A case of paradoxical cerebral infarction by spraying thrombus in the catheter for dialysis

• Main Authors: Seiji Hashimoto, Hiroyoshi Sasaki, Hiroshi Matsuura, Takao Koike, Tomoaki Haga
• Format: Article
• Language: English
• Published: BMC 2017-10-01
• Series: Renal Replacement Therapy
• Subjects: Paradoxical cerebral infarction; Catheter; Foramen ovale
• Online Access: http://link.springer.com/article/10.1186/s41100-017-0124-9

Abstract Background The authors herein report a case of paradoxical cerebral infarction by spraying thrombus in the catheter for dialysis. The clinical manifestations of paradoxical cerebral infarction are nonspecific, and the diagnosis is sometimes difficult to establish. Patients with paradoxical cerebral infarction may present with neurologic abnormalities or features suggesting arterial embolism. And paradoxical cerebral infarction has been associated with foramen ovale (PFO). Case presentation A multi-lumen catheter for dialysis was inserted into the right internal jugular vein. After injecting heparin-added physiological saline solution to confirm the patency of the catheter, paradoxical cerebral infarction developed. Detailed examination revealed PFO. PFO patent is a common condition that affects one in four people. Conclusion The size of multi-lumen catheter for dialysis is relatively large. We learned from this case that the use of multi-lumen catheter poses a potential risk of paradoxical infarction. Clinicians should be aware that central venous catheter is a risk factor for paradoxical cerebral infarction.