AIM  To investigate the imaging diagnosis of cryptic ischemic stroke (CS) caused by patent foramen ovale (PFO).

  METHODS  Sixty-four PFO patients combined with CS in the General Hospital of the Northern Theater Command from May 2017 to June 2020 were selected as the study group, and 64 CS patients without PFO at the same period were selected as the control group. Brain imaging examinations were performed and the types of cerebral infarction lesions and vascular distribution of infarction lesions in both groups were statistically analyzed.

  RESULTS  The fusion rate of small infarcts in the same vascular distribution area in the study group was lower than that in the control group (14% vs. 30%, P<0.05) and the rate of multiple infarcts in different vascular distribution areas was higher than that in the control group (31% vs. 14%, P<0.05). The proportions in the study group distributed in the vertebrobasilar artery system and the specific involved vessel, posterior cerebral artery, were higher than those in the control group (34% vs. 14% and 36% vs. 12%, P<0.01). The percentage of infarction lesions in the right internal carotid artery system in the study group was lower than that in the control group (11% vs. 34%, P<0.01).

  CONCLUSION  The multiple infarcts in the multi-vessel distribution area are imaging features of PFO-induced CS , and moreover, posterior circulation infarction is dominant.