Development of paradoxical cerebral embolism during lymphatic draining massage: A case report

Abstract

Key words acute ischemic stroke, massage, paradoxical cerebral embolism, patent foramen ovale, recombinant tissue plasminogen activator. AbstractA 62-year-old woman presented with left hemiparesis just after finishing lymphatic draining massage involving the four extremities. Diffusion-weighted magnetic resonance imaging showed an acute infarct in the right precentral gyrus. The diagnosis of paradoxical cerebral embolism was established on the findings of transesophageal echocardiography and detected thrombi in the leg veins. Movement of extant thrombi in the legs to the right atrium, in association with massage, is considered to have contributed to the stroke onset.