Ischemic Stroke and Atrial Septal Defect

choi

Vincent M Mallozzi,  Diana Hardeman, Naveen Selvadurai: Taking a New Leaf, and Finding Love. New York Times, Aug 20, 2017 (wedding announcement in "SundayStyles" section).
https://www.nytimes.com/2017/08/ ... adurai-married.html


Note:  "Among the many things they talked about [In 2015 when their relation was getting serious] was her health. Ms Hardeman told Mr Selvadurai that two years earlier, she had suffered an acute ischemic stroke. * * * [A year passed] they moved in together. Two months later, Mr Selvadurai had just gone to bed when he heard Ms Hardeman scream out to him.  'Her right arm had gone numb, and she was slurring her words [suggesting problems with her facial muscle or tongue],' Mr Selvadurai recalled.  He rushed her to the hospital, where more tests revealed that Ms Hardeman had suffered a second stroke.  'I went through three months of going to different doctors and different neurologists, doing blood work and MRI's before ultimately realizing I had a hole in my heart,' she said. 'In order to have it closed, I elected to have heart surgery.' "
(a) There are two kinds of stroke: ischemic and hemorrhagic. In the former, blood supply was blocked, whereas in the latter, a blood vessel ruptures, releasing blood to brain tissue.

In both occasions, Hardeman suffered ischemic type.
(b) Internal carotid artery has a major branch: middle cerebral artery (MCA). The latter supplies blood to most cortex 大脑皮层.

Of Internal carotid artery and its branches, one panel with frontal view, and another with lateral view:
https://autodo.info/pages/i/internal-carotid-artery/
(c) Identify the Vessel, Recognize the Stroke. American Nurse Today, undated
https://www.americannursetoday.c ... cognize-the-stroke/
("The largest vessel branching off the internal carotid artery, the middle cerebral artery (MCA) is the most common cerebral occlusion site [ischemic stroke]. * * * [Depending on location of the occlusion.]  MCA strokes [may] typically cause:
* hemiplegia (paralysis) of the contralateral side, affecting the lower part of the face, arm, and hand while largely sparing the leg
* contralateral (opposite-side) sensory loss in the same areas")
(d) paradoxical embolism
https://en.wikipedia.org/wiki/Paradoxical_embolism
(The opening is typically an atrial septal defect [ASD], but can also be a ventricular septal defect [VSD] )
(e) ASD is caused by persistence of foramen ovale into childhood. All human fetuses has an oval hole (Latin: foramen ovale) between right atrium and left atrium, which closes upon birth.
https://en.wikipedia.org/wiki/Foramen_ovale_(heart)

"In about 25% of adults, the foramen ovale does not entirely seal."  en.wikipedia.org for ASD
(f) The photo shows a woman with flawless chest. ASD can be repaired with a catheter, without open heart surgery, which leaves a scar through the midline of chest.