Role of transcranial Doppler in the early diagnosis of paradoxical brain embolism following pulmonary valve endocarditis: A case report

Paradoxical brain embolism may result from acute pulmonary thromboembolism, when a patent foramen ovale (PFO) provides a potential right-to-left shunt (RLS). The gold standard for detection of a PFO is transoesophageal echocardiography but transcranial Doppler (TCD) has been suggested as a potential method to diagnose RLS. The Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology recommends TCD in the diagnosis of RLS as Type A, Class II of evidence.