부산대학교 도서관

OBJECTIVE:: To investigate the frequency of acute stroke in patients with a recent travel history and to analyse risk factors, stroke patterns and presence of a patent foramen ovale (PFO) in this patient group. DESIGN:: One-year prospective observational study. SETTING:: Single-centre study. METHODS:: Enrolling all patients presenting with a first cerebral ischaemia and complementing the usual history with a standardised travel history. RESULTS:: Of 338 patients with acute stroke, 42 had a positive travel history (PTH) (12.4%). Patients with a PTH were significantly younger (56.6 (SD 13) years) than patients (66.9 (13.2) years, p = 0.0001) with a negative travel history (NTH). Frequency of PFO in the PTH group (13; 44.8%) was significantly higher than in the NTH group (7; 10.8%) (p = 0.0001), even after patients were dichotomised into two age groups (younger and older than median of all patients: 31%v 6.1%, p = 0.007 and 13.8%v 4.6%, p = 0.022, respectively). PTH patients had fewer stroke risk factors (2.2 (1.4)v 3.3 (1.6), p = 0.0001) and a different risk profile with a lower frequency of diabetes (11.9%v 31.4%, p = 0.009), hypertension (52.4%v 78.7%, p = 0.0001), atrial fibrillation (7.1%v 22%, p = 0.025) and others (16.7%v 38.9%, p = 0.005). In contrast, PTH patients had significantly more cardioembolic (35.7%v 19.3%, p = 0.023) and cryptogenic strokes (50%v 19.9%, p = 0.0001) and more often ischaemia in the territory of the posterior cerebral artery (29.6%v 6.3%, p = 0.0001). CONCLUSIONS:: The finding that more PTH patients had a PFO and a cardioembolic stroke pattern but that fewer had other typical stroke risk factors led to the hypothesis that PFO is a risk factor for economy class stroke syndrome.