Paradoxical embolus straddling patent foramen ovale demonstrated by computed tomographic pulmonary angiography

Figure 1 Findings at computed tomographic pulmonary angiography. A: Computer tomography pulmonary angiogram (CDPA) demonstrating a serpiginous low attenuation filling defect in the left atrium which extends across into the right atrium through a patent foramen ovale representing a paradoxical embolus (oblique axial view). There are also filling defects in the left lower lobe pulmonary artery due to pulmonary emboli; B: Demonstrating a filling defect in the left atrium filling defects in the right lower lobe pulmonary artery due to pulmonary emboli (axial view); C: CDPA demonstrating a filling defect in the left atrium, abutting the intra-atrial septum and bowing of the intra-ventricular septum due to raised right heart pressure (axial view).

Figure 2 Neurological imaging. A: Unenhanced computer tomography brain examination (axial view) demonstrating left occipital high attenuation with surrounding low attenuation; B: Magnetic resonance imaging brain examination (axial view, FLAIR sequence) demonstrating left occipital lobe infarct with haemorrhagic transformation.