Accidente cerebrovascular isquémico en paciente joven asociado a aneurisma del septo interauricular multifenestrado

Stroke in young individuals has multiple etiologies, including cardioembolism. It may be associated with cardiac malformations, such as patent foramen ovale (PFO), interatrial septum aneurysm (IASA), or atrial septal defects (ASD). We present the case of a patient with stroke associated to multi-fenestrated IASA. Female patient, 28 years old, contraceptive use. She presented with mixed aphasia, hemianopsia and right hemiparesis. CT scan showed insular and left basal ganglia hypoattenuation. She received intravenous thrombolysis. MRI: left middle cerebral artery infarction. Echocardiogram showed interatrial communication due to IASA and multi-fenestrated ASD. Cardioembolic stroke was suspected (association with cardiac pathology and contraceptive use). She was placed in anticoagulation. 30% of strokes in young adults are cardioembolic strokes. Large PFO, multi-fenestrated IASA, or its association, may increase the risk of paradoxical embolization and have a relationship with stroke. The management is controversial-the choice is between anticoagulation or closure for complex defects.