Patent foramen ovale (PFO) is a congenital cardiac anomaly resulting from the incomplete closure of the atrial septum, allowing blood to shunt from the right to the left atrium and bypass pulmonary filtration. This shunting can lead to paradoxical embolism, where emboli enter systemic circulation and potentially cause brain ischemia. Due to this possibility, PFO’s have been increasingly recognized as potential contributors to cryptogenic stroke. This paper examines four pediatric cases of cryptogenic strokes associated with PFOs and highlights the current lack of specific guidelines for PFO closure in the pediatric population.

Stroke in pediatric patients is an important cause of morbidity and mortality that is gaining more recognition in the medical community. Key risk factors in pediatric patients include cardiac defects, arteriovenous malformations, sickle cell disease, prothrombotic disorders, cancers, and infections. Cryptogenic strokes, which constitute a substantial proportion of pediatric strokes, often involve a PFO as an underlying factor. However, there are no current pediatric guidelines on PFO closure for prevention of stroke recurrence.

N/A, case series 

N/A

PFOs have been associated with cryptogenic strokes in both adult and pediatric populations. We examined four pediatric cases of cryptogenic strokes associated with PFOs. These cases highlight the potential role of PFOs in pediatric ischemic strokes and the current lack of specific guidelines for this population. While adult studies indicate that PFO closure can reduce stroke recurrence, the RoPE (Risk of Paradoxical Embolism) score used in adults is not directly applicable to children due to differing physiological factors and risk profiles. There is an urgent need for age-specific research and tailored guidelines to evaluate the efficacy of PFO closure in preventing stroke recurrence in pediatric patients. The study suggests potential benefits, but emphasizes the necessity for further investigation for informed clinical decision-making in this area.