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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2021; 5(02): 123-126
DOI: 10.1055/s-0041-1730104
Case Report

Paradoxical Cerebral Embolism Secondary to Superior Vena Cava Occlusion and Development of a Systemic Right-to-Left Shunt

Ronny J.D. Kuang
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
,
Anna L Beale 
2   Department of Medicine, Monash University, Melbourne, Victoria, Australia
3   Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
,
Jason E Bloom
2   Department of Medicine, Monash University, Melbourne, Victoria, Australia
3   Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
,
Warren Clements 
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
4   Department of Surgery, Monash University, Melbourne, Victoria, Australia
5   National Trauma Research Institute, Melbourne, Victoria, Australia
› Author Affiliations Funding 
None declared.

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Abstract

Paradoxical cerebral embolism, although rare, can be secondary to acquired causes such as superior vena cava (SVC) occlusion and development of a mediastinal right-to-left shunt. Such shunts allow undisturbed passage of thromboemboli to bypass the pulmonary circulation and enter the systemic circulation. This report presents a case of paradoxical cerebral embolism due to a right-to-left shunt originating from occlusion of the SVC. The etiology of the SVC occlusion stems from a prior central venous access line used for treatment of lymphoma. The patient underwent endovascular treatment with successful coil embolization of the mediastinal shunt.

Keywords

superior vena cava obstruction - right-to-left shunt - embolization


Publication History

Article published online:
18 May 2021

© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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