is an essential investigation. However, clinicians need to be aware of rare sources of embolism. We report a rare and interesting case of a 61-year-old Caucasian man who presented with stroke and on evaluation was found to have a large thrombus coiled striding over a patent foreman ovale into the right and left atrium consistent with a ‘thrombus in transit’. The origin of the thrombus was later confirmed to be from the left saphenous vein. This case highlights an interesting case of ‘thrombus in transit’.

Keywords: Cerebrovascular accident, myxoma, patent foreman ovale, paradoxical embolism

                    Brunei Int Med J. 2012;8(2):102-106